Bladder cancer

For a lay person:

Bladder cancer starts in the lining of the bladder. Smoking is the biggest risk factor, along with workplace chemical exposure and long-term bladder irritation; aristolochic acid in some herbal products has also been linked to it. The most common sign is painless blood in the urine.

For a trained medical person:

Most are urothelial carcinomas, divided into non-muscle-invasive and muscle-invasive disease. Diagnosis is by cystoscopy with transurethral resection for histology and staging, plus CT urography of the upper tracts. Non-muscle-invasive disease is treated with resection and intravesical BCG or chemotherapy; muscle-invasive disease with cystectomy or bladder-preserving chemoradiotherapy, and systemic therapy for advanced disease.

In Chinese medicine:

Liu and Tseng's textbook differentiates this condition into these patterns: Lower Jiao Damp-Heat; Liver Qi Stagnation; Blood Stasis and Obstruction; Yin Deficiency and Deficient Fire; Spleen and Kidney Qi Deficiency; Internal Accumulation of Stasis and Toxins; Cancerous Toxins Traveling in Body; Qi and Blood Deficiency. Treatment follows the pattern a patient presents with, not the Western diagnosis alone.

When to get help: This needs specialist urology and oncology care; Chinese medicine is adjunctive at most. See a doctor for any blood in the urine, and avoid herbs that may contain aristolochic acid (for example some Guang Fang Ji or Guan Mu Tong products), which can harm the kidneys and urinary tract.