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Seventy percent of urothelial tumours are superficial at presentation; two-thirds
will subsequently recur locally or elsewhere in urinary tract, and in 10-15%,
the recurrence will be invasive. This potential instability of the urothelium
is often described in terms of a "field change".
- majority are transitional cell carcinomas that arise from the specialised
waterproof epithelium that lines the urinary tract. In men, this extends from
the tips of the renal papillae to the navicular fossa; in women, to halfway
along the urethra
Tumours can arise at any site in this epithelium and are often multifocal.
The bladder is the most common site.
- bladder cancer is the seventh most common cancer in the UK. It is 3-4 times
more common in men than in women. In the UK in 2011, it was the fourth
most common cancer in men fand the thirteenth most common in women
- bladder cancer is usually identified on the basis of visible blood in the
urine or blood found on urine testing, but emergency admission is a common
way for bladder cancer to present, and is often associated with a poor prognosis
- most bladder cancers (75-80%) do not involve the muscle wall of the bladder
and are usually treated by telescopic removal of the cancer (transurethral
resection of bladder tumour [TURBT])
- often followed by instillation of chemotherapy or vaccine-based therapy
into the bladder, with prolonged telescopic checking of the bladder (cystoscopy)
- some people in this group who are at higher risk are treated with major
surgery to remove the bladder (cystectomy). People with cancer in or through
the bladder muscle wall may be treated with intent to cure using chemotherapy,
cystectomy or radiotherapy, and those who have cancer too advanced to
cure may have radiotherapy and chemotherapy
Last reviewed 01/2018