Bladder Cancer

The Bladder

The bladder is an organ in your lower abdomen that stores urine.

Bladder Cancer

Bladder cancer is an abnormal growth on the bladder wall. It affects approximately 0.03% of people, and is the 7th most common cancer in Singapore. Bladder cancer can remain confined to the bladder, or invade nearby tissues and organs, or spread to other parts of the body by way of the bloodstream or lymphatic system. If not detected early, it can be life-threatening.

Who gets bladder cancer?

Most patients who get bladder cancer are 50 years or older. The strongest risk factor is cigarette smoking and smokers are three times as likely to have bladder cancer. Other risk factors include workplace exposure to industrial chemicals found in the dye industry and previous radiation for other diseases to pelvis. Genetics and family history can play a role. Chronic infection due to a parasitic worm (Schistosomiasis) is also linked to bladder cancer though this is rare in Singapore.


The most common symptom of bladder cancer is visible blood in the urine. Blood in the urine can also be the sign of a number of disorders other than cancer. But no matter what the cause, the condition should be brought to the attention of a doctor. Other common symptoms of bladder cancer are urinary frequency and urgency, and rarely lower abdominal pain. In the advanced stage, patients may also experience loss of appetite, weight loss and anemia.


Diagnosis begins with a physical examination by your doctor. For early bladder cancer, a flexible cystoscopy (a small telescope) is required to visualize the internal lining of your bladder to confirm the presence of a tumor. This is usually done in the clinic with just local anaesthetic lubricant jelly with minimal discomfort.

What are the stages of bladder cancer?

  1. Superficial : early cancer which has not invaded into bladder muscle
  2. Muscle-invasive: locally advanced cancer which has invaded into the muscle of the bladder or beyond
  3. Metastatic: the cancer has spread to distant parts of the body, most commonly the lung, bones or distant lymph nodes

Which treatment is suitable for me

Your medical history, general health, the type and location of the cancer and other factors are considered in determining the treatment needed. Your treatment must be tailored to your individual needs.


Transurethral resection of bladder tumor (TURBT)

TURBT is the removal of a bladder tumor with using an endoscope inserted into the bladder through the urethra. The surgeon will remove your tumor ( pictured) by shaving it off gradually until it is completely removed. The tumor fragments are removed and sent for pathology analysis.


Cystectomy is the surgical removal of the bladder. It is indicated in advanced bladder cancer which has invaded into or beyond the muscle wall of the bladder. Since the organ for urine storage is removed, urinary diversion is required, usually involving the use of a segment of the patient’s intestines to transport urine to an opening in the abdomen (ileal conduit)


Chemotherapy may be given in patients before undergoing cystectomy. Chemotherapy is also considered in the treatment of metastatic bladder cancer. Chemotherapy suppresses the growth of cancer cells throughout the body and therefore slows the progression of disease. Patients may benefit from relief from symptoms like pain and improved quality of life.


Radiation therapy utilises high-energy radiation to kill cancer cells. Radiotherapy can be used together with TURBT if a patient is not fit for cystectomy.

Your future after treatment for Bladder Cancer

After treatment of your bladder cancer, you will need to have regular follow ups with your urologist. Tests and procedures may be required during the follow up period. These include regular radiological scans and flexible cystoscopy to look for tumour recurrence.

You may download the PDF version from: Patient materials – Bladder Cancer.