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Bladder Cancer

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Bladder cancer affects men more than women, but the mortality rate is higher in women. Experts warn women should take symptoms of Urinary Tract Infections, which often mimic symptoms of Bladder Cancer, more seriously.

Prevalence

Bladder cancer is the seventh most common cancer in the United Kingdom, with about 10,000 people developing bladder cancer each year. It is more common in men (7,300) than in women (2,800) with 55% of cases diagnosed in people aged 75 or over. The most common early symptom of bladder cancer is Haematuria (blood in urine). In the early stages the cancer is likely to be in the lining of the bladder. With early diagnosis, treatment is relatively easy to deal with and survival rates are high, especially in younger people. If the cancer has spread to deeper layers of the bladder wall, it is more difficult to treat. Even then, however, treatment can slow the progression and give precious time.

Women, in particular, need to be extra vigilant as it would appear they are presenting late and this is affecting outcomes negatively. Sara Hiom, Cancer Research United Kingdom's director of early diagnosis, has called for women to seek medical help as soon as they spot any unusual symptom.

The good news is that survival rates have increased substantially over the last 50 years and are projected to continue improving.

Bladder Cancer Symptoms

Blood in urine

The first symptom most people become aware of is blood in your urine. You should always consult a Doctor if you see blood in your urine, even if it is intermittent and a pattern that you habitually associate with UTI's. While a urinary tract infection is the most likely explanation for blood in the urine it can also be a sign of bladder cancer. Bladder cancer symptoms mimic cystitis symptoms, prompting experts to warn women not to dismiss blood in the urine as a simple urine infection. Doing so may lead to later diagnosis, and lower survival rates.

Bladder Cancer Symptoms - Early Stages

Passing urine more frequently
Feeling pain or a burning sensation when passing urine
Needing to urinate urgently but then passing only small amounts of urine

Bladder Cancer Symptoms - Advanced Stages

Loss of appetite
Weight loss
Unable to pass urine
Lower back pain on one side
Swelling in the feet
Lump in the pelvis

Bladder Cancer Risk Factors

Many triggers have been cited alongside hereditary factors. There are factors which are generally accepted to increase the risk of bladder cancer developing. Broadly, these include:

Birth defects affecting the bladder
Family history of bladder cancer
Being male, more men are affected than women
Exposure to toxins and chemicals in the environmental
Occupational exposure to toxins and chemicals
Lifestyle choices such as smoking, poor diet and lack of exercise
Age, over 55% of cancers diagnosed are in the over 75 age group

More specifically:

Smoking: Smoking is considered the most important causative factor for bladder cancer.
Hair dyes: The University of Southern California studied 897 bladder cancer patients and findings suggest a link between hair dye use and bladder cancer. There is not universal agreement on hair dye as a trigger for bladder cancer. It may be wise, should you have a family history or already have cancer, to minimize risks by using chemical free hair dyes. Avoid using hair dyes that contain any of the following ingredients: ammonia, peroxide (bleaching agent), PPDs (para-phenylenediamines - also used in tattoos), lead, coal tar, toluene and resorcinol.
Chemicals: Occupational exposure to aromatic amines as well as exposure to dyes, paints, fungicides, cigarette smoke, plastics, metals and motor vehicle exhaust.
Testing: Procedures used to diagnose bladder or kidney problems such as 'Intravenous Pyelogram Tests' that examine the urinary system by injecting a dye into a vein have a risk/benefit ratio. Dye is removed from the bloodstream by the kidney as part of urine production. By taking x-ray pictures while the kidneys are excreting the dye, the urologist can see any abnormalities in the outline of the urinary system.
Previous radiotherapy or chemotherapy slightly increases risk.

Bladder infections and Cancer - are there any links?

Schistosomiasis

Schistosomiasis is a condition affecting the bladder, caused by infection with a water bourne parasite commonly found in Egypt. Chronic inflammation of the bladder resulting from multiple Schistosoma infections can lead to more rapid cell reproduction. Repeated inflammation of the bladder can lead to a rarer form of Bladder Cancer known as Squamous Cell Carcinoma (SCC) which makes up around 8% of Bladder Cancer cases.

Chronic Cystitis

Recurrent bladder infection, infections that happen repeatedly, are referred to as Chronic Cystitis. Risk factors for Chronic Cystitis include :

Long-term urinary tract infection
Catheterisation, a tube inserted into the urethra to drain urine
Urinary calculi or stones

A small number of catheterised paraplegics, estimates range from 2% - 10%, also go on to develop the rarer form of Bladder Cancer known as SCC.

Prostatitis

In men, there are links with Prostatitis, and blood in the urine in men is considered a more serious sign than in women. This is partly because men are less prone to infections in the bladder, but also because of the known causes of cystitis in men. For serious bladder infections in men, even if D'Mannose clears the symptoms, it is strongly advised to see a Doctor for a thorough check-up.

How is bladder cancer diagnosed and assessed?

Urine microscopy - A urine sample is sent to the laboratory. This test may detect cancer cells. However, if no cancer cells are detected, further tests may be ordered if other symptoms suggest bladder cancer.
Cystoscopy - This test is often done to examine the bladder. A cystoscopy uses a thin telescope called a cystoscope. The cystoscope is passed into your bladder via your urethra.

During cystoscopy a Doctor is able to: