Bladder Cancer

There are a number of symptoms you should look out for, including:

• blood in the urine
• needing to pee more often
• feeling like you need to pee straight away, or urgently
• feeling like it hurts to pee or unable to pee when you feel the urge
• having pain in the belly area or lower back.

It is important to remember that blood in the urine should never be ignored.

Having these symptoms may not mean you have cancer, but it is important to check. If you have any of these problems, or are worried about something else, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.
 

You won’t know if you have bladder cancer until your doctor has talked to you, done a physical examination, and carried out some tests. Having these tests does not mean you will have cancer, but it is really important to check. You can request a male or female doctor, nurse or health worker to assist with following Men’s Business and Women’s Business protocols.

The tests might include:

• checking a sample of your urine
• blood tests
• imaging tests such as an ultrasound, CT scan or MRI scan to see what your insides look like
• a cystoscopy, when they put a tube into your bladder to have a close look at the inside of your bladder
• a biopsy, which is when they take a tiny bit of the inside lining of your bladder while you’re having a cystoscopy and look at it with a microscope.
   

If you have bladder cancer, you might be told it’s at a certain stage. This describes whether or not the cancer it has spread to other parts of your body, and where it has spread to. Knowing the stage of the cancer helps you and your doctors to decide on the best treatment for you.
Doctors may also use numbers from 0 to 4 to describe the stage of bladder cancer, however, this is not used as commonly.

• Stage 0: The cancer is in the inner layer of the bladder lining
• Stage 1: The cancer has grown through the inner lining of the bladder into the connective tissue beneath, but not into the muscle layer yet
• Stage 2: The cancer has grown into the thick muscle wall of the bladder 
• Stage 3: The cancer has grown through the muscle into the fat layer and may have spread to nearby organs (vagina, prostate or womb) and lymph nodes
• Stage 4: The cancer has spread to other parts of the body 

With all stages of bladder cancer, there is plenty of treatment and support that can help you, including traditional medicine and practices like ceremony and being on Country.

There are different ways to treat bladder cancer. The main ones are:

• surgery
• immunotherapy
• chemotherapy
• radiotherapy

If you have bladder cancer, you might need one of them or a combination of them. 

Your doctors will yarn with you about what treatments they recommend and what your options are. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about which treatment/s might be best for you. You can also yarn with them about including any traditional healing, bush medicines and/or cultural practices you would like included in your treatment plan.  

Surgery

Surgery is a procedure done in hospital to remove the cancer and help to stop it from spreading to other parts of your body. Surgery involves staying in hospital and having an anaesthetic and an operation. 

Some people have only the lining of their bladder scraped off. Others have part of the bladder containing the cancer removed, and others have all their bladder removed.

Some people will have some of their lymph nodes taken out. 

Some people may need to have procedure called a urostomy, which means that their urine will drain into a bag attached to the outside of the tummy. There are special nurses to help people if this is needed. 

If you need to travel away from home for surgery, there is assistance available for travel and accommodation for you and your family. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about surgery and any concerns related to having surgery.

Read more about surgery.

Immunotherapy

Immunotherapy is treatment with drugs that help your immune system attack the cancer cells. Immunotherapy for bladder cancer is given through a tube into the bladder. It is usually given once a week for six weeks to start with. 

Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker, and with others who have had the treatment. 

If you need to travel away from home for immunotherapy, there is assistance available for travel and accommodation for you and your family. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about immunotherapy and any concerns related to having this treatment. 

Read more about immunotherapy.

Chemotherapy

Chemotherapy or ‘chemo’ involves you taking strong drugs to stop the growth of cancer cells. This is different for each patient, depending on what you need. 

Chemo may be given through a tube into the bladder or as injections into your arm or hand that drip in over an hour or two. Some chemo comes as tablets. If you’re having chemo, your doctor will tell you exactly how it will work for you.

Chemo that is given through a tube into the bladder can be given once a week for a few weeks. It can also be given as a one-off treatment after your surgery.

Chemo injections can also be given in cycles, for example every 2 or 3 weeks.   Most people need to go to a hospital or clinic to get chemo, however a small number of people may have some of their treatment at home if available. But you usually don’t need to stay in hospital for chemo.

Chemo can make people feel sick for a while, but there are things they can take and do to help. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

If you need to travel away from home for chemo, there is assistance available for travel and accommodation for you and your family. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about chemo and any concerns related to having this treatment. 

Read more about chemotherapy and side effects.

Radiotherapy

Radiotherapy, also called radiation therapy, uses X-rays to destroy cancer cells in one part of your body.

Most people who have radiotherapy have it every day (Monday to Friday) for 4-6 weeks, and each session can take 15 minutes. But it might be different for you. 

You may be treated with chemo at the same time as radiotherapy, in which case, you may need to have injections with chemo 1 or 2 days per week.

You can only have radiotherapy in cities and some big towns – see this list. If your doctor thinks radiotherapy would help, and you don’t live near a radiotherapy site, assistance is available for travel and accommodation. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker. 

Read more about radiotherapy.
 

It’s important for you to understand why you are getting the treatment your doctor recommends and how it is supposed to help you. Different treatments try to do different things. It depends on what cancer you have, and whether it has spread, and what you want. Ask your doctor or specialist if the treatment they suggest:

• is meant to cure you, by getting rid of the cancer and stopping it spreading, or
• won’t cure you, but is meant to prolong your life, or make your feel better.

Your doctors should talk to you and explain this. You can talk to them, ask questions, and tell them what you think, and what you want. Some people will want to try everything possible to stay alive. Others want simpler treatments, or don’t want to leave Country for treatment, or don’t want any treatment. You can yarn with your doctor about any traditional healing, bush medicines and cultural practices you want to include during your treatment plan. It’s your choice. You can also talk to another doctor to help you decide.

It can take time to decide about treatment. There are usually some options to hear about and choices to make. You can read more about treatment.

It can be helpful to write things down and have someone else come to appointments to help remember information.

Yarn with to your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker about treatment. You can also yarn about any traditional healing, bush medicines and cultural practices you want to include during your treatment plan.

Always ask about the cost of treatment. Many treatments are free through public hospitals, but some are not. Yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Learn more about financial support.

It all depends on the type of treatment you’re having. People will have treatment for different durations of time. After treatment is over, your doctor might keep in touch with you to check how you’re going and monitor your health.

During your cancer journey you will have the opportunity to build trust and safe relationships with your doctors, nurses and Aboriginal and/or Torres Strait Islander health workers that may last beyond your treatment.

It is not possible to say what causes bladder cancer in a single person. We do know there are some features that are more common in people who develop bladder cancer. These features are called “risk factors”.

But it is usually hard to be sure whether a risk factor contributed to the development of the cancer. And having one or more risk factors for bladder cancer does not mean that someone will develop this cancer. In fact, many people with bladder cancer have no obvious risk factors.

Risk factors for bladder cancer include:

• smoking tobacco
• exposure to certain chemicals (such as benzene derivatives and arylamines (chemicals used in certain industries)
• radiotherapy treatment for cancers in the pelvis/lower abdomen.

If you have any of these risk factors or you’re worried about your risk for bladder cancer, yarn with your doctor, nurse or Aboriginal and/or Torres Strait Islander health worker.

Clinical trials might be an option for you. Yarn with your doctor to help you decide if taking part is a good option. Read more about clinical trials.

Read more about bladder cancer here.