Bladder cancer is estimated to be diagnosed in 82,290 Americans in 2023, with around 90% of those affected being over the age of 55. However, diagnosis of the disease can be challenging as symptoms may be absent until it reaches an advanced stage. As per urologist Mark Tyson, M.D., M.P.H., even if not life-threatening at diagnosis, bladder cancer tends to be aggressive and recur, sometimes requiring multiple procedures and treatments. Around 20% of patients have an invasive form of the disease requiring more aggressive treatment that can be life-threatening.
Survival rates are 77% for 5 years, 70% for 10 years, and 65% for 15 years, varying depending on individual factors like smoking and overall health. Urothelial carcinoma is the most common type of bladder cancer, with the tumor type, grade, and stage determining the type of treatment needed.
To help catch the disease early, experts recommend keeping an eye out for these common bladder cancer symptoms.
1) Recognizing the Symptoms of Bladder Cancer
Bladder cancer is a serious condition that requires immediate attention. The most common symptom of bladder cancer is blood in the urine, also known as hematuria. According to Dr. Tyson, a urologist, patients usually notice the blood in their urine or are informed of it during a test conducted by a primary care physician. Delaying an evaluation by a urologist can cause delays in care, which is a significant problem. Therefore, any bleeding requires immediate medical attention.
Apart from blood in the urine, patients may also experience painful and frequent urination, especially at night. While these symptoms are not a common presentation, they may indicate more aggressive forms of the disease. Patients may also notice changes in their urinary symptoms, such as frequency and urgency, which are irritative voiding symptoms. However, generally, bleeding is the most common symptom of bladder cancer.
It's important to note that bladder cancer may present itself differently in some cases. Some rare types of bladder cancer may cause dramatic changes in voiding function, which requires prompt evaluation by a urologist. Therefore, it's essential to seek medical attention if you notice any changes in your urinary habits or if you experience any bleeding. Early diagnosis and treatment are crucial for the successful management of bladder cancer.
2) Early Detection of Bladder Cancer
The World Health Organization's International Agency for Research on Cancer has revealed that a simple urine DNA test could detect mutations up to a decade before clinical diagnosis for bladder cancer. The study, published in The Lancet, is an exciting development towards the validation of a non-invasive early detection tool, according to Florence Le Calvez-Kelm, IARC scientist, and principal investigator of the study.
The study's co-first author, Ismail Hosen, said, "Our results provide the first evidence from a prospective population-based cohort study of the potential of urinary TERT promoter mutations as promising non-invasive biomarkers for the early detection of bladder cancer." If the findings are validated, large trials in individuals at high risk of developing bladder cancer should be designed to determine the health and cost benefits of screening for TERT promoter mutations for the global bladder cancer burden, says Mahdi Sheikh, a postdoctoral scientist at IARC and the co-first author of the study.
The new urine test is a significant advancement that could make it easier to detect bladder cancer. Early diagnosis and treatment of bladder cancer can significantly improve outcomes, and this new test could potentially simplify the process of detection. If proven effective through further research, the urine DNA test could be a game-changer in the early detection of bladder cancer.
3) Factors That Increase the Risk of Bladder Cancer
According to Dr. Tyson, smoking is the leading cause of bladder cancer, accounting for around 50% of all cases. Many patients are surprised to learn this because they often associate smoking with lung disease. However, the chemicals inhaled while smoking are excreted into the bladder and held there before being voided, leading to changes in the urothelium. The urothelium is the inner lining of the bladder and can occur anywhere along the urinary tract, from the kidneys to the tip of the urethra.
While bladder cancer is the most common site of urothelial carcinoma, other parts of the urinary tract can also develop this type of cancer, such as the kidneys or the urethra. Besides smoking, there are other risk factors associated with bladder cancer. Individuals raised in rural communities with arsenic-based pesticides in their groundwater may have an increased risk, particularly those who live on wells, such as in farming communities.
Understanding the risk factors associated with bladder cancer is crucial in reducing the likelihood of developing the disease. Smoking is the most important risk factor, and avoiding smoking or quitting smoking can significantly reduce the risk of bladder cancer. For individuals living in rural communities with exposure to arsenic-based pesticides in their groundwater, taking necessary precautions, such as using filtered water, may help reduce the risk of bladder cancer.
4) Treatment Options for Bladder Cancer
Bladder cancer is a treatable condition, and the type of treatment depends on the stage of detection. Surgery to remove tumor cells, chemotherapy to destroy cancer cells, immunotherapy to boost the immune system, and radiation therapy using high-energy waves to kill cancer cells are some of the typical methods of treatment. Promising new research has revealed that treatment using antibody-drug conjugates and checkpoint inhibitors could be an effective alternative for individuals who cannot have chemotherapy.
According to Jonathan Rosenberg, a genitourinary oncologist at Memorial Sloan Kettering Cancer Center (MSK), while bladder cancer cases are decreasing, the death rates have not changed significantly. The availability of new treatment options, however, brightens the outlook considerably for many bladder cancer patients. While immunotherapy has received more attention in recent years, antibody-drug conjugates may make a bigger positive impact in the near future.
Checkpoint inhibitors have been a revolution for some people with highly aggressive, life-threatening bladder cancer. However, immunotherapy still does not work in enough patients. Improving response rates and survival is essential. Even if checkpoint inhibitors and antibody-drug conjugates do not cure bladder cancer, they can help individuals live longer or delay the progression of the disease. In some cases, it may even allow them to avoid bladder removal or chemotherapy after surgery, which can significantly improve their quality of life.
Treatment for bladder cancer can be challenging, but there are various options available. Individuals diagnosed with bladder cancer should work with their healthcare provider to determine the best treatment options for their particular situation. Early detection and prompt treatment can significantly improve outcomes and quality of life.
5) Strategies for Preventing Bladder Cancer
Several lifestyle factors can increase the risk of developing bladder cancer. According to Petros Grivas, an oncologist with a PhD, elderly age is a significant risk factor for cancer in general. Repeated exposures to risk factors, such as smoking, can lead to an accumulation of genetic changes that may contribute to the development of bladder cancer.
Dr. Grivas notes that men have a higher risk of developing bladder cancer than women due to their increased likelihood of smoking tobacco and being exposed to harmful chemicals. Certain professions, such as firefighting, machining, and truck driving, may also increase the risk because individuals in these professions have more exposure to toxins and chemicals, and smoking can further increase the risk.
Dr. Grivas recommends several strategies to help prevent bladder cancer, including not smoking, staying hydrated, eating a healthy diet, and protecting oneself against chemical exposure. Staying hydrated is particularly important as it helps to flush toxins out of the body. A healthy diet can also help reduce the risk of developing bladder cancer by providing essential nutrients and antioxidants that may help protect against cancer.
Increasing awareness and community involvement may also contribute to more effective research with new meaningful treatments and life-saving drugs. Individuals should work with their healthcare provider to determine the best strategies for preventing bladder cancer based on their particular circumstances. Early detection and prompt treatment can significantly improve outcomes and quality of life.