Bladder cancer
Smoking and visible haematuria, cystoscopy and CT urogram, non-muscle-invasive versus muscle-invasive disease, BCG and its complications, neoadjuvant cisplatin before cystectomy, and enfortumab vedotin with pembrolizumab for advanced urothelial cancer.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Urothelial carcinoma makes up about 90% of bladder cancers. It is commoner in men (about 3:1) and in older people, with a median age at diagnosis around 70.
- Painless visible haematuria is the presenting symptom in most patients. Any adult with it needs cystoscopy and upper tract imaging.
- The key split is non-muscle-invasive (NMIBC, about 75%), a recurring disease managed by urologists with resection and intravesical therapy, versus muscle-invasive (MIBC), which needs systemic chemotherapy plus cystectomy or chemoradiation.
Loading the rest of the note…
Finished reading?
Sources
- Optimal care pathway for people with bladder cancerAU/NZCancer Council Australia
- eviQ Cancer Treatments Online (genitourinary protocols)AU/NZCancer Institute NSW
- PBS Schedule: durvalumab (urothelial carcinoma, neoadjuvant then adjuvant), enfortumab vedotin (locally advanced or metastatic urothelial cancer) and avelumab (maintenance), checked November 2026AU/NZAustralian Government Department of Health, Disability and Ageing, 2026
- EAU Guidelines on Non-muscle-invasive Bladder CancerEuropean Association of Urology, 2026
- EAU Guidelines on Muscle-invasive and Metastatic Bladder CancerEuropean Association of Urology, 2026
- Powles T et al. Bladder cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Ann Oncol 2022;33:244-58European Society for Medical Oncology, 2022
- NCCN Clinical Practice Guidelines in Oncology, Bladder CancerNational Comprehensive Cancer Network
- Powles T et al. Enfortumab vedotin and pembrolizumab in untreated advanced urothelial cancer (EV-302). N Engl J Med 2024;390:875-88New England Journal of Medicine, 2024
- Powles T et al. Perioperative durvalumab with neoadjuvant chemotherapy in operable bladder cancer (NIAGARA). N Engl J Med 2024;391:1773-86New England Journal of Medicine, 2024
- Powles T et al. ctDNA-guided adjuvant atezolizumab in muscle-invasive bladder cancer (IMvigor011). N Engl J Med 2025;393:2395-2408New England Journal of Medicine, 2025
- Powles T et al. Avelumab maintenance therapy for advanced or metastatic urothelial carcinoma (JAVELIN Bladder 100). N Engl J Med 2020;383:1218-30New England Journal of Medicine, 2020
- Bajorin DF et al. Adjuvant nivolumab versus placebo in muscle-invasive urothelial carcinoma (CheckMate 274). N Engl J Med 2021;384:2102-14New England Journal of Medicine, 2021
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy