Bladder cancer is where a growth of abnormal tissue known as a tumour develops in the lining of the bladder. In some cases the tumour spreads into the surrounding muscles.

The most common symptom of bladder cancer is blood in your urine, which is usually painless.

If you notice blood in your urine, even if it comes and goes, you should visit your GP so the cause can be investigated.

Types of bladder cancer

Once diagnosed, bladder cancer can be classified by how far it has spread.

If the cancerous cells are contained inside the lining of the bladder, doctors describe it as superficial or non-muscle-invasive bladder cancer. This is the most common type of bladder cancer, accounting for 7 out of 10 cases. Most people do not die as a result of this type of bladder cancer.

When the cancerous cells spread beyond the lining into the surrounding muscles of the bladder, it’s referred to as muscle-invasive bladder cancer. This is less common, but has a higher chance of spreading to other parts of the body and can be fatal.

Why does bladder cancer happen?

Most cases of bladder cancer appear to be caused by exposure to harmful substances that lead to abnormal changes in the bladder’s cells over the course of many years.

Tobacco smoke is a common cause and it is estimated that half of all cases of bladder cancer are caused by smoking.

Contact with certain chemicals previously used in manufacturing is also known to cause bladder cancer. However, these substances have since been banned.

Treating bladder cancer

In cases of non-muscle-invasive bladder cancer, it is usually possible to remove the cancerous cells while leaving the rest of the bladder intact.

This is done using a surgical technique called transurethral resection of a bladder tumour (TURBT). This may be followed by a dose of chemotherapy medication directly into the bladder to reduce the risk of the cancer returning.

In cases with a higher risk of recurrence, a medication known as Bacillus Calmette-Guérin (BCG) may be injected into the bladder to reduce the risk of the cancer returning.

Treatment for muscle-invasive bladder cancer may involve surgically removing the bladder in an operation known as a radical cystectomy.

When the bladder is removed, you will need another way of collecting your urine. Possible options include making an opening in the abdomen so urine can be passed into an external bag, or constructing a new bladder out of a section of bowel. This will be done at the same time as a radical cystectomy.

If it’s possible to avoid removing the bladder or if surgery is not suitable, a course of radiotherapy and chemotherapy may be recommended. Chemotherapy may sometimes be used on its own before surgery or before being combined with radiotherapy.

After treatment for all types of bladder cancer, you will have regular follow-up tests to check for signs of recurrence.

Who is affected?

About 10,000 people are diagnosed with bladder cancer every year.

The condition is more common in older adults, with the average age at diagnosis being 68 years old.

Rates of bladder cancer are four times higher in men than in women, possibly because in the past men were more likely to smoke and work in the manufacturing industry.

Signs and symptoms

Symptoms of liver cancer are often vague and don’t appear until the cancer is at an advanced stage. They can include:

• unexplained weight loss
• loss of appetite
• feeling very full after eating, even if the meal was small
• feeling sick and vomiting
• pain or swelling in your abdomen (tummy)
• jaundice (yellowing of your skin and the whites of your eyes)
• itchy skin
• feeling very tired and weak

Visit your GP if you notice any of the symptoms listed above. Although they are more likely to be the result of a more common condition, such as an infection, it’s best to have them checked.

You should also contact your GP if you have previously been diagnosed with a condition known to affect the liver, such as cirrhosis or a hepatitis C infection, and your health suddenly deteriorates.

What causes liver cancer?

The exact cause of liver cancer is unknown, but most cases are associated with damage and scarring of the liver known as cirrhosis.

Cirrhosis can have a number of different causes, including drinking excessive amounts of alcohol over many years and having a long-term hepatitis B or hepatitis C viral infection.

It is also believed obesity and an unhealthy diet can increase the risk of liver cancer because this can lead to non-alcoholic fatty liver disease.

By avoiding or cutting down on alcohol, eating healthily and exercising regularly, and taking steps to reduce your risk of becoming infected with hepatitis B and C, you may be able to significantly reduce your chances of developing liver cancer.

Read more about the causes of liver cancer and preventing liver cancer.

Who is affected?

Despite being a common type of cancer worldwide, liver cancer is relatively uncommon in the UK, with just over 4,000 new cases diagnosed each year. However, the chances of developing the condition are high for people with risk factors for the condition.

The number of people affected by liver cancer rises sharply with age, with around 8 in every 10 cases diagnosed in people aged 60 or older, although it also affects many people younger than this. Around two in every three cases affect men.

Over the past few decades, rates of liver cancer in the UK have risen considerably, possibly as a result of increased levels of alcohol intake and obesity.

Diagnosis and screening

Liver cancer is usually diagnosed after a consultation with a GP and a referral to a hospital specialist for further tests, such as scans of your liver.

However, regular check-ups for liver cancer (known as surveillance) are often recommended for people known to have a high risk of developing the condition, such as those with cirrhosis.

Having regular check-ups helps ensure the condition is diagnosed early. The earlier liver cancer is diagnosed, the more effective treatment is likely to be.

Read more about diagnosing liver cancer.

How liver cancer is treated

Treatment for liver cancer depends on the stage the condition is at. If diagnosed early, it may be possible to remove the cancer completely.

Treatment options in the early stages of liver cancer include:

• surgical resection – surgery to remove a section of liver
• liver transplant – where the liver is replaced with a donor liver
• microwave or radiofrequency ablation – where microwaves or radio waves are used to destroy the cancerous cells

However, only a small proportion of liver cancers are diagnosed at a stage where these treatments are suitable. Most people are diagnosed when the cancer has spread too far to be removed or completely destroyed.

In these cases, treatments such as chemotherapy will be used to slow down the spread of the cancer and relieve symptoms such as pain and discomfort.

Because liver cancer is most often detected at an advanced stage, only around one in every five people live for at least a year after being diagnosed, and just 1 in every 20 people live at least a further five years.