Bladder Tumour

Urine is formed in kidneys and via ureters it goes into the urinary bladder. Further it is passed through urethra. Bladder cancer happens when normal cells in the bladder change into abnormal cells, and grow out of control.

Prostate Cancer

Bladder Symptoms

Bladder cancer causes mild symptoms that can come and go. These include:

  • Blood in the urine, which makes your urine look pink or red
  • Pain on the sides of your back or above your pubic area
  • Pain when urinating, urinating often, or leaking urine

Bladder Investigations

Urine tests – Urine tests can show what kind of cells are in the urine.

USG Abdomen

These tests create images of the entire urinary tract, which includes the kidneys, ureters, and the bladder. They can show tumors or abnormal growths.

USG Abdomen


Cystoscopy is a procedure that allows the doctor to look directly inside the bladder. To do a cystoscopy, the doctor inserts a small tube into the urethral opening, the opening through which urine leaves the body. Then he or she pushes the tube up into the bladder. The tube has a tiny camera that projects images of the bladder onto a screen. If the doctor sees anything unusual, he or she might take a sample of tissue (called a biopsy) to look at under the microscope.


Transurethral Resection of Bladder tumour and Biopsy

If there is tumour in bladder, it is resected and sent for Biopsy. Biopsy will tell if

  • There is cancer or not
  • Grade of cancer
  • Level of tumour invasion


These tests are done to find out

  • Local extent – how much of the bladder is involved, and if it is going outside bladder wall
  • Regional extent – If the tumour is going into lymph nodes ( Lmph nodes are the glands which are normally present in body and are usually the first site to which the cancer goes.
  • Distant extent – to see if the cancer has gone to other organs like liver/ bone/ lungs.

Bladder Staging and Treatment options

Non Muscle Invasive Bladder Cancer (Ta, T1) :

Low grade – Trans Urethral Resection of Bladder tumour (TURBT) with Intravesical immunotherapy/ chemotherapy.

High grade –

  • TURBT with Immunotherapy
  • Radical cystectomy is required if there are multiple tumours/ recurrent tumour

Muscle Invasive Bladder Cancer (T2/3) :

  • Radical Cystectomy with B/L Pelvic Lymph node dissection with Urinary Diversion
  • Chemotherapy may be added in certain cases
  • Radiotherapy – may be given to non surgical candidates after Removal of bladder tumour transurethrally.

Locally Advanced/ Nodal disease (T4, N1) :

  • Multimodality treatment including chemotherapy and Bladder Cancer surgery

Metastatic Bladder Cancer - Chemotherapy


Radical Cystectomy

In Radical Cystectomy, whole of bladder is removed and urine is diverted through one of the following ways