A treatment given after the main treatment to reduce the risk of recurrence.

Detrimental change in health occurring in a person receiving the treatment whether or not it has been caused by the treatment.

A plastic tube (stent) placed between the kidney and the bladder, within the body's own drainage pipe (the ureter), inserted using access to the kidney, gained through the skin, to relieve a blockage..

Without obvious signs or symptoms of disease. Cancer may cause symptoms and warning signs, but, especially in its early stages, cancer may develop and grow without producing any symptoms.

Originally developed as a vaccine against tuberculosis, BCG is made from modified bacteria from the same family as the tuberculosis bacteria, and is used in the treatment of bladder cancer by instilling it into the bladder through a catheter. It does not contain tuberculosis bacteria and tuberculosis cannot be caught from BCG vaccine.

Substances found in the blood, other body fluids or tissues. They may be associated with the presence of a certain type of cancer in the body, or may act as a prognostic indicator.

Removal of a sample of tissue from the body to assist in diagnosis or inform the treatment of a disease.

An operation that reconstructs the bladder using bowel after the bladder has been removed surgically (radical cystectomy).

Replacement of the bladder with a reservoir made from bowel, connected to the urethra, to allow urine to be stored and passed in a more or less normal way.

Cancer that has spread to the bone

A diagnostic imaging technique based on the detection of radiation emitted by a radioactive tracer injected into the body. The tracer is preferentially taken up by bone according to the metabolic activity of the bone and this may help to identify areas of disease, such as cancer.

Cancer networks became part of Strategic Clinical Networks, serving larger populations, in April 2013.

A group of cancers which arise from the lining tissues of the body and are the most common type of cancer in humans.

In the bladder, this means aggressive malignant cells spreading in flat patches within the surface lining (urothelium) of the bladder.

A document that details the care and treatment that a person/user receives and identifies who delivers the care and treatment and where this will be delivered.

The use of medication (drugs) that is toxic to cancer cells, given with the aim of killing the cells or preventing or slowing their growth.

The extent to which an intervention produces an overall health benefit in routine clinical practice.

Research studies in which groups of patients with a particular condition or specific characteristic are compared with matched groups who do not have it.

The effect of all other diseases an individual person might have other than the primary disease of interest.

Imaging technique in which the person lies on a table within a x-ray gantry. The images are acquired using a spiral (helical) path and banks of detectors, allowing presentation of the internal organs and blood vessels in different projections including 3-D views.

Examination of the bladder using either a rigid metal or fibreoptic telescope passed into the bladder usually via the urethra (waterpipe).

The microscopic analysis of cells from body fluids or organs, to help to identify and/or assess disease. In the case of urine cytology this refers to the characterisation and enumeration of cells that appear in the urine.

The Diagnostic odds ratio (DOR of a test is the ratio of the odds of a positive test in someone with a disease relative to the odds of a positive test in someone without the disease.

An operation done by an X-ray specialist (radiologist) who gains access to the arterial system using a fine plastic tube (catheter) through which material is passed to block the blood supply to an area of tissue. This is usually done to stop bleeding by blocking the blood vessels that supply that tissue that is bleeding.

This is radiotherapy given by using ionising radiation (e.g. high energy X-rays) produced in a machine and directed at the tumour from outside the person.

An individual who is truly positive for a disease, but who a diagnostic test classifies as disease-free

An individual who is truly disease-free, but who a diagnostic test classifies as having the disease

A scan that uses a radioactive tracer and combines scanning based on the metabolic activity of a given tissue with CT scan images. It is used to try to identify cancer.

Cystoscopy done using a fibreoptic cystoscope, usually under local anaesthesia.

A molecular test that is performed on biopsy or cytology samples. Different molecular labels are applied so that specific genes on the chromosomes show up in different fluorescent colours. The test can be used to show the presence or absence of extra copies of these genes.

Destruction of tissue using diathermy (cautery), generated by passing an electric current through an electrode. Fulguration can be used to destroy bladder cancers, usually at the time of cystoscopy.

The GRADE approach is a method of grading the quality of evidence and strength of recommendations in healthcare guidelines. It is developed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group.

The degree of malignancy of a cancer, judged by its appearance under the microscope. High grade reflects a more aggressive-looking cancer than low grade.

Unit of radiotherapy dose

The presence of blood in the urine. It can be visible, or only detectable by urine testing (non-visible haematuria), depending on the amount of blood in the urine.

A term used to describe the amount of difference between results or effects.

Cancer in the surface lining (urothelium) or connective tissue layer (lamina propria) of the bladder, deemed to be at high risk of subsequent spread into or beyond the muscle wall of the bladder.

Examination of tissue using a microscope

An individualised package of information and support for people with cancer and, if they wish, their partners, families or carers.

A trade name applied to a specific test that can be applied to urine samples to try to label and identify cancer cells.

The use of medication or vaccines to manipulate a person's immune system to fight disease.

The number of new cases of a disease in a given time period

The difference in the mean costs in the population of interest divided by the differences in the mean outcomes in the population of interest for one treatment compared with another.

These provide up-to-date and accurate information from the NHS and from patient organisations about a persons condition and treatment options; local care services (ranging from the local GP surgery, to equipment to help you get around the house, to specialised exercise classes); benefits a person may be able to claim; housing support; self help and support groups. Information prescriptions also provide useful contact details and website addresses.

Cancer in the surface lining (urothelium) or connective tissue layer (lamina propria) of the bladder, deemed to be at moderate risk of subsequent spread into or beyond the muscle wall of the bladder.

Bleeding which cannot be stopped by conventional means.

Treatment given into the bladder by instillation through a catheter.

A type of X-ray that uses an injected intravenous contrast agent that is excreted by the kidneys into the urine, thus outlining the kidneys, ureters and bladder when X-rays images are taken.

The connective tissue layer of bladder. It lies between the lining of the bladder (urothelium) and the main muscle wall of the bladder (detrusor muscle).

A bias seen in epidemiology studies of survival resulting from differences in the time point at which the disease is first diagnosed which leads to an apparent improvement in survival of the group detected earlier.

The reappearance of cancer cells after treatment, close to where the cancer was originally found, as opposed to spread to elsewhere in the body (metastasis). In bladder cancer, if cancer comes back anywhere within the bladder, this is regarded as recurrence.

Bladder cancer that has started to invade into the surrounding structures and / or the lymph nodes in the pelvis or beyond.

Cancer in the surface lining (urothelium) or connective tissue layer (lamina propria) of the bladder, deemed to be at low risk of subsequent spread into or beyond the muscle wall of the bladder.

Cancer cells invading blood and lymph vessels.

Small structures which act as filters in the lymphatic system, and in which cells of the immune system are found. Lymph nodes close to the primary tumour are often the first sites to which cancer spreads.

A tumour that can invade and destroy nearby tissue and spread to other parts of the body, eg a cancer, a lymphoma or a sarcoma.

A type of scan which uses a magnetic field and radio waves to produce images of sections of the body.

A form of statistical analysis used to synthesise results from a collection of individual studies.

Spread of cancer away from where it started (the primary site) to somewhere else via the bloodstream or the lymphatic system.

Spread of cancer away from the primary site to somewhere else via the bloodstream or the lymphatic system.

A chemotherapy drug that can be used intravenously to treat cancer. It has also been widely used by instillation into the bladder to treat bladder cancer (intravesical therapy).

Detrimental effects on health.

Either (1) the condition of being subject to death; or (2) the death rate, which reflects the number of deaths per unit of population in relation to any specific region, age group, disease, treatment or other classification, usually expressed as deaths per 100, 1,000, 10,000 or 100,000.

A team with members from different health care professions and specialties (e.g. urology, oncology, pathology, radiology, nursing).

A meeting where members of the Multi Disciplinary Team discuss and make recommendations about the care of people.

Cancer that involves the muscle of the bladder wall.

A technology used to try to improve the chance of identifying cancer during cystoscopy. It involves the use of restricted wavelengths of light, rather than white light.

A survey done to gather information about the experiences of people with cancer in their dealings with the NHS

Treatment given before the main treatment.

A tube used to drain the kidney, usually because of obstruction to drainage either within or close to the urinary tract, eg cancer, stone, the effect of other treatment. It is placed through the skin of the loin directly into the kidney, usually under local anaesthetic by a doctor using X-rays or a scan to aid them.

A calculation aid based on statistical probabilities, which is used to provide individualised estimates of the likelihood of clinical outcomes.

Cancer in the surface lining (urothelium) or connective tissue layer (lamina propria) of the bladder, rather than cancer that involves the muscle wall of the bladder.

The study of cancers. This term also refers to the medical specialty of cancer care, with particular reference to the use of radiotherapy or drugs to treat cancer. The medical specialty is often split into Clinical Oncology (doctors who use radiotherapy and drug treatment) and Medical Oncology (doctors who use drug treatment).

Anything which serves to alleviate symptoms due to the underlying cancer but is not expected to cure it.

Care that is offered as a result of a partnership between the heathcare team and the person with the condition and their carers/family.

See nephrostomy.

A procedure involving the insertion of a catheter, through the skin, into the kidney to drain urine when there is a blockage in the ureter or bladder.

The use of a specific agent to produce fluorescence when tissue is illuminated with light of a particular wavelength. Used in conjunction with cystoscopy by instillation of a photodynamic diagnosis agent into the bladder via a catheter, to try to identify cancer within the bladder.

A specialised imaging technique using a radioactive tracer to produce a computerised image of body tissues and find abnormalities. PET scans may be used to help diagnose cancer, to see if it has spread and to investigate response to treatment.

Services provided in a community setting, outside hospitals (secondary care), with which people usually have first contact.

Surgical removal of the bladder as the initial treatment.

Original site of the first cancer

A prediction of the likely outcome or course of a disease; the chance of recovery, recurrence or death.

Characteristics of a cancer or the person who has it, e.g. grade of tumour or co-morbidity, that influence the course of the disease under study.

Cancer that is growing beyond the organ where it started. This is judged either by physical examination, scans, or blood tests.

The prevention of disease; preventative measures or treatment. Interventions to prevent an unwanted outcome.

A study in which people are entered into research and then followed up over a period of time with future events recorded as they happen.

Concerned with psychological or sociological influences on disease or other states

Research in which the outcomes are usually recorded in words, rather than with numbers. Often used to explore and understand peoples' beliefs, experiences, attitudes, behaviour and interactions.

A measure of health outcome which looks at both length of life and quality of life. QALYs are calculated by estimating the years of life remaining for a patient following a particular care pathway and weighting each year with a quality of life score (on a 0-1 scale). One QALY is equal to 1 year of life in perfect health, or 2 years at 50% health, and so on.

Research which uses numerical measurement techniques (eg. measuring survival times after treatment).

Surgical removal of the bladder. The lymph nodes in the pelvis are also removed. In men, the prostate is removed with the bladder, and in women, the womb, Fallopian tubes, ovaries, and part of the vagina are usually removed. Urinary drainage has to be re-established and this is done either by formation of a urinary stoma (ileal conduit) or bladder reconstruction.

Treatment given with the aim of cure, rather than just improving symptoms or extending survival with the disease.

A drug used at the same time as radiotherapy to increase the anticancer effect.

The use of radiation, usually x-rays or gamma rays, to kill cancer cells.

A type of experiment that is used to compare the effectiveness of different approaches, measures or treatments. The crucial feature of this form of trial is that people or groups are assigned at random to groups which receive the interventions being assessed or control treatments. RCTs offer the most reliable (i.e. least biased) form of evidence on effectiveness.

Recurrence is when new cancer cells are detected following treatment. This can occur either at the site of the original tumour or at other sites in the body.

Where cancer starts to grow again after treatment.

A plastic splint (stent) placed between the kidney and the bladder, within the body's own drainage pipe (the ureter), inserted via the bladder by doing a cystoscopy.

Cystoscopy done using a rigid metal cystoscope, usually under general or spinal anaesthesia.

The proportion of individuals with a disease who have that disease correctly identified by the study test

A means of representing uncertainty in the results of economic evaluations. Uncertainty may arise from missing data, imprecise estimates or methodological controversy. Sensitivity analysis also allows for exploring the generalisability of results to other setting. The analysis is repeated using different assumptions to examine the effect on the results.

A single recurrent cancer seen in the bladder at cystoscopy, in a person who has had bladder cancer in the past.

The proportion of individuals who do not have a disease and who are correctly identified as not having it by the study test.

The local extent of a cancer, in particular which parts of the organ of origin or adjacent organs are affected.

Survival is the time alive after diagnosis of a disease

A review of the literature carried out in order to address a defined question and using quantitative methods to summarise the results.

Treatment, usually given by mouth or by injection, that reaches and affects cancer cells throughout the body rather than targeting one specific area.

Telescopic removal done using an adapted cystoscope called a resectoscope.

Telescopic removal of a new or recurrent bladder cancer, done using an adapted cystoscope called a resectoscope.

A type of scan in which high-frequency sound waves are used to outline a part of the body.

The body's normal tubes carrying urine from the kidneys to the bladder

A blockage in the ureters (for example by tumour or stone).

The body's normal tube leading from the bladder through which urine leaves the body. In men the ureter exits at the tip of the penis, in women through the vulva.

An artificially created hole in the abdominal wall to allow drainage of urine from the kidneys (for example when the bladder has been removed).

An xray or scan which specifically outlines the kidneys, ureters and bladder.

Cancers of the urinary tract. This term usually includes cancers of the kidney, ureter, bladder, prostate, penis and testicles.

A branch of medicine concerned with the diagnosis and treatment of diseases of the urinary organs in females and the urogenital system in males.

Cancer arising from the urothelium.

The lining of the bladder, urethra, ureter and the collecting system of the kidney.