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Managing bladder cancer

I am Brian Fretwell and I have had a urostomy now for just short of 13 years. My bladder was removed due to cancer. I had only one showing of blood in my urine and went straight to my GP and was referred to a Urology consultant at Bassetlaw Hospital in Worksop. Three months later I had my bladder removed and have lived with a stoma ever since. I have had a few minor problems but life in general is good.  I actually posted my application form to join the UA on my way home from the hospital. I have been National Chairman of the UA now for seven years.

About 10,000 people are diagnosed with bladder cancer every year and it’s the 11th most common cancer in the UK, so it is important to know the symptoms:

  • Blood in your urine (note: blood in your urine can be symptomatic of a range of conditions. For most people, it does not lead to a bladder cancer diagnosis)
  • More frequent urination  
  • Painful urination  
  • Back pain 
  • Recurrent urinary infections 

“Receiving a bladder cancer diagnosis can feel frightening and overwhelming, but it’s important to remember that with the right information, care and support, many people survive and go on to live an active, fulfilling life.    
“Understanding the condition and the available treatment options is the first step towards getting a plan that’s right for you. The right treatment will give you the best chance of surviving bladder cancer.” 

Professor Chris Harding MA MB Bchir MD FRICSUrol
Consultant Urological Surgeon, The Freeman Hospital, Newcastle Hospitals NHS Foundation Trust 

If you’ve received a diagnosis of bladder cancer, your hospital’s multidisciplinary team of experts will work with you to determine the best way to proceed with your treatment. They’ll provide you with a comprehensive assessment of your condition, helping you understand the stage of the cancer (extent), its grade (how aggressive the cancer is) and the recommended courses of action.  
You should be given the contact details for a clinical nurse specialist, who will be keep in touch with all members of your medical team. They will be able to answer your questions and support you throughout your treatment.  

Treatment options for bladder cancer depend on several factors, including the type (non-muscle invasive or muscle invasive), grade and stage of the cancer, and your overall health and treatment preferences.

Non-muscle invasive bladder cancer means the cancer cells are only in the bladder’s inner lining. Most patients with non-muscle invasive bladder cancer have surgery to remove the cancer from their bladder lining. Further treatments – such as chemotherapy into your bladder – might also be needed following the initial surgery.

Muscle invasive bladder cancer means that the cancer cells have spread into or through the muscle layer of the bladder wall. Treatments include surgery and radiotherapy.  In some cases, patients may be recommended to have chemotherapy prior to the definitive treatment of surgery and radiotherapy.  In a small number of cases, post-operative immunotherapy (a kind of chemotherapy) may be considered necessary. 

Surgery is one of the main treatments for muscle invasive bladder cancer. The surgeon usually removes all your bladder (cystectomy) and makes a new way for you to urinate, known as a urinary diversion

There are different types of urinary diversion, and several choices of operation depending on which type of urinary diversion you have.  
A urostomy (ileal conduit) is where your surgeon creates a new opening (stoma) on your tummy, through which urine continually passes into a bag worn outside your body.   
A continent urinary diversion is where your surgeon makes an internal pouch to hold your urine, and a new opening (stoma) on your tummy. You pass a thin tube (catheter) into the stoma to pass urine and you don’t have to wear a bag as urine will only empty when a catheter is inserted. 

A bladder reconstruction (neobladder) is an operation to make a new bladder after the surgeon removes your own. After surgery you continue to pass urine in the usual way, but many patients need to self-catheterise to fully empty their neo bladders.   

While the decision to undergo urinary diversion surgery requires careful consideration, it ultimately plays a pivotal role in preserving quality of life and minimising complications associated with bladder cancer treatment.  

Whether you’re facing surgery or already have a urinary diversion, the Urostomy Association is here to support you every step of the way. There’s helpful information here on our website, and you can get in touch with us on 01223 910854 or via