The urinary tract is made up of the kidneys, ureters, bladder and urethra. The bladder is lined with a layer of cells called the urothelium, which is separated from the bladder wall muscles by a thin, fibrous band called the lamina propria. Bladder cancer is a common type of cancer that most often begins in the (urothelial cells) that line the inside of the bladder.

Bladder Cancer Treatment In Malaysia

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Booklet all about Bladder Cancer Treatment In Malaysia
  • Foreword
  • Overview of bladder cancer
  • Risk factors linked to bladder cancer
  • Signs and symptoms of bladder cancer
  • Diagnosing bladder cancer
  • Stages of bladder cancer
  • Treatment strategies for bladder cancer
  • What to expect post-treatment?
  • Resuming routine function after bladder cancer 


Types of bladder cancer

The 3 main types of bladder cancer are:

Urothelial carcinoma

accounts for about 90% of all bladder cancers and is also called transitional cell carcinoma.

Squamous cell carcinoma

accounts for about 4% of all bladder cancers.


accounts for about 2% of all bladder cancers and develops from glandular cells.

Sarcoma and small cell

bladder cancer are much less common types of bladder cancer.

Bladder cancer may be described as non-muscle-invasive, or muscle-invasive.

Non-muscle-invasive bladder cancer typically has grown only into the lamina propria and not into muscle, also called stage I.


Muscle-invasive bladder cancer has grown into the bladder's wall muscle and into the surrounding tissue outside the bladder.

Risk Factors

The following factors may raise a person’s risk of developing bladder cancer.

Tobacco use
Smokers are 4 to 7 times more likely to develop bladder cancer than nonsmokers.
More than 70% of people with bladder cancer are older than 65.
Men are 4 times more likely to develop bladder cancer than women.
Used in the textile, rubber, leather, dye, paint, and print industries can increase the risk of bladder cancer.
Chronic bladder problems
Such as bladder stones and infections may increase the risk of bladder cancer.
People who have some forms of this parasitic disease are more likely to develop squamous cell bladder cancer.
Lynch syndrome
Is an inherited condition, associated with DNA mismatch repair defect. People with Lynch syndrome have an increased risk of developing bladder cancer.
When found in drinking water has been associated with an increased risk of bladder cancer.


Symptoms and signs of bladder cancer

  • Blood or blood clots in the urine
  • Pain or burning sensation during urination
  • Frequent urination
  • Feeling the need to urinate many times throughout the night
  • Feeling the need to urinate, but not being able to pass urine
  • Lower back pain
  • Unexplained appetite loss, and weight loss


Diagnosis of bladder cancer

Cystoscopy can detect growths in the bladder and determine the need for a biopsy or surgery.

Biopsy, If abnormal tissue is found during a cystoscopy, a biopsy will be carried out

Transurethral resection of bladder tumor (TURBT) allows the removal of the tumor and a sample of the bladder muscle near the tumor. TURBT is used to diagnose bladder cancer and find out the type of tumor, how deeply it has grown into the layers of the bladder, and identify any additional microscopic cancerous changes, called carcinoma in situ.


Stages of bladder cancer

Stage 1 bladder cancer

The cancer has grown through the inner lining of the bladder and only into the lamina propria.

Stage 2 bladder cancer

The cancer has spread into the thick muscle wall of the bladder. It is also called muscle-invasive cancer.

Stage 3 bladder cancer

The cancer has spread through the muscle wall into the tissues around the bladder.


  • Stage 3a: The tumor has grown into the perivesical tissue or has spread into the prostate, uterus, or vagina.
  • Stage 3b: The cancer has spread into 2 or more regional lymph nodes.


Stage 4 bladder cancer

The tumor has spread into the pelvic wall or abdominal wall, or to lymph nodes outside of the pelvis or to other parts of the body.



Talk to our bladder cancer oncologists at Onco Life Centre about your treatment options. The main treatments for bladder cancer are surgery, chemotherapy, targeted therapy, immunotherapy and radiation therapy. Often the best approach uses 2 or more of these treatment methods. It is important that you understand the goal of your treatment. If a cure is not possible, treatment is aimed at relieving symptoms such as pain.


Surgery for bladder cancer

Transurethral bladder tumor resection may be able to eliminate non-muscle-invasive bladder cancer.

Radical cystectomy and lymph node dissection is the removal of the whole bladder. For men, the prostate and urethra also may be removed. For women, the uterus, fallopian tubes, ovaries, and part of the vagina may be removed. For all patients, lymph nodes in the pelvis are removed, called pelvic lymph node dissection. If the bladder is removed, a section of the small intestine or colon will be used to divert urine to a stoma on the outside of the body.

Systemic therapies for bladder cancer

The types of systemic therapies used for bladder cancer include Chemotherapy, Immunotherapy and Targeted therapy.

Chemotherapy for bladder cancer can be intravesical or systemic. During intravesical chemotherapy, drugs are delivered into the bladder through a catheter that has been inserted through the urethra to destroy superficial tumor cells that come in contact with the chemotherapy solution. In systemic chemotherapy, a combination of drugs works better than 1 drug alone.

Immunotherapy for bladder cancer is designed to boost the body’s natural defenses to fight the cancer. Immune checkpoint inhibitors block a protein called PD-1. PD-1 is found on the surface of T cells and keeps the immune system from destroying cancer cells. Thus, stopping PD-1 from working allows the immune system to better eliminate the cancer. These are new treatments for bladder cancer approved by the US-FDA. Neoadjuvant immunotherapy for bladder cancer is administered before surgery to reduce the size of the tumor. Adjuvant immunotherapy for bladder cancer may be used after surgery to reduce the risk of the cancer coming back. Our bladder cancer specialists will be able to advise on the use of adjuvant and neoadjuvant immunotherapy.

Please click here to learn more about Immunotherapy


Targeted therapy for bladder cancer targets the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival to block the growth and spread of cancer cells while limiting damage to healthy cells. A type of targeted therapy for metastatic bladder cancer (eg. for patients with metastatic urothelial carcinoma with FGFR3 or FGFR2 genetic mutations) has been approved for use after receiving platinum chemotherapy.

Please click here to learn more about Targeted Therapy


Radiation therapy for bladder cancer

The most common type of radiation treatment for bladder cancer is called external-beam radiation therapy. Combined radiation therapy and chemotherapy may be used to treat cancer that is located only in the bladder to destroy any cancer cells that may remain after TURBT, to relieve symptoms caused by a tumor, such as pain, bleeding, or blockage, to treat brain or bone metastasis.


Our Best Bladder Cancer Oncologist

Onco Life Centre combines key elements of bladder cancer care and bladder cancer treatment under one roof, with convenience and speed. At Onco Life Centre, we have the necessary medical disciplines to achieve this. Our board certified highly experienced consultant oncologists have earned recognition for excellence in the field of bladder cancer treatment, providing our patients with the most advanced bladder cancer treatment options.


Dr. Christina Ng is a Consultant Medical Oncologist and Founder President of Empowered, The Cancer Advocacy Society of Malaysia.…


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Cost of bladder cancer treatment

Treatment cost for bladder cancer depends on several factors, such as the staging and the type of the bladder cancer. Generally, using only chemotherapy is cheaper compared to using targeted therapy or immunotherapy. The more advanced the cancer stage, the more expensive it becomes to treat the cancer. At Onco Life Centre, the cost for treating bladder cancer using chemotherapy for most of our patients is around MYR5,000 per cycle. The cost of bladder cancer immunotherapy can range from MYR10,000 and above depending on the specific type and dosage of immunotherapy drug used.


Patients and their families have opportunities to talk about the way they are feeling with our oncologists, nurses, counselors, or join our psychosocial program and support group at Onco Life Centre.

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