What is bladder cancer?
A bladder tumour is a lump created by an abnormal and uncontrolled growth of cells. It can either be malignant (cancer­ous) or benign. Cancerous tumours can grow through your bladder and spread to other parts of your body (through the bloodstream or the lymph system) where they may grow and form secondary tumours. This spread of cancer is called a metastasis. Early detection of the tumours has significantly improved the survival rates however incidence rates are continuing to rise.

Who is at risk?
Bladder cancer occurs most commonly in people between 50 and 70 years of age. It is twice as common in men as in women. Bladder cancer is very rare in men and women younger than 40 years of age.

The two main risk factors known to increase the risk of developing bladder cancer include: (1) smoking, and (2) Occupational exposure to certain chemicals at work.

(1) Smoking
Tobacco consumption is the main life-style risk factor in western countries. Specific chemicals that cause bladder cancer have been found in cigarette smoke. Some of the carcinogens (cancer-causing chemicals) in tobacco smoke are absorbed from the lungs and get into the blood. From the blood, they are filtered by the kidneys and concentrated in the urine. These chemicals in the urine damage the urothelial cells that line the inside of the bladder. This damage increases the chance of cancer developing. It takes a long time for the chemicals to cause bladder cancer, and the more cigarettes smoked, the greater the risk.

(2) Occupational exposure to certain chemicals at work
Occupational exposure to certain industrial chemicals is one of the main causes of bladder cancer. Some workers will have an increased risk of getting bladder cancer due to carcinogens (cancer- causing substances) in the work place. Aromatic amines (including amongst others 4-Aminobiphenyl (xenylamine), ß-naphthylamine, Benzidine, Auramine and magenta (in manufacture only)) are one of the best known and most studied of chemical carcinogens.

The bladder is the main target organ. It can take approximately 25 years after the exposure to certain chemicals before a bladder cancer is likely to develop. If you believe that you may have been exposed to particular chemicals through your occupation you should inform your cancer doctor. You could be entitled to claim Industrial Disease Benefit from the De­partment of Social Security.

Occupations causally associated with bladder cancer

• Rubber workers
  (in tyre, tube, and cable making)
• Textile dyeing
• Printing industry (especially if working with a substance called ‘carbon black’ that is used to make inks).
• Manufacture of some chemicals
  (such as MbOCA)
• Gas workers (in old vertical retort houses)
• Laboratory and testing work (using chromogens)
• Rodent controllers
  (formally using ANTU ((alpha)-naphthylthiourea)
• Painters and decorators
• Mechanics
• Miners
• Leather workers
• Manufacture of patent fuel
  (such as coke) and firelighters
• Tar and pitch workers
  (roofing and road maintenance)
• Aluminium refining
• Truck Drivers
  (exposure to diesel fumes)
• Clerical Workers
• Metal casters, machine setters and operators
• Hairdressing

Types of bladder cancer

There are several different types of bladder cancer.

Transitional cell carcinoma (TCC) is the most common type of cancer in the UK and starts in the layer of cells that forms the lining of the bladder.

Squamous cell carcinomas (SCC) originate in one of the types of cell in the bladder lining.

Adenocarcinomas originate in glandular cells.

Bladder cancer is also classified according to how far it has spread. If the cancer is only in the bladder lining, it is called a superficial cancer. If the cancer has spread to the muscle wall of the bladder it is called an invasive cancer.

Symptoms of bladder cancer

• Blood in the urine (the quantity of blood does not relate to the extent of the cancer).
• A burning feeling when passing urine.
• Passing urine more often than usual.
• Feeling the need to urinate without being able to do so.
• Pain in the pelvis.
• Lower back pain.
• It is important to note that these symptoms are normally a result of an infection rather than a cancer. It is extremely important that you visit your doctor to ensure accurate diagnosis and treatment.

Diagnosis and Treatment

Your doctor will ask you about your symptoms and will examine you. He or she may test your urine with a “dipstick” to look for blood and infection. Your doctor may refer you to a hospital specialist (urologist) for further tests including the following.

A flexible cystoscopy allows the urologist to see the inside of your bladder and detect abnormalities. If the urologist sees anything unusual in the bladder, you may be asked to return for a further cystoscopy, probably using a rigid cystoscope. This allows for special surgical instruments to also be passed into the bladder so that tissue samples (biopsies) can be taken and, if necessary, abnormalities removed. Samples taken are examined in a laboratory to see whether cancer cells are present and, if so, what kind of cells they are. A general anaesthetic is used for rigid cystoscopy.

An intravenous pyelogram (or urogram) examines the urinary system by using a dye that is injected into a vein. This dye is removed from the bloodstream (excreted) by the kidney as part of urine production. By taking X-ray pictures while the kidneys are excreting the dye, the urologist can see any abnormalities in the outline of your urinary system.

CT (computerised axial tomography), MRI (magnetic resonance imaging) and bone scans can help your doctor see how far the cancer has spread (if at all). A bone scan involves injecting a small amount of radioactive liquid into your vein. This can show if the cancer has spread to the bone.

The prognosis (chance of recovery) depends on the following:

• The stage of the cancer (whether it is superficial or invasive bladder cancer, and whether it has spread to other places in the body). Bladder cancer in the early stages can often be cured.
• The type of bladder cancer cells and how they look under a microscope.
• The patient’s age and general health.
• Treatment options depend on the stage of bladder cancer.

Compensation Advice

There are time limits to make a claim. If you or someone you know has developed bladder cancer, please contact us now for accurate claims advice. We will be happy to advise you and if you instruct us to deal with your case and we win, we will recover our legal fees from the person who injured you.

Case Study

Mr S worked for Boots as an assistant Chemist between 1946 and 1953. During this employment he had to prepare and use quantities of pure beta napthylamine for the Chester Beatty Research Institute without any safeguards being taken. Beta napthylamine is known to cause cancer and in 1998 he developed a bladder cancer. Mr S instructed us to bring a claim for compensation against Boots. A court action was started. Boots said that Mr S’s bladder cancer was caused by his smoking and not exposure to beta napthylamine. The case settled shortly before trial for the sum of £39,780.86.

What can John Pickering and Partners LLP do?

You may have a claim for compensation for dermatitis caused at work, if your employer has not done enough to stop you getting dermatitis.  If you think you have a claim, please get in touch.  We can also help you claim benefits from the Department for Work and Pensions.

We offer conditional fee agreements (also known as ‘no win, no fee’ agreements).  For a fuller explanation, please see our asbestos compensation guide.