HEALTHPLAN MAGAZINE

The Signs of Bladder Cancer

The first and most obvious sign that something is amiss with your bladder is that you will find blood in your urine. This blood is known as haematuria and will not usually cause you any pain. Blood in your urine can manifest itself as either streaks of red or it may turn your urine brown, or it can look pink or reddy-brown. You may see clots of blood in it. Sometimes the blood may be there and on other occasions it may not. This is the most common symptom of bladder cancer. It can happen suddenly and may come and go.

There are other reasons why you may have blood in your urine. These include cystitis, kidney stones or an enlarged prostate gland in men. However, if you do ever spot blood in your urine – regardless of whether it comes and goes – you must visit your GP so that the cause can be investigated. Take a sample of urine with you when you go.

Remember that sometimes blood in the urine can't be seen, but it will be picked up in a simple urine test.

Symptoms of Bladder Cancer

The early symptoms of bladder cancer will vary between individuals. You may have some or all of the following:

• The need to urinate quite often
• A need to urinate very suddenly
• A burning sensation when you urinate

Where bladder cancers are diagnosed while they are still in the bladder lining and have yet to spread, 80 to 90% of patients are able to live for more than 5 years. Early bladder cancers can often be cured or controlled with minor surgery or treatment into the bladder and the prognosis is good.

The later symptoms of bladder cancer can include:

• Pain in the pelvis
• Pain in your bones
• Weight loss that you had not planned for
• Swelling of your legs

Five Year Survival Rates

Doctors follow what happens to people for five years or more after their treatment for bladder cancer in medical research studies, and the phrase they use to discuss the results is five year survival. However, this does not mean that bladder cancer patients will only live 5 or 10 years.

The outcome for bladder cancer tends to depend on where the cancer is located. If it is just in the bladder lining this is hopeful. Where it has spread into the muscle wall of the bladder or beyond this can be more problematic to treat.

For all of the people who have a bladder cancer diagnosis, 58 out of every 100 men (58%) live for at least 5 years after they are diagnosed and 50 out of every 100 women (50%) live for at least 5 years. Men have a slightly better survival rate due to the somewhat different structure of the male bladder.

The outlook for bladder cancer depends on a number of factors. These include:

• How far the cancer cells have moved into the bladder lining
• The number of tumours
• The size of the tumours
• The abnormality of the cancer cells under the microscope
• Whether high grade changes in the bladder lining are present

Your GP will examine all of these factors together and decide what the risk is of the cancer coming back or spreading into the muscle of the bladder. Specialist surgeons will either use surgery to remove your bladder or use radiotherapy treatment. The treatments generally work well. The choice will probably depend on your own preferences in consultation with your specialist's recommendations.

Advanced (Metastatic) Bladder Cancer

Advanced metastatic bladder cancer is a bladder cancer that has spread further into the body. This can occur in 10% of cases before they are diagnosed. The outlook is not as good for patients as for those whose cancer was diagnosed at an earlier stage.

Risk Factors

A risk factor is anything that alters your chance of getting a disease such as cancer. Different cancers have different risk factors and all will vary according to the individual. The biggest risk factors associated with bladder cancer include the following:

Smoking

Smokers are 3 times more likely to get bladder cancer than non-smokers. Smoking causes almost half of the bladder cancers in men and women because the carcinogens (cancer-causing chemicals) from tobacco smoke are absorbed from the lungs and get into the blood where they are filtered by the kidneys and concentrated in the urine. These chemicals in urine then damage the cells that line the bladder.

Workplace Exposure

You may be more at risk of developing cancer if you are exposed to certain chemicals in the workplace such as benzidine and beta-naphthylamine. The industries that have the highest risks include rubber, leather, textile, and paint manufacturers, but also painters, machinists, printers, hairdressers and truck drivers.

Race and Ethnicity

White people are the most at risk.

Age

90% of bladder cancers occur in people aged 55 or over.

Gender

Bladder cancer is more common in men than women.

Previous Chronic Bladder Irritation and Infections

Urinary infections, kidney and bladder stones, and other causes of chronic bladder irritation have been linked with bladder cancer as well as a personal history of bladder or other urothelial cancer.

Family History

People who have family members with bladder cancer have an increased risk of getting it themselves. This may be because of exposure to the same cancer- causing chemical or it may be because of genes.

Low Fluid Consumption

Failure to drink enough fluid can increase the risk of bladder cancer. People who drink plenty of fluids each day have a lower rate of bladder cancer. This is thought to be because they urinate more often which prevents chemicals from remaining in their bodies.

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