10 Things to Know About Bladder Cancer

Key Stats and Facts About This Urinary Tract Cancer

Facing Bladder Cancer
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Your bladder is a pouch-like organ located in your pelvis that collects urine from the kidneys until it is urinated out of the body. Bladder cancer occurs when cells within the bladder begin to grow uncontrollably.

While the process of being diagnosed, treated, and monitored with bladder cancer can be complex and fear-provoking, you can move forward with proper knowledge and support from loved ones and your health care team.

Here are ten facts meant to give you an overview of how bladder cancer begins, to life after diagnosis and treatment.

Painless Blood in the Urine Is the Most Common Symptom of Bladder Cancer

Painless blood in the urine (either visible or nonvisible, and only detected on a urinalysis) is the most common first symptom of bladder cancer. Urinary irritation like burning with urination, urinating frequently, or having a persistent urge to urinate may also occur as the first symptom, although this is less common.

Blood in the Urine Is Not Always Bladder Cancer

The most common first symptom of bladder cancer, blood in the urine, is also common in a number of benign (non-cancerous) conditions. In fact, blood in your urine is less likely to be bladder cancer and more likely to be a urinary tract infection or kidney stone.

It's important to know that only a doctor can determine the cause of blood in your urine, with urine and imaging tests and/or a cystoscopy.

So be sure to see your doctor if you notice blood, have persistent or worsening symptoms of urinary irritation or feel like something is simply not right.

Bladder Cancer Is More Common in Older People and in Men

Bladder cancer occurs predominantly in people over the age of 55, with the average age being 73, although this is not a hard and fast rule.

According to the American Cancer Society, about 10 percent of bladder cancers do occur in people younger than 55. In addition, men are about three times more likely to develop bladder cancer than women.

It's important to note that gender and age are risk factors that are out of your control.  On the other hand, cigarette smoking (a factor you can control) accounts for about 50 percent of all cases of bladder cancer in western countries.

Quitting Smoking Can Decrease Your Chances of Developing Bladder Cancer

Cigarette smoking is the most common risk factor for bladder cancer. The good news is that quitting smoking decreases your chance of developing bladder cancer, compared to someone who keeps smoking, although it is still higher (about twice as high) than someone who has never smoked.

Certain chemical exposures have also been linked to bladder cancer (for example, chemicals used to make hair dye, paint, metal, and petroleum products). So being careful around certain chemicals (and limiting exposure when possible) can also help reduce your risk of bladder cancer.

Bladder Cancer Is Not Contagious

You cannot get bladder cancer from someone else. If you are perplexed by the fact that more than one family member has bladder cancer, be reassured that it is not because one gave it to the other.

Instead, a number of other factors could be at play, like shared genes or an exposure to the same carcinogen.

In the big scheme of things, if someone you love has bladder cancer, spending time with them is critically important, so they feel cared for and supported. There's no need to worry about contracting cancer from your loved one. Likewise, there is no way you can give your bladder cancer to someone else.

Surgery Is the Primary Treatment

If you have been diagnosed with bladder cancer, you will likely undergo some form of surgery, either a removal of the tumor and some of the muscle layer of the bladder or a removal of your entire bladder (likely with the removal of surrounding organs)—this is called a radical cystectomy.

If you just had the tumor removed (and not your entire bladder), you may also receive a medication that is administered directly into your bladder with a catheter. The purpose of this medication (called a chemotherapy or immunotherapy) is meant to get rid of any residual cancer cells.

If you have your whole bladder removed, you may receive whole-body chemotherapy (given through an IV) prior to surgery.

Chance of Recovery Depends on Stage and Grade of Cancer

The grade of the disease refers to how abnormal the cancer cells appear under a microscope. High-grade means the cells look abnormal whereas low-grade means the cells appear more normal, like typical cells in the bladder.

The stage of the tumor (or how far it has spread) also plays a role in a person's chance of recovery, and the higher the stage, the more advanced the cancer.

Non-muscle invasive bladder cancer (NMIBC) accounts for approximately 70 to 75 percent of all bladder cases in the United States. This type of bladder cancer means that the tumor has not yet penetrated the thick muscular layer of the bladder wall. 

The survival rate for high-grade NMIBC at 10 years is about 70 to 80 percent. This means that 10 years after diagnosis, 70 to 80 percent of people with bladder cancer will be alive. For low-grade disease, the survival rate is much higher.

This is just a statistic and does not predict an individual's risk, so try not to get too bogged down on the number. The big picture here is that the chance of recovery after a diagnosis of non-muscle invasive bladder cancer is quite favorable.

Bladder Cancer Tends to Recur

You may be surprised to learn that about 50 percent of non-muscle invasive bladder cancers recur, meaning they come back. That being said, it can be very tricky predicting who is more likely to have their cancer recur. This is why it's important to follow up with your urologist and any tests he or she orders as advised

Cystoscopy Is the Gold Standard For Diagnosing and Monitoring Bladder Cancer

 According to the American Urological Association, the most reliable way to check for cancer recurrence is with a cystoscopy—an instrument that a urologist uses to examine your bladder, allowing for direct visualization.

In other words, other laboratory tests like urine cytology or urine biomarkers can provide clues or help guide a doctor's plan, but they are not sufficient for predicting whether a person will have a recurrence of their cancer.

If your bladder has not been removed, plan on seeing your urologist for periodic cystoscopies, often starting within three months of completing treatment. Imaging tests, like a CT scan, are also routinely ordered.

Life After Urostomy Can Be Just as Enjoyable as Before

For people who have their bladders removed for their cancer, a new path for urine to leave the body needs to be made—this part of the surgery is called urinary reconstruction. For many people, this means having a urostomy. A urostomy is when an opening in the skin on the front of the abdomen (called a stoma) is created during surgery that allows for urine to collect outside the body in a pouch.

The good news is that there are ostomy nurses who can teach you how to best manage your urostomy, so you can return to your normal social life and activities.

Sources:

American Cancer Society. Bladder Cancer.

Davis R, Jones JS, Barocas DA et al: Diagnosis, evaluation and follow-up of asymptomatic microhematuria (AMH) in adults: AUA guideline. J Urol 2012;188:2473

Freedman ND, Silverman DT, Hollenbeck AR, Schatzkin A, Abnet CC. Association between smoking and risk of bladder cancer among men and women. JAMA. 2011;306(7):737-45.

Chang et al. Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO guideline. J Urol. 2016 Oct;196(4):1021-9.

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