Bladder cancer is the third most common type of cancer that is not gender-specific (like breast cancer or prostate cancer). It is three times more common in men than women and accounts for close to 200,000 deaths in the United States every year. As with any cancer, early diagnosis and treatment is important for a better outlook. Therefore early detection of the signs and symptoms of bladder cancer is crucial.
Who is at risk of bladder cancer?
Bladder cancer can affect any person of any age but it tends to be more common in men around the age of 65 years. It is rare for bladder cancer to occur in people younger than 40 years. Apart from age and gender, there are other risk factors that need to be considered. This simply means that some people are more likely to develop bladder cancer and high risk groups should be closely monitored and regularly screened.
Other risk factors for bladder cancer includes:
- Tobacco smokers, including cigarette, cigar and pipe smoking.
- Exposure to industrial chemicals, such as polycyclic aromatic amines, arylamines, aniline dyes, nitrites and nitrates.
- History of cancer, either personal or family history.
- Chronic bladder inflammation, such as repeated bladder infections (cystitis) or long term catheterization.
- Previous treatment for cancer, particularly with the use of radiation therapy for other pelvic cancers.
It is important to note that bladder cancer may arise even in the absence of any of these risk factors. In developing nations, bladder cancer is also closely associated with schistosomiasis (infection with the Schistosoma species of worms, especially Schistosoma haematobium).
Read more on bladder cancer causes.
How to Spot Bladder Cancer
Bladder cancer is where abnormal cells arise in the bladder. These cancerous cells grow rapidly and invade healthy bladder tissue, thereby destroying it. Eventually the cancerous cells may spread beyond the bladder. As with all cancers, there may be little to no symptoms when bladder cancer first arises.
As the tumor grows and destroys more tissue, various symptoms arise which may not always be unique to bladder cancer. In fact, bladder cancer may present similar to many other bladder and urinary tract conditions. Therefore diagnostic investigations are necessary to confirm the presence of bladder cancer.
Blood in Urine
Blood in the urine (hematuria) is seen in as many as 9 in 10 people with bladder cancer. Usually hematuria in bladder cancer is painless. Hematuria is not unique to bladder cancer. It occurs in many urinary tract conditions, including urinary tract infections (UTIs) and urinary stones. In fact, most of the time hematuria is not due to bladder cancer but it is important to exclude cancer as a possible cause.
However, in most of these cases the blood in the urine is microscopic, meaning that it is not visible to the naked eye. With bladder cancer, the hematuria is gross meaning that it is visible to the naked eye. Urine may appear discolored, ranging from brown to red. Microscopic hematuria may also be present in bladder cancer, particularly in the early stages, and is only detected with diagnostic investigations like a urine dipstick test.
Although pain is not present with the hematuria in the early stages, it does eventually arise. The pain may not always be present on a constant basis. Instead the pain may arise during urination. Dysuria may also occur with a host of other non-cancerous conditions, such as bladder infections. It is therefore not a sign of bladder cancer on its own and should be considered in conjunction with other symptoms and associated risk factors for bladder cancer.
Frequent Urination and Urgency
Frequent urination and urgency to urinate are other symptoms that occur with bladder cancer. Normally a person urinates about 6 to 7 times daily, although this can be a few times more or less within a 24 hour period. Following urination, the urgency to urinate subsides. However, in conditions like bladder cancer a person passes urine significantly more times in a 24 hour period, and this is not always a “full bladder”. The urge to urinate may not completely subside after urination or arises again a very short while after passing urine which is abnormal.
Pelvic and Back Pain
Pelvic and back pain are other symptoms that may arise with bladder cancer. The pain may be diffuse or isolated to the location of the bladder in the pelvic cavity. The bladder is located in the midline, below the umbilicus (belly button) and just in line with or above the area where the pubic hair is present. When back pain does occur, it is usually in the lower back around the lumbosacral region, and sometimes lower.
Fatigue and Weight Loss
Fatigue and unintentional weight loss are two non-specific symptoms that are common in most types of cancer. The severity may vary among individuals and also with the stage of cancer. However, it is important to note that fatigue and weight loss can also occur with many other conditions that do not involve the bladder and are not cancerous. It is therefore important to correlate the fatigue and unintentional weight loss with other symptoms to attempt to isolate a possible cause.
How to Confirm Bladder Cancer
The presence of these signs and symptoms, especially gross hematuria, should warrant further diagnostic investigations. It is only with these tests, scopes and scans that blader cancer can be confirmed. These investigations may include:
- Urine cytology where a urine sample is collected and microscopically examined for bladder cancer cells. Other tests may also be conducted on the urine to detect the presence of certain proteins which may be present due to the presence of a malignant (cancerous) tumor in the bladder.
- Cystoscopy and biopsy where a scope is inserted into the bladder through the urethra and viewed for any abnormal growths (cystoscopy) as well as collection of a bladder tissue sample (biopsy) which is examined microscopically to identify any abnormal cells.
- Computed tomography (CT) and magnetic resonance imaging (MRI) scans allow for visualization of the tumor in the bladder. It is less invasive than cystoscopy and can also help to identify the size and depth of the tumor. It is useful to identify infiltration of the tumor into neighboring tissues or organs.
Read more on bladder cancer tests.