Bladder cancer 101

bathroom stall

Bladder cancer is a type of cancer that starts in the bladder. It most often affects the trigone (the triangle-shaped area inside the bladder), the bladder neck (a group of muscles that work together to hold urine in and then release to let it out) or the walls of the bladder.

Bladder cancer affects about 8,700 Canadians per year.

Dr. Ewa Szumacher, radiation oncologist at Sunnybrook, answered some questions about bladder cancer and how we can reduce our risk.

What are the risk factors for bladder cancer?

Smoking. Smoking cigarettes, cigars or pipes may increase your risk of bladder cancer by causing harmful chemicals to accumulate in your urine. These harmful chemicals may damage the lining of your bladder, which can increase your risk of cancer.

Age. Your risk of bladder cancer increases as you age. Bladder cancer can occur at any age, but it’s rarely found in people younger than 40.

Race. People who are white have a greater risk of bladder cancer than people of other races.

Men. Men are more likely to develop bladder cancer than women. Women however are more likely to die from it than men.

Exposure to certain chemicals. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacturing of dyes, rubber, leather, textiles and paint products.

Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide increases your risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer have a higher risk of developing bladder cancer.

Taking a certain diabetes medication. People who take the diabetes medication pioglitazone (Actos) for more than a year have an increased risk of bladder cancer. Other diabetes medications contain pioglitazone. Talk to your doctor.

Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as might happen with long-term use of a urinary catheter, may increase your risk of a squamous cell bladder cancer.

Personal or family history of cancer.  If one or more of your immediate relatives have had bladder or other cancer, you may have an increased risk of the disease, although it’s rare for bladder cancer to run in families. A family history of hereditary nonpolyposis colorectal cancer, also called Lynch syndrome, can increase your risk of cancer in your urinary system, as well as in your colon, uterus, ovaries and other organs.

What are the signs and symptoms of bladder cancer?

In the early stages of bladder cancer, there may not be any signs or symptoms of the disease. Symptoms may not appear until the bladder tumour has become large enough or has grown far enough into the bladder wall.

The most common symptom of bladder cancer is blood in the urine (called hematuria).

The colour may vary from pale yellow-red to bright or rusty red. Blood may always be in the urine, or it may come and go. Sometimes the blood can only be seen with a microscope or found with other urine tests.

Other symptoms of bladder cancer that often go along with blood in the urine:

  • The need to pee often (called urinary frequency)
  • An intense need to go pee (called urinary urgency)
  • Trouble starting the flow of pee.
  • A burning sensation or pain during urination
  • Back, pelvic or groin pain

Talk to your doctor about your risk factors and if you have any of the above symptoms.

What can we do to reduce our risk of this disease?

While we do not have any control over some of the bladder cancer risk factors like our race or family history, there are some things we can do to reduce the risk:

Quit smoking. If you currently smoke, stop. Talk to your healthcare team about smoking cessation programs and support.

Take care with chemicals. If you work with or around chemicals, follow all safety rules to avoid exposure.

Drink water to be properly hydrated. Drinking water may dilute harmful substances in your urine and flush them out of your bladder faster.

Eat a well-balanced diet. Eat a diverse variety of fruits and vegetables, nuts and fish rich in omega-3 fatty acids, as well as lean protein. Reduce fat and red meat.

Report any symptoms. When bladder cancer is in its earliest stages, you have the best chance of survival (survival rates can exceed 80 percent).

Talk to your family doctor if you notice any changes in your urinating habits. Also discuss any family history of cancer as well and if you work with the hazardous chemicals mentioned above, so your doctor fully understands your risk level.

What do you wish people would know about this kind of cancer?

Bladder cancer is a common cancer in older adults.

This cancer can be successfully treated if diagnosed at the earlier stage. Keep an eye out for changes in your urinary habits and other symptoms and try to lower your risks.

There are lots of treatment options. Patients with this cancer should talk about the pros and cons of each treatment with a multidisciplinary team (urologist, medical oncologist, radiation oncologist) so that their treatment is personalized based on tumour type, stage, location and your overall health. Find more about treatment options here.

Follow-up after bladder cancer treatment, particularly for a patient with muscle invasive bladder cancer, is extremely important. Lifelong surveillance with a multidisciplinary team will improve the treatment outcomes if cancer comes back.


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About the author

Alexis Dobranowski

Alexis Dobranowski is a Communications Advisor at Sunnybrook.

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