​​Bladder Cancer

Symptoms may include blood in the urine, pelvic pressure, fever, frequent urination or a burning sensation during urination.​

If you experience any of the above symptoms for a prolonged time, you should see your doctor or consult the urologists from the Kidney and Bladder​ service line or an oncologist from the Oncol​ogy​ Service Line at Aga Khan University Hospital, Karachi. The symptoms of bladder cancer may resemble those of other diseases. An accurate diagnosis early on is important for an effective treatment. ​​​

Your time with your doctor may be limited, so make sure to prepare for your visit beforehand. Here​ are some tips to help get you started.​​

The doctor may begin by assessing your medical history, performing a physical exam and running urine tests. This would help determine the presence of any cancerous cells in the urine.

Cystoscopy is usually recommended for a visual inspection of the bladder. The process involves inserting a long, thin, camera-fitted tube into the bladder for a visual inspection of the inner bladder linings.

Imaging tests might further be performed to obtain visual images of the bladder and kidney. These tests include magnetic resonance imaging (MRI), ultrasound and computerized tomography (CT) scan. Finally, a biopsy of the bladder may be recommended for a confirmatory diagnosis. This would involve extracting sample tissues from your bladder during cystoscopy and sending them to the laboratory for analysis. This helps determine the presence of cellular changes responsible for cancerous growth.​

Complete blood count (CBC): One or more parameters related to red blood cells, white blood cells and platelets might be affected in this condition. Therefore, it is an ancillary test in the diagnostic workup of this disease.

Bone marrow biopsy: It is done as staging workup if it is suspected that primary tumor (kidney or bladder) has also involved bone marrow.

​​Disclaimer: Kindly consult your physician before getting the above-mentioned tests.​

The treatment for bladder cancer almost always involves endoscopic procedure or surgery. Milder levels of the disease can be dealt with minimally invasive procedures such as endoscopic surgery. Endoscopic surgery (transurethral resection of bladder tumor - TURBT) involves attaching a set of surgical probes and tools to a scope, which is then inserted in the urethra for removal of cancer outgrowth in the bladder.

In case the bladder cancer is found to be non invasive after TURBT, it is usually managed by instillation of medications in bladder in clinic and frequent follow up with endoscopic examination of bladder (cystoscopy) to look for cancer regrowth or progress. Bladder medication involves placing medicines in the bladder for sixty minutes and then expelling the solution. This process may be repeated over a period of six weeks.

In case the bladder cancer is found to be muscle invasive, you may require surgical removal of the bladder. There are several ways to manage normal urine passage after removal of bladder. These include connecting urine passage to abdomen to be collected in a pouch/bag or reconstruction of a bladder from your intestine to allow urine flow via normal urinary passage.

Carefully selected invasive cancers can be managed by preservation of bladder, but in that case you will require complete endoscopic removal of tumour followed by chemotherapy and radiotherapy. You will also require close follow-up with possibility of bladder removal if the disease recurs.

In certain case the use of drug treatment via chemotherapy might be involved to kill or reduce the number of cancerous cells. Chemotherapy can be prescribed both before and after surgery, depending on the severity of the cancerous overgrowth.​

The Aga Khan University Hospital offers various support services to help with managing or recovering from the disease or condition. These include but are not limited to nutrition, physiotherapy, rehabilitation, specialized clinics and some patient support groups. Your doctor or nurse will advise you accordingly.

The Aga Khan University Hospital offers financial assistance to those who are in need and fulfil the eligibility criteria. For further information, you can contact the Patient Welfare Department. You can find the contact number of the Patient Welfare Department in the ‘Important Numbers’ section on the website homepage.

The financial counselling staff is available during office hours, at the main PBSD (Patient Business Services Department), to answer your financial queries on treatments’ costs and authorize admissions on partial deposit as per hospital policies allow. The financial counsellor in the emergency room is open 24/7. You can find the contact number of the Patient Business Services in the ‘Important Numbers’ section on the website homepage.​

Your doctor and or nurse will give you specific instructions about the prescribed medication. Please ensure that you take or use the prescribed medicine as advised. It can be dangerous to your health if you self-prescribe. Please inform the doctor or nurse beforehand if you have experienced any adverse reactions to any medications in the past. If you experience any symptoms of drug poisoning, overdose or severe reaction please contact the Pharmacy Service at The Aga Khan University Hospital immediately. You can find the contact number of the Pharmacy Services in the ‘Important Numbers’ section on the website homepage.​