Ghatkopar (East), Mumbai)
Bladder Cancer
Blood in the urine - seen once and then gone - is the most common symptom of bladder cancer. It is also the most frequently ignored. Bladder cancer is the fifth most common cancer in India, and when caught early, it is among the most treatable. At Shree Hospitals, our uro-oncology team delivers expert bladder cancer treatment in Mumbai: from diagnostic cystoscopy and TURBT staging through to cystectomy and bladder reconstruction - with a multidisciplinary team that manages every patient from first symptom to long-term surveillance.
(24×7 Emergency Care)
Our Approach
(24×7 Emergency Care)
Our Approach In Managing Bladder Cancer
Stage precisely. Treat completely. Surveil rigorously.
Bladder cancer management is dictated almost entirely by stage - non-muscle-invasive disease and muscle-invasive disease are fundamentally different clinical entities with different treatments and different prognoses. Getting the staging right is everything.
- Initial Evaluation & Risk Assessment
All patients presenting with haematuria receive a structured urgent evaluation:
- Urine cytology - sensitive for high-grade disease; exfoliated tumour cells identified in a voided sample
- Flexible cystoscopy - direct visualisation of the bladder mucosa; identifies tumour location, size, and appearance
- CT urogram - upper tract assessment for ureteric or renal pelvic tumours; detects lymphadenopathy
- Risk stratification - age, sex, smoking history, occupational aniline dye or aromatic amine exposure
- TURBT - Transurethral Resection of Bladder Tumour
TURBT surgery Mumbai is simultaneously diagnostic and therapeutic for most bladder cancers:
- Endoscopic resection of the tumour and a sample of the underlying detrusor muscle under general anaesthesia
- Muscle sampling is mandatory to exclude muscle invasion - the most critical staging step
- Blue light cystoscopy (hexaminolevulinate HAL) - improves detection of flat, high-grade CIS lesions invisible under white light
- Re-TURBT at 4–6 weeks for T1 high-grade tumours - ensures complete resection and re-stages accurately
- Non-Muscle-Invasive Bladder Cancer (NMIBC) Treatment
NMIBC (Ta, T1, CIS) is treated endoscopically with adjuvant intravesical therapy:
- Low-risk disease - single-dose mitomycin C at TURBT; cystoscopy at 3 months
- Intermediate-risk - 6-week induction course of intravesical mitomycin C followed by maintenance
- High-risk NMIBC (T1 HG, CIS) - BCG induction (6 weekly instillations) plus 1–3 years maintenance BCG therapy
- BCG failure - consideration of early cystectomy vs. alternative intravesical agents (pembrolizumab, nadofaragene)
- Muscle-Invasive Bladder Cancer (MIBC) - Staging & Planning
Muscle-invasive disease (T2–T4) requires restaging and multidisciplinary planning:
- CT chest-abdomen-pelvis for lymph node and distant metastasis assessment
- PSMA or FDG PET-CT in selected patients - improving staging accuracy for nodal disease
- Cystectomy and neobladder vs. bladder-sparing trimodality therapy - discussed at tumour board
- Pre-operative cisplatin-based neoadjuvant chemotherapy - improves survival for eligible MIBC patients
- Radical Cystectomy & Urinary Diversion
The standard treatment for MIBC without distant metastases:
- Laparoscopic or robotic-assisted radical cystectomy - removal of bladder, prostate (men) or uterus/vagina (women) and pelvic lymph nodes
- Cystectomy and neobladder reconstruction - creating a new bladder from a segment of ileum; enables urethral voiding
- Ileal conduit - urostomy using a short segment of ileum; simpler, more reliable for older or high-risk patients
- Indiana pouch - continent cutaneous diversion; catheterised via a stoma; no external bag required
- Trimodality Therapy - Bladder Preservation
Selected MIBC patients can achieve bladder preservation with equivalent cancer outcomes:
- Maximal TURBT to remove as much visible tumour as possible
- Concurrent chemoradiotherapy - cisplatin or gemcitabine sensitises tumour cells to radiation
- Bladder cancer surveillance cystoscopy at 3 months post-treatment - confirms complete response
- Salvage cystectomy offered promptly for incomplete response or recurrence
- Systemic Therapy for Metastatic Bladder Cancer
For locally advanced unresectable or metastatic transitional cell carcinoma:
- First-line: cisplatin-based combination chemotherapy (GC or MVAC)
- Checkpoint immunotherapy - pembrolizumab or atezolizumab for cisplatin-ineligible patients or second-line
- Enfortumab vedotin + pembrolizumab - emerging first-line standard for metastatic urothelial cancer
- FGFR3-inhibitor (erdafitinib) for FGFR3-altered tumours - precision oncology for selected patients
Happy Patients & Their Case Stories
I had one episode of blood in the urine and almost didn't go to the doctor. The team here found a low-grade bladder tumour early - TURBT done, BCG completed. Three years of surveillance - still clear.
Mr. Mahesh Kulkarni
I needed a cystectomy and was terrified about quality of life. The bladder cancer specialist in Mumbai India team created a neobladder - I urinate normally and have no bag. That outcome exceeded every expectation.
Mr. Dilip Deshmukh
How To Identify Bladder Cancer?
The most important sign of bladder cancer is often dismissed or attributed to infection:
Primary Symptoms:
- Painless blood in the urine - visible haematuria, typically intermittent; may appear once and then disappear for weeks or months before returning
- Microscopic haematuria - blood only detectable on urine testing; equally important as a warning sign
- Urinary frequency and urgency without an identified infection - may indicate carcinoma in situ (CIS)
- Burning on urination - particularly in flat, high-grade CIS that mimics a UTI
Symptoms of Locally Advanced Disease:
- Flank pain - from ureteric obstruction by a bladder tumour at the ureteric orifice
- Pelvic pain or mass - from locally advanced disease
- Lower limb oedema - from pelvic lymph node involvement
Risk Factors to Know:
- Smoking - the single biggest modifiable risk factor; smokers have 3x higher bladder cancer risk
- Occupational exposures - aniline dyes (rubber, textile, printing industries), aromatic amines, arsenic
- Age over 60 - peak incidence in the sixth and seventh decades
- Male sex - bladder cancer is 3–4x more common in men
Any adult - particularly a smoker over 50 - with visible blood in the urine requires urgent TURBT surgery Mumbai workup. Do not accept repeated antibiotic prescriptions as a response to recurrent haematuria.
Treatments For Bladder Cancer At Shree Hospitals
TURBT (Transurethral Resection of Bladder Tumour)
Endoscopic resection of bladder tumours - simultaneously removes the cancer and provides the pathological staging essential to guide all subsequent treatment decisions.
Intravesical BCG Therapy
Weekly instillations of Bacillus Calmette-Guérin (BCG) directly into the bladder - the most effective treatment for high-risk non-muscle-invasive bladder cancer; reduces recurrence and prevents progression.
Intravesical Chemotherapy (Mitomycin C)
Chemotherapy instilled directly into the bladder - immediately after TURBT (single dose) or as a 6-week course for intermediate-risk disease to prevent tumour reimplantation and recurrence.
Radical Cystectomy (Laparoscopic / Robotic)
Removal of the bladder and surrounding structures for muscle-invasive disease - followed by neobladder construction or ileal conduit for urinary diversion. Curative intent surgery.
Top Urologists In Mumbai Now At Shree Hospitals
Dr. Neeraj Singh
Consultant Neurosurgeon & Neurointerventional Specialist
Dr. Natasha Tipnis
Temporal Lobe & Focal Epilepsies, Stroke Management
Dr. Akash Chedda
Epilepsy Diagnosis
Dr. Aditya Chandrashekhar Aundhakar
Head, Memory & Dementia Clinic
Consultant Neurologist & Cognitive Neurologist
Every doctor and specialist at Shree Hospitals is board-certified and brings an average of 15 or more years of clinical experience in their area of subspecialty.
For Appointment/Query
1800-268-4000
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Important FAQs: Bladder Cancer
Is bladder cancer curable?
Yes - when detected at an early stage. Non-muscle-invasive bladder cancer (NMIBC) - the most common type - has a 5-year survival rate exceeding 90% with appropriate TURBT and intravesical therapy. Muscle-invasive disease treated with radical cystectomy has a 5-year survival of 50–60% for pathological stage T2 disease. The critical factor is prompt diagnosis. Any episode of painless haematuria in an adult deserves urgent bladder cancer treatment in Mumbai evaluation.
What is TURBT and will I need to repeat it?
TURBT surgery Mumbai (Transurethral Resection of Bladder Tumour) is an endoscopic procedure that removes visible bladder tumours and provides tissue for staging. Re-TURBT - a repeat resection 4–6 weeks later - is recommended for T1 high-grade tumours to ensure complete initial resection and confirm the staging. Re-TURBT has been shown to upstage approximately 25% of T1 HG tumours and significantly reduces recurrence risk.
What is BCG treatment and what does it involve?
BCG (Bacillus Calmette-Guérin) is a modified tuberculosis bacteria instilled directly into the bladder via a catheter - it stimulates a local immune response that attacks remaining tumour cells. It is given as a 6-week induction course, then as maintenance instillations over 1–3 years for high-risk disease. Side effects include bladder irritation, urgency, and frequency. BCG is the most effective treatment available for high-risk non-muscle-invasive bladder cancer surveillance and significantly reduces both recurrence and progression to muscle invasion.
What happens after a cystectomy - how do I urinate?
After bladder removal, urine must be diverted through an alternative pathway. The three main options are: an ileal conduit (a short segment of bowel used to bring urine to a stoma bag on the abdomen - simple and reliable), a neobladder (cystectomy and neobladder reconstruction - a new pouch created from bowel, connected to the urethra, allowing normal voiding), and a continent cutaneous diversion (an internal pouch self-catheterised through a stoma). Our team discusses all options in detail pre-operatively so you make an informed choice.
How often do I need follow-up after bladder cancer treatment?
Bladder cancer surveillance is lifelong - bladder cancer has one of the highest recurrence rates of any cancer. For non-muscle-invasive disease, cystoscopy is performed at 3 months post-TURBT, then every 3–6 months for the first 2 years, then every 6–12 months indefinitely. Urine cytology is checked at each visit. Upper tract imaging is repeated annually for higher-risk disease. Missing surveillance appointments significantly increases the risk of undetected progression to muscle-invasive disease.
(24×7 Emergency Care)
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