How to Detect Bladder Cancer Early

Article written by Dr Yau Tsz Kok, Specialist in Clinical Oncology

Reprinted from 《Metro Daily》

The bladder is the organ that temporarily stores urine in the body. When the cells lining the inside of the bladder are exposed to carcinogens in urine over a long period, it may lead to bladder cancer. Many members of the public know that smoking causes lung cancer, but in fact, smoking also increases the risk of bladder cancer by three times. Although long-term exposure to carcinogenic chemicals in dyeing and chemical plants also raises the risk of bladder cancer, very few patients in Hong Kong are linked to this. Therefore, to prevent bladder cancer, the most important step remains quitting smoking.

Bladder cancer is relatively more common in Western countries, while the incidence rate among Asians is slightly lower, showing a mild downward trend in recent years. In 2013, Hong Kong recorded 425 new cases, accounting for 1.5% of all cancer cases, with over 70% being male. Furthermore, 80% of bladder cancer patients are elderly individuals aged 65 or above. The vast majority of bladder cancer patients present with blood in their urine (haematuria) as their initial symptom, which is generally painless. Although kidney stones, bladder stones, and urethritis can also cause haematuria, these conditions are usually accompanied by pain. In any case, haematuria is an important symptom, and medical advice should be sought promptly. If bladder cancer is suspected, a cystoscopy is generally required for a detailed examination, alongside a tissue biopsy for pathological testing.

In about half of bladder cancer patients, the tumour is still confined to the epithelial layer at initial diagnosis and has not invaded the muscle layer of the bladder. Most of these early-stage patients only require endoscopic resection using specialized instruments to remove the tumour, thereby preserving bladder function. Some patients may subsequently require periodic intravesical instillation of medication (such as BCG, Bacillus Calmette-Guérin, which is a form of immunotherapy) to prevent recurrence. However, if there are too many early-stage tumours within the bladder, or if the cancer cells have already invaded the muscle layer, partial or total cystectomy (bladder removal) will need to be considered, which will inevitably bring some inconvenience to daily life. Some patients may also require adjuvant chemotherapy and radiotherapy to enhance treatment efficacy.

*The original article was published in Chinese. In the event of any inconsistency or ambiguity, the Chinese version shall prevail.