The inside of the bladder is lined with cells called transitional epithelium. These cells line the bladder, the tubes that carry urine from the kidney to the bladder, and part of the tube carrying urine outside the body. Cancers that start in the bladder are called transitional cell or urothelial carcinomas. Cancers that start in the same sort of cells outside the bladder are also called transitional cell or urothelial carcinomas and often behave in similar ways.
Bladder cancers often start by involving just the superficial lining of the bladder. In this situation they can often be treated and cured by removal using a device like a thin telescope that allows the surgeon to see inside the bladder itself. If the cancer comes back it can be removed in the same way again, but it often means that it will keep coming back. For that reason, additional treatments are often administered, such as putting substances in the bladder to cause irritation or to kill the cells directly. The BCG bacteria, which once was a vaccine for tuberculosis, causes irritation of the bladder and can significantly reduce the risk of these early bladder cancers coming back. Sometimes other treatments, like chemotherapy drugs, are put into the bladder as well as, or instead of, BCG.
If the cancer has grown through the muscle wall of the bladder there is a greater chance of it returning or spreading elsewhere. Usually, more aggressive treatment is needed. This might include removal of part, or all, of the bladder by operation; radiation treatment (radiotherapy); chemotherapy (drug treatment); or a combination of these. The team of doctors looking after you will give you advice on which option might be best for you.
If the cancer has spread to other parts of the body then it is usually not curable, although it can respond to treatment. This will usually be in the form of chemotherapy (drug treatment) and offers a good chance of shrinking the cancer and helping with any side effects it might be causing.
Even though there are treatments available, we need to do better. This can only happen through understanding the science comprehensively, and performing clinical trials to see which treatments are most likely to help. ANZUP is involved in clinical trials in urothelial carcinoma through its clinical trials program, both in the early and later stages of the cancer. Talk to your doctor about what options might be the best for you.