Regency Specialist Hospital +6017 523 3183
Clinic F7, Ground Floor, No 1, Jln Suria, Bandar Seri Alam, 81750 Masai
Singapore Mount Alvernia Hospital +65 9727 3900
Medical Centre A, #02-03, 820 Thomson Road Singapore 574623
Bladder Cancer

What is bladder cancer?

Bladder cancer begins when abnormal cells in the bladder lining grow uncontrollably. The bladder, a hollow organ in the lower abdomen, stores urine before it is expelled from the body. Bladder cancer can affect the bladder’s normal function and, if left untreated, can spread to surrounding tissues or distant organs.
There are several types of bladder cancer, with the most common being urothelial carcinoma (also known as transitional cell carcinoma). This type makes up around 90% of all bladder cancer cases. It starts in the urothelial cells, which line the inside of the bladder.
Bladder Cancer Singapore
Bladder cancer occurs when abnormal cells in the bladder lining grow uncontrollably, often leading to tumours that can spread to nearby tissues or distant organs if not treated.

Urothelial carcinoma can be classified into two categories:

  • Non-Muscle-Invasive Bladder Cancer (NMIBC) — cancer remains within the bladder’s inner layers and has not invaded the bladder muscle. NMIBC accounts for most bladder cancer diagnoses and has a better prognosis when caught early.
  • Muscle-Invasive Bladder Cancer (MIBC) — in this more aggressive form, cancer has spread into the bladder’s muscle layers and potentially beyond. It requires more intensive treatment, such as surgery and chemotherapy​.

Other, less common types of bladder cancer include:

  • Squamous Cell Carcinoma — often associated with chronic bladder irritation and infection, this type makes up about 1–2% of cases.
  • Adenocarcinoma — a rare form, accounting for around 1%, that arises from glandular cells.
  • Small Cell Carcinoma — this rare and fast-growing type accounts for less than 1% of bladder cancers​.

What causes bladder cancer?

Bladder cancer occurs when the cells within the bladder undergo abnormal changes at the genetic level, leading to uncontrolled growth. Under normal conditions, cells grow, divide, and die in a regulated manner. However, in bladder cancer, genetic mutations disrupt this process, causing cells to multiply rapidly and form a tumour. The majority of bladder cancers begin in the urothelial cells, which line the inner surface of the bladder. These cells are constantly exposed to waste products filtered by the kidneys, including toxins and chemicals from the body. Long-term exposure to carcinogens in urine can damage the DNA of urothelial cells, leading to mutations. Over time, these mutated cells may lose their ability to function normally, triggering continuous growth and eventually forming cancerous tumours.

The process typically follows these steps:

DNA mutations

Changes in the genetic code of urothelial cells lead to uncontrolled cellular growth and a failure to undergo normal cell death (apoptosis). These mutations can involve oncogenes, which promote cancer cell growth, or tumour suppressor genes, which normally inhibit such growth.

Abnormal cell division
The mutated cells begin to divide uncontrollably. In normal tissues, cell division is carefully regulated, but in bladder cancer, the control mechanisms fail, resulting in the formation of a tumour.
Tumour formation
As the abnormal cells accumulate, they form a mass, which can invade nearby tissues. In its early stages, bladder cancer typically remains confined to the inner lining of the bladder. However, as it progresses, it can invade the deeper muscle layers and potentially spread to other parts of the body (metastasis).
The biological mechanisms behind bladder cancer progression can vary depending on the cancer’s type and grade, but the primary issue remains the accumulation of mutations that lead to the loss of cellular control mechanisms, causing unchecked growth and tumour formation.

What are the symptoms of bladder cancer?

  • Blood in the urine (hematuria), often painless and intermittent
  • Frequent need to urinate
  • Pain or burning sensation during urination
  • Feeling the urge to urinate but being unable to do so
  • Lower back pain, usually on one side
  • Unexplained weight loss or loss of appetite (in advanced stages)
  • Fatigue or weakness (in advanced stages)
If you experience any of these symptoms, it’s important to consult a urologist for further evaluation.
Bladder Cancer Symptoms Singapore
Bladder cancer symptoms often include blood in the urine, frequent or painful urination, and lower back pain.

Who is at risk of bladder cancer in Singapore?

Bladder cancer can affect anyone, but certain factors can increase the likelihood of developing the disease. In Singapore, some common risk factors are linked to lifestyle choices and environmental exposures.
Smoking

The leading cause of bladder cancer, smokers are up to three to four times more likely to develop the disease.

Chemical exposure

Workers in industries such as dye, rubber, leather, and paint may face higher risks due to exposure to carcinogenic chemicals.

Age

Most bladder cancer cases occur in individuals over the age of 55.

Gender

Men are more likely to develop bladder cancer than women.

Previous cancer treatments

Chemotherapy or radiation treatments for other cancers can increase the risk.

Chronic bladder inflammation

Conditions like recurrent urinary infections (link to service page ‘UIT’) or prolonged catheter use may elevate risk levels.

Family history

A family history of bladder cancer may increase your likelihood of developing it.

How is bladder cancer diagnosed?

At Allen Sim Urology, we understand that an early and accurate diagnosis is crucial for effectively treating bladder cancer. We are committed to providing comprehensive care, and uses advanced diagnostic techniques to ensure you receive the best possible treatment plan.
Cystoscopy Singapore
A cystoscopy allows your doctor to visually examine the bladder’s interior by inserting a small camera through the urethra, which helps them detect early signs of bladder cancer or other structural abnormalities.

Common methods for diagnosing bladder cancer include:

This is one of the most common and effective ways to examine the bladder. Our experienced urologist inserts a small camera attached to a thin tube through the urethra to visually inspect the bladder lining. If needed, our healthcare team may also take tissue samples (biopsies) during this procedure.

We analyse a sample of your urine to detect cancerous cells. This test can help identify the presence of cancer cells that are shed into the urine.

We may use imaging techniques like CT urograms or MRI scans to get detailed pictures of the bladder and surrounding structures, which helps us identify any abnormalities or the extent of cancer.

If an abnormality is detected, we may perform a biopsy to confirm whether it’s cancerous. This involves taking a small tissue sample from the bladder lining for lab analysis.

What are the treatment options for bladder cancer in Singapore?

At Allen Sim Urology, we focus on the type, stage, and grade of the cancer, as well as your overall health and preferences while developing a treatment plan tailored to your needs. Common treatments include:

Transurethral Resection of Bladder Tumour (TURBT)

For early-stage bladder cancer, TURBT can be performed to remove tumours from the bladder lining. This minimally invasive procedure uses a cystoscope to access the bladder without making any incisions.

Intravesical therapy

To prevent the recurrence of cancer after TURBT, we may recommend intravesical therapy. This involves delivering chemotherapy or immunotherapy drugs directly into the bladder to target cancer cells.

Radical or Partial Cystectomy

For more advanced cancers, surgery to remove part or all of the bladder may be necessary. We specialise in both partial cystectomy, which removes only the tumour-affected portion, and radical cystectomy, which involves the complete removal of the bladder and surrounding lymph nodes.

Chemotherapy

Chemotherapy can be administered before or after surgery to shrink the tumour or reduce the risk of recurrence.

Radiation therapy

Radiation is another effective option, especially for patients who may not be suited for surgery. We provide advanced radiation therapy to target and kill cancer cells while preserving surrounding healthy tissue.

Immunotherapy

For certain types of bladder cancer, we suggest immunotherapy to boost your body’s natural defences to fight cancer. BCG therapy is one of the most effective immunotherapies for bladder cancer that remains confined to the bladder lining.

Radiation therapy

radiation is another effective option, especially for patients who may not be suited for surgery. We provide advanced radiation therapy to target and kill cancer cells while preserving surrounding healthy tissue.
Listen to your body. If you’re experiencing any symptoms or have concerns about bladder cancer, consult a Urologist. Schedule a consultation with us for a comprehensive diagnosis and personalised treatment plan.

Frequently Asked Questions (FAQs)

Bladder cancer is highly treatable, especially when detected early. Non-muscle-invasive bladder cancer, in particular, has a good prognosis, but more advanced stages may require more aggressive treatments. Regular follow-ups are essential to monitor recurrence.

The survival rate depends on the stage at diagnosis. More than 50% of people diagnosed with bladder cancer live for 5 years or more, while about 45% survive for 10 years or more after diagnosis​.

Yes, bladder cancer has one of the highest recurrence rates among cancers. Between 50-80% of patients may experience recurrence, which is why close monitoring through regular cystoscopies and urine tests is crucial.

Bladder cancer’s spread depends on the type and grade. While non-muscle-invasive cancers are less likely to spread, aggressive forms like muscle-invasive bladder cancer and small cell carcinoma can spread more rapidly to other parts of the body, including lymph nodes and distant organs.

If a radical cystectomy (bladder removal) is necessary, patients will need a urinary diversion. Options include a neobladder, where a new bladder is constructed using intestinal tissue, or an ileal conduit, which diverts urine into an external pouch.