Bladder cancer is the 4th most common cancer in men worldwide, with a peak incidence around age 65. Risk factors include smoking, occupational exposure, and certain infections. Symptoms depend on whether the cancer is non-metastatic or metastatic, and may include blood in the urine, bladder irritability, and pelvic or flank pain. Diagnosis involves cystoscopy, imaging tests, and urine cytology. Treatment depends on the stage, and includes surgery, chemotherapy, and immunotherapy.

1. Bladder Cancer
Mohammed Fathy Bayomy, MSc, MD
Lecturer of Clinical Oncology
Clinical Oncology & Nuclear Medicine Department
Faculty of Medicine
Zagazig University

2. The 4th most common
cancer among men
worldwide.
7% of all adult male cancers
Peak incidence
around
65
Male
3X
Female

3. Smoking
Occupational
exposure
Schistosomum
haematobium
Iatrogenic
Aromatic amines
(anilines intermediate)
2-naphthylamine
4-nitrobiphenylBenzidine
4-aminobiphenyl
Pelvic irradiation
Cyclophosphamide

4. Transitional cell carcinomas (TCC) Other tumors
Rhabdomyosarcoma
Squamous cell carcinomas
90%
8%
Adenocarcinoma Carcinoid
Lymphomas
Leiomyosarcoma

5. Liver
Brain
Bone
Lung
Metastatic
Painless haematuria
(90%)
Bladder irritability
(25%)
Symptoms of
infection
Pain in pelvis or
flank
Non-
metastatic
Bladder mass
Edema of lower
extremities/genitalia
Hesitancy
Urgency
Frequency
Dysuria
postvoiding
pelvic
discomfort

6. Cystoscopy
Abdominal
imaging
Chest
Imaging
Intravenous
pyelogram (IVP)
LaboratoryCT urography
(CTU)
Urine cytology

7. T stage M stageN stage

8. TNM
-
AJCC
Stage I
Stage II
Stage III
Stage IV
Stage 0

9. Non-muscle Invasive
Bladder Cancer (NMIBC)
Surgery Bladder Preservation Therapy
TransUrethral Resection of
Bladder Tumor (TURBT)
Cystectomy
Muscle Invasive Bladder Cancer (MIBC)
Adjuvant
Intravesical
Therapy
Surgery
Partial cystectomy
Maximal TURBT
Induction
chemoradiation
Response Assessment
Consolidation
chemoradiation
Neoadjuvant
Chemotherapy
Radical cystectomy
Salvage
Cystectomy
M-VAC

10. Metastatic Bladder Cancer (MBC)
Chemotherapy
Platinum based
combination
Non-platinum-
based combination
Cisplatin
-based
Carboplatin
-based
M-VAC
GC
PGC
Gemcitabine
+
Carboplatin
Paclitaxel +
Gemcitabine
Immunotherapy
Immune Checkpoint Inhibitors (ICI)
Anti-PD-1Anti-PD-L1
Avelumab Pembrolizumab
Surgery
Palliative
Radiotherapy