🚨 Who’s at Risk?

• Tobacco smoking: The single strongest risk factor, linked to over 50% of cases.
• Occupational exposures: Chemicals in industries like dyes, rubber, and paint.
• Chronic bladder irritation: From infections, catheters, or schistosomiasis.
• Age & sex: Most common in adults aged 65+, more often in men than women.

🔍 Signs & Symptoms

• Blood in urine (with or without pain) is the most common and often early sign.
• Urinary symptoms: burning, frequent or urgent need to urinate.
• In advanced stages, symptoms may include pain in the lower back, pelvis, or bones.

🧪 Diagnostic Process

1. Medical history + urine cytology: Examining urine for abnormal cells.
2. Cystoscopy with biopsy/TURBT: Endoscopic view and tissue sampling via transurethral resection—gold standard for diagnosis.
3. Imaging tests:
   • CT urography or MRI for staging (muscle involvement).
   • CT chest/abdomen/pelvis and bone scan if invasion suspected.

Advanced imaging like PET or MRI is under research and may speed up diagnosis, especially for muscle-invasive bladder cancer.

📈 Staging & Classification

• Non-muscle-invasive bladder cancer (NMIBC): Stage 0-I; confined to lining or lamina propria.
• Muscle-invasive bladder cancer (MIBC): Stage II+; spread into muscle wall or beyond.
• Metastatic bladder cancer: Spread to lymph nodes or distant organs.

💉 Treatment Options

1. NMIBC

• TURBT procedure to diagnose and remove visible tumors.
• Intravesical therapy (directly into bladder):
  • Chemotherapy (e.g. mitomycin C, gemcitabine) for low-risk tumors.
  • Immunotherapy with BCG vaccine for high-risk NMIBC, often with maintenance doses.
• Follow-up surveillance:
  • Cystoscopy every 3–6 months initially, then less often based on risk.

2. MIBC

• Radical cystectomy + pelvic lymph-node dissection; may include prostate/uterus removal and creation of urinary diversion (neobladder, ileal conduit).
• Neoadjuvant chemotherapy (usually platinum-based) improves survival before surgery.
• Bladder-preserving trimodality: TURBT + radiation + chemotherapy, as alternative for some patients.

3. Metastatic Disease

• Systemic chemotherapy: Cisplatin + gemcitabine or MVAC or DDMVAC.
• Targeted therapy: Erdafitinib approved for FGFR-altered cancers improves survival (from ~7.8 to 12.1 months).
• Immunotherapy: Immune checkpoint inhibitors like pembrolizumab (Keytruda) and atezolizumab for maintenance or non-responders.

📊 Prognosis & Survival

• Non-muscle-invasive (Ta/T1/CIS): 80–90% 5-year survival.
• Muscle-invasive: 30–60% 5-year survival.
• Metastatic: only 8–15% survive five years.
• Recurrence is common: ~70% within five years for superficial cancers.

Long-term outcomes depend on stage at diagnosis, tumor grade, response to treatment, and general health.

🧩 Living with Bladder Cancer

• Regular follow-up: Cystoscopy, imaging, and lab tests help detect recurrence early .
• Manage side effects: Bladder removal may affect urinary control; chemotherapy/immunotherapy may cause fatigue, nausea, or infections.
• Support network: Emotional and informational support, from groups like “Fight Bladder Cancer,” helps patients and families’ cope.
• Healthy lifestyle: Quitting smoking, avoiding exposure to harmful chemicals, balanced diet, and exercise aid recovery and reduce recurrence.

🔑 Key Takeaways

• Bladder cancer is often detected early through symptoms like visible blood in urine.
• Early-stage disease has high cure rates—especially NMIBC.
• Advanced disease requires aggressive treatment but has poorer prognosis.
• New options like targeted therapy and faster MRI diagnostics are improving outcomes and speeding treatment.
• Regular monitoring is essential due to high recurrence risk.

📞 When to Contact Your Doctor

• New or persistent blood in urine.
• Urinary symptoms that don’t resolve with treatment.
• Side effects from therapies.
• Concerns about follow-up care or recurrence.