This map explains bladder and upper urinary tract cancer step by step: what it is, the types, the tests, the stages, the treatment and its side effects.
Tap any topic on the map to read about it. Topics with an arrow open more topics.
Tap a type on the map.
Why this matters: non-muscle-invasive cancer is treated inside the bladder; muscle-invasive cancer needs major treatment.
About 75 out of 100. Limited to the lining (Ta, T1 or carcinoma in situ). Often comes back, so regular checks are needed, but rarely becomes life-threatening if well treated.
Grown into the muscle of the bladder wall (T2 or more). Needs surgery or chemoradiotherapy with chemotherapy.
In the kidney pelvis or ureter. Usually treated by removing the kidney and ureter (nephroureterectomy), sometimes with chemotherapy.
Tap a test on the map to see why it is done.
Please wait for all the reports. Why we wait
A thin camera passed into the bladder through the urethra, usually under local anaesthesia, to look for tumours.
Removal of the tumour through the urethra under anaesthesia. It is both diagnosis and treatment, and shows whether the muscle is involved. Sometimes repeated after a few weeks.
CT urogram checks the kidneys, ureters and spread. MRI helps judge depth in the bladder wall.
Looks for cancer cells in the urine; useful for high-grade cancer and the upper tract.
In advanced cancer: FGFR3 mutation (erdafitinib), HER2 and PD-L1.
Before starting chemotherapy, immunotherapy or targeted therapy, these tests check that you are fit for treatment, and give a starting point to compare with later.
| Test | Why it is done |
|---|---|
| CBC (complete blood count) | Haemoglobin, white cells and platelets. Treatment can lower them. |
| RFT (kidney function) | Many medicines are cleared by the kidneys; the dose may need to change. |
| LFT (liver function) | Many medicines are processed by the liver. |
| Viral markers: HBsAg, anti-HCV, HIV | Hepatitis B can flare up during treatment. If positive, a tablet is given to prevent this. |
| Blood sugar (and HbA1c if diabetic) | Steroids given with chemotherapy can raise blood sugar. |
| ECG and 2D Echo | Check the heart rhythm and pumping before treatment, as some medicines affect the heart. |
Before immunotherapy, also:
| Test | Why it is done |
|---|---|
| Serum TSH (thyroid) | Immunotherapy can affect the thyroid gland. |
| Serum cortisol (morning sample) | Immunotherapy can affect the adrenal and pituitary glands. |
Sometimes needed, depending on your treatment:
Your doctor will choose the tests that apply to you. Some of them are repeated during treatment.
Tap your stage on the map.
Ta, T1 or carcinoma in situ (CIS): limited to the lining.
Grown into the muscle or through the bladder wall, possibly to nearby organs or pelvic lymph nodes. The aim is cure.
Spread to lymph nodes higher up or to other organs such as the lungs, liver or bones. Usually not curable; treatment controls it.
Tap your stage on the map.
Side effects: BCG
Side effects: chemotherapy · immunotherapy · surgery and urostomy
Side effects: enfortumab vedotin · immunotherapy · chemotherapy
Tap a treatment on the map.
Heavy blood in urine with clots or inability to pass urine, fever with chills, no urine from a urostomy, or fever of 38°C or more during chemotherapy need urgent care.
This information is general. Your own treatment plan may be different. Please discuss it with your doctor.
Written and medically reviewed by Dr Prathyusha Eaga, MD, DM (Medical Oncology). Last reviewed: 12 October 2026. Based on NCCN and ESMO guidelines.
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