Medically reviewed by
M.Ch. Urology (CMC Vellore) · Fellowship in Urologic Oncology & Robotic Surgery (University of Miami) · NMC Reg. No. NMC/2005020914
This page is for general health information and education only. It does not replace a consultation, diagnosis or treatment by a qualified doctor who has examined you.
Bladder cancer usually first shows up as painless blood in the urine. It is diagnosed with cystoscopy and removal of the tumour (TURBT). Treatment depends mainly on whether the cancer has grown into the bladder muscle.
Blood in the urine
Visible blood in the urine, even once and even without pain, should always be checked, especially in smokers and people over 40. Smoking is the most important risk factor for bladder cancer.
Cystoscopy and TURBT
A cystoscopy uses a thin camera to look inside the bladder. If a tumour is seen, it is removed through the urethra in a procedure called TURBT. The tissue tells the doctor the grade of the cancer and how deep it has grown.
Non-muscle-invasive vs muscle-invasive
| Type | What it means | Usual treatment |
|---|---|---|
| Non-muscle-invasive (Ta, T1, CIS) | Cancer limited to the inner lining | TURBT, then bladder instillations (chemotherapy or BCG) and regular cystoscopy |
| Muscle-invasive (T2 and above) | Cancer has grown into the bladder muscle | Chemotherapy followed by radical cystectomy with urinary diversion, or bladder-preserving chemoradiation in selected patients |
Urinary diversion after cystectomy
After the bladder is removed, urine is redirected either into a small bag on the abdomen (ileal conduit) or into a new bladder made from bowel (neobladder) for suitable patients.
Research on robotic cystectomy
The RAZOR trial, published in The Lancet in 2018, compared robotic and open radical cystectomy and found similar cancer control at two years, with less blood loss and a shorter hospital stay after robotic surgery. Dr. Vivek Venkatramani contributed to this trial during his fellowship at the University of Miami.
Frequently Asked Questions
Is bladder cancer curable?
Many bladder cancers are treatable, particularly when found early. The outlook depends on the stage and grade, and on how the cancer responds to treatment.
Will I need my bladder removed?
Most non-muscle-invasive cancers are treated without removing the bladder. Removal (cystectomy) is mainly considered for muscle-invasive cancer or high-risk cancers that do not respond to BCG.
How often is follow-up cystoscopy needed?
Bladder cancer can recur, so regular cystoscopy is needed; how often depends on the risk group.
References
- EAU Guidelines on Non-muscle-invasive Bladder Cancer and on Muscle-invasive and Metastatic Bladder Cancer, 2025 editions. uroweb.org
- Parekh DJ et al. Robot-assisted radical cystectomy versus open radical cystectomy in patients with bladder cancer (RAZOR). Lancet 2018;391:2525–2536.