Do You Know the Warning Signs of Bladder Cancer?

Jeanny B. Aragon-Ching, MD, is the clinical program director of genitourinary cancers at the Inova Schar Cancer Institute. She is board certified in medical oncology, hematology and internal medicine and has a special interest in caring for patients with prostate, bladder, kidney and testicular cancers. Read Dr. Aragon-Ching’s profile. 

(Originally published May 15, 2017)

Bladder cancer doesn’t get the attention that some cancers do, though it isn’t rare. In 2017, an estimated 79,000 new cases will be diagnosed.

May is Bladder Cancer Awareness Month – which makes it the perfect time to learn about the risks and warning signs.

Who is at Risk for Bladder Cancer?

Several factors can increase the odds of developing cancer of the bladder:

• Gender: Bladder cancer is about 4 times as common in men as in women.
• Racial background: Bladder cancer is more common in white Americans than in African-Americans or Americans of Hispanic descent. Asian-Americans have the lowest rates.
• Smoking: People who smoke tobacco are diagnosed with bladder cancer twice as often as those who don’t smoke.
• Occupational exposures: People who work in jobs handling paint, dyes, rubber, leather and textiles have an increased risk of bladder cancer.
• Age: As with many cancers, the likelihood of developing bladder cancer goes up as you age. Most diagnoses are in people over 55.

While these factors increase your risk, anyone can be diagnosed with bladder cancer. Let’s look at women’s risk, for instance. Bladder cancer is less common in women, but those who develop the disease are often diagnosed at more advanced stages, when it is harder to treat.

Spotting the Signs

The first sign of bladder cancer is usually blood in the urine. The urine may look orange or pink. Usually, that bleeding is painless, and it may come and go.

Other symptoms can include:

• Frequent urination
• A feeling of having to urinate, even when your bladder isn’t full
• Pain or discomfort during urination
• Difficulty urinating
• Weight loss, fatigue or low back pain (in advanced disease)

One reason that women tend to be diagnosed later might be because of significant delays in the diagnosis. Women might ignore signs of blood in the urine, assuming it’s because of their menstrual period, a bladder infection, or a urinary tract infection (UTI).

It’s true that UTIs sometimes cause bleeding, as do other common problems, such as kidney stones. But if you notice blood in the urine, you should always talk to your doctor or to a urologist to get to the bottom of it – especially if the bleeding comes back after antibiotic treatment for a UTI.

Diagnosing and Treating Bladder Cancer

In the U.S., bladder cancer is usually diagnosed at “superficial” or non-invasive stages, when it involves only the lining of the bladder. In such cases, we can often remove the cancerous tissue with surgery alone.

Some patients, however, develop high-risk tumors that are more likely to come back (recur) or grow deeper into the muscle and surrounding tissues. Treating these cancers usually involves surgery as well as chemotherapy. We’ve also had great success using immunotherapy.

Cancer immunotherapy uses a patient’s own immune system to recognize and attack cancer cells. This exciting treatment area is growing quickly; 4 new immunotherapy drugs for advanced bladder cancer have been approved within the past year alone! In fact, the American Society of Clinical Oncology (ASCO) named immunotherapy the 2017 advance of the year.

Shining a Light on Rare Bladder Cancer Types

More than 90 percent of people with bladder cancer have a type of tumor known as urothelial carcinoma, also called transitional cell cancer. But among every 100 people with bladder cancer, as many as 5 to 10 typically have rare types that affect other cells. Those cancers tend to be more aggressive, too.

Unfortunately, treating those rare subtypes is often challenging. On June 3, I’ll be chairing an educational session about these rare genitourinary tumors at the American Society of Clinical Oncology (ASCO) annual meeting, one of the largest educational and scientific events in the oncology community. In particular, I will discuss the diagnosis, treatment and advances in knowledge regarding those rare bladder cancers.

At Inova, we treat all types of bladder cancer, whether it’s common or rare, early or more advanced. We bring together a team of urologists, medical oncologists, radiation oncologists, surgeons and other experts to design a treatment plan in the most personalized way possible.

Learn more about the Inova Genitourinary Cancer Program and our commitment to personalized care.