Bladder cancer

Bladder cancer (BCa) is the seventh most common cancer in the UK with around 10,300 UK cases diagnosed in 2010. It is one of the most expensive human malignancies to manage because it requires long-term bladder surveillance, most patients do not die from the disease and it is a recurring, relapsing disease requiring multiple treatments. Genetic predisposition and environmental exposures are associated with the development of BCa. Half of all tumours are caused by tobacco smoking and 20% by occupational exposure. Visible haematuria is a common presenting symptom and full investigation of the whole urinary tract is warranted to exclude other causes. The management pathways for BCa depend upon the tumour's stage, grade and likely future behaviour. Options include transurethral resection, intravesical chemo- or immunotherapy, radical radiotherapy, radical cystectomy and systemic chemotherapy. Whilst research into urinary biomarkers, and targeted therapies show promise, to date few have impacted on the early diagnosis or have been shown to improve outcomes from BCa.