Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 9 July 2026
Bladder cancer is one of the more common urological cancers, yet it receives far less public awareness than prostate or kidney cancer. Because its main symptom — blood in the urine — is often painless and intermittent, diagnosis can be delayed. This guide covers the warning signs, how bladder cancer is diagnosed, and the full range of treatment options available in Melbourne.
What Is Bladder Cancer?
Bladder cancer develops in the cells lining the inside of the bladder (the urothelium). The vast majority are urothelial carcinomas. Bladder cancer is classified by how deeply it has invaded the bladder wall:
- Non-muscle-invasive bladder cancer (NMIBC) — confined to the inner lining, accounting for approximately 75% of new diagnoses
- Muscle-invasive bladder cancer (MIBC) — has grown into the muscular wall of the bladder, requiring more aggressive treatment
Signs and Symptoms
- Painless visible blood in the urine — the most common presenting symptom, often intermittent
- Microscopic blood found incidentally on a urine test
- Increased urinary frequency or urgency without evidence of infection
- Pain on urination in some cases, mimicking a urinary tract infection
- Flank pain or swelling if the tumour is blocking the flow of urine from a kidney
For a detailed explanation of why blood in the urine should never be ignored, see our related guide on haematuria and when to see a urologist.
Risk Factors
- Smoking — the leading risk factor, responsible for roughly half of all bladder cancer cases
- Occupational exposure — chemicals used in dye, rubber, leather and printing industries
- Age — most commonly diagnosed in people over 60
- Chronic bladder inflammation — including recurrent infections or long-term catheter use
- Prior pelvic radiation
Diagnosis
Cystoscopy
Cystoscopy is the cornerstone of bladder cancer diagnosis. A thin telescope is passed into the bladder via the urethra to directly visualise the bladder lining and identify any suspicious lesions.
Imaging
A CT urogram is typically performed to assess the kidneys and ureters for additional tumours and to check for any spread beyond the bladder.
TURBT
Transurethral resection of bladder tumour (TURBT) is performed under general or spinal anaesthetic. The tumour is resected using a resectoscope passed through the urethra, and the tissue is sent for pathological analysis to determine the grade and depth of invasion — information that guides all further treatment decisions.
Treatment Options
Non-Muscle-Invasive Bladder Cancer
After TURBT, low-risk tumours may only require cystoscopic surveillance. Higher-risk non-muscle-invasive tumours are typically treated with a course of intravesical therapy — medication instilled directly into the bladder — such as BCG immunotherapy or mitomycin C, to reduce the risk of recurrence and progression.
Muscle-Invasive Bladder Cancer
Muscle-invasive disease generally requires more definitive treatment. The standard of care is robotic radical cystectomy — removal of the entire bladder (and prostate in men) — combined with urinary diversion, either an ileal conduit (a stoma bag) or a neobladder (a reconstructed internal reservoir allowing near-normal voiding). A course of chemotherapy before surgery is often recommended to improve long-term outcomes. Our detailed guide to robotic radical cystectomy, ileal conduit and neobladder reconstruction covers this pathway in depth.
Comparing Treatment Pathways
| Stage | Typical Treatment | Bladder Preserved? |
|---|---|---|
| Low-risk NMIBC | TURBT + surveillance | Yes |
| High-risk NMIBC | TURBT + BCG/mitomycin instillation | Yes |
| Muscle-invasive | Chemotherapy + robotic radical cystectomy | No — urinary diversion required |
Dr Dias' Approach to Bladder Cancer
Dr Brendan Dias offers the complete bladder cancer pathway in Melbourne, from initial cystoscopy and TURBT through to complex robotic reconstructive surgery for muscle-invasive disease. He works closely with medical oncologists to coordinate chemotherapy when needed and provides structured follow-up to detect and treat recurrences early.
Frequently Asked Questions
What is the first sign of bladder cancer?
The most common first sign is painless blood in the urine (haematuria), which may be visible or only detectable on a urine test. Other early symptoms can include increased urinary frequency or urgency without infection.
Is bladder cancer curable?
Many bladder cancers are curable, especially when caught early. Non-muscle-invasive bladder cancer (confined to the bladder lining) has a good prognosis with resection and surveillance, while muscle-invasive bladder cancer requires more aggressive treatment such as radical cystectomy but can still be cured in many cases.
What is a TURBT?
Transurethral resection of bladder tumour (TURBT) is a surgical procedure performed via cystoscope to remove and biopsy a bladder tumour. It is both diagnostic (determining the tumour grade and depth of invasion) and therapeutic (removing visible tumour).
What is robotic cystectomy?
Robotic radical cystectomy is the surgical removal of the entire bladder (and prostate in men) using the da Vinci robotic system, performed for muscle-invasive bladder cancer or high-risk non-muscle-invasive disease. Urinary diversion is created using either an ileal conduit or a neobladder.
Does smoking cause bladder cancer?
Yes. Smoking is the single biggest risk factor for bladder cancer, responsible for approximately half of all cases. Chemicals from cigarette smoke are absorbed into the bloodstream, filtered by the kidneys, and concentrated in the urine, where they can damage the bladder lining over years.
Does Dr Dias treat bladder cancer in Melbourne?
Yes. Dr Brendan Dias provides the complete pathway for bladder cancer in Melbourne, from cystoscopy and TURBT through to robotic radical cystectomy with ileal conduit or neobladder reconstruction.
The Bottom Line
Bladder cancer is highly treatable when detected early, and painless blood in the urine should always prompt prompt assessment. If you notice blood in your urine or have risk factors such as a smoking history, speak to your GP about referral for cystoscopy. Early diagnosis allows for bladder-preserving treatment in the majority of cases.