Among men in the United States, bladder cancer is the fourth most common cancer. Men are more frequently diagnosed than women, and the risk of bladder cancer increases with age. 90% of people who are diagnosed with bladder cancer are above the age of 55, and the average age of diagnosis is 73. According to National Comprehensive Cancer Network, smoking is the greatest risk factor for bladder cancer—smokers are three times more likely to be diagnosed with the disease than non-smokers. Exposure to certain chemicals present in dyes, rubber, printing materials, leather, textiles, and paint products are also associated with increased risk of bladder cancer. People who have had bladder cancer or who have a family history of the disease are at higher risk, as are white people, who are roughly twice as likely to develop bladder cancer than non-white people.
The Main Symptom: Blood in Urine
Bladder cancer can often be detected early because its first sign—blood in the urine—is not easy to overlook. This condition is called hematuria, and the blood can change the urine’s color to orange, pink, and in some extreme cases, dark red.Read More
Two aspects of hematuria that might cause people to put off seeking a medical evaluation are that it is not painful, and the symptoms can be brief and irregular. If there are only small amounts of blood in the urine, sometimes it will not make a visible difference and can only be detected through urinalysis. Patients who catch the disease early can confront it while it is still highly treatable.
When someone reports blood in their urine, doctors run tests to evaluate the entire urinary system. This encompasses the kidneys, the ureters (tubes that bring the urine from the kidneys to the bladder), the bladder, and the urethra (which empties the urine).
“So for anyone with blood in the urine, we have to do tests to determine what the source of that bleeding might be. And that source of bleeding could be anywhere in the urinary tract,” Dr. Jay Shah, a urologic oncologist specializing in the treatment of bladder cancer and other urologic cancers at the Stanford Cancer Center, tells SurvivorNet.
According to Dr. Balar, other bladder cancer symptoms resemble the symptoms of a urinary tract infection. In fact, patients may only learn that they have bladder cancer after “many courses of antibiotics to treat what was thought to be a urinary tract infection that simply did not get better,” Dr. Balar says. “Early acknowledgement of symptoms, and not ignoring symptoms is probably one of the other most important things that you can do,” he adds.
Besides blood in the urine, other symptoms involve changes in urinary habits or discomfort while urinating. These may include:
- Needing to urinate more frequently than you typically would
- Feeling like you need to urinate urgently even when your bladder isn’t full
- Waking up to urinate many times throughout a night
- Having a trouble urinating because of pain or a burning sensation
Frequent urination, urgent urination, and uncomfortable urination are all symptoms of bladder cancer. People with advanced bladder cancer may experience additional symptoms, including:
- Inability to urinate
- Pain on one side of the lower back and pelvis
- Loss of appetite
- Unintended weight loss
- Fatigue or weakness
- Bone pain
- Swollen feet
Screening for bladder cancer is not common, because no screening methods have been shown to reduce the risk of dying from bladder cancer for people with an average level of risk. Doctors may recommend screening for certain high risk individuals. Dr. Balar’s main message for people who want to avoid bladder cancer? “Hydrate well, don’t smoke, and make sure that you get in to see your physician if you have symptoms that concern you.”
If you find blood in your urine or a urine test discovers trace amounts of blood, the next step is typically to undergo a cystoscopy. A cystoscopy is a procedure in which a small camera on the end of a long tube is inserted through the urethra into the bladder to look for signs of cancerous tumors. If cancer is detected, there are a variety of imaging tests (CT scan, CT urography, MRI, MR urography, renal ultrasound, retrograde ureteropyelogram) that can be used to determine whether the cancer has spread beyond the bladder to surrounding tissues, organs or lymph nodes.