Estimates suggest a significant number of new bladder cancer cases in men in 2022.
Detecting bladder cancer early is crucial because it can lead to less invasive treatments.
Early detection also reduces the risk of cancerous cells spreading.
Therefore, knowing the signs and symptoms of bladder cancer is key.
What is bladder cancer?
Bladder cancer is a disease where malignant (cancerous) cells form in your bladder. Bladder cancer can occur in both men and women, but it’s much more common in men.
There are five stages of bladder cancer, including stage “zero” which is when bladder cancer affects the outer layer of the bladder and hasn’t progressed to the inner bladder lining. Stage five bladder cancer is the most advanced and sometimes means the cancer cells have spread to other body organs. The more invasive bladder cancer is, the more difficult it can be to treat.
There are two main types of bladder cancer grades:
Low-grade bladder cancer indicates that the cancer cells resemble your normal cells to some extent. Low-grade bladder cancer can be easier to treat and isn’t as quickly growing.
High-grade bladder cancer is characterized by cancer cells that differ from normal cells. These types of cancer cells are more aggressive and may spread more easily to other organs and your lymph nodes. Advanced bladder cancer (stage IV) indicates the cancer has spread to the lymph nodes or other organs that aren’t close to your bladder.
Signs and symptoms of bladder cancer
Blood in your urine
Blood in your urine is called hematuria and is a common first symptom of bladder cancer. Hematuria can also be a sign of other problems that aren’t cancer. However, if your urine is turning pink, orange, or red and it isn’t going away, it can be a warning sign of bladder cancer.
Microscopic hematuria is when there is blood present in your urine, but it’s such small amounts that it can’t be seen by the human eye. This type of hematuria is detected with routine urine tests.
Microscopic hematuria isn’t necessarily linked to bladder cancer. Approximately 10% of microscopic hematuria cases are associated with malignancy (bladder cancer).
Changes in your bladder habits
Bladder habits can change subtly from day to day, but if you notice major changes in your bladder habits it can be a red flag. Some bladder habit changes can be a sign of other underlying health issues, so it’s never a bad idea to seek medical attention if you’re concerned.
Some examples of changes in bladder habits that might be warning signs for bladder cancer include:
- Having to urinate more often than usual (can also be a sign of prostate problems or high blood sugar/undiagnosed diabetes)
- Pain or burning during urination (can also be a sign of a bladder infection)
- Feeling as if you need to urinate right away, even when your bladder isn’t full (can also be a sign of overactive bladder)
- Having trouble urinating or having a weak urine stream
- Having to get up to urinate many times during the night (can also be a sign of prostate problems or high blood sugar/undiagnosed diabetes)
Advanced cancer symptoms
If the bladder cancer cells have multiplied and spread, your symptoms can go beyond urinary symptoms.
Some signs of more advanced bladder cancer include:
- Being unable to urinate
- Lower back pain on one side
- Loss of appetite and weight loss
- Feeling tired or weak
- Swelling in your feet
- Bone pain
When to seek medical advice
Any symptoms that seem worrisome or affect your quality of life should be a call for concern. When you notice any of these symptoms, you should make a doctor’s appointment.
Cystoscopy
If your healthcare provider suspects you might have bladder cancer, they might recommend a cystoscopy. During a cystoscopy, a urologist inserts a small narrow tube (with a camera at the end) in your urethra so they can view your urethra and bladder.
This procedure carries a risk of side effects like bleeding, blood in urine, urethral stricture, and infection. Patients may also experience abdominal pain and a burning sensation while urinating, but these should gradually start to fade after the procedure.
Transurethral resection of bladder tumor (TURBT)
If your urologist suspects bladder cancer, they may recommend performing a transurethral resection of bladder tumor (TURBT) during the cystoscopy.
A transurethral resection is when a small piece of tissue is removed from your bladder in order to be biopsied to determine if it’s cancerous. A transurethral resection can also be used to treat a bladder tumor.
The most common side effects of the TURBT are bleeding, pain, and burning when urinating. These may be intermittent and can last for up to one month. In rare cases, it can cause a small tear or injury to the bladder.
Urine cytology
Urine cytology is when a urine sample is examined under a microscope to look for cancer cells.
Imaging studies
Yet another method of diagnosing bladder cancer is through imaging studies such as a CT scan. If you’re diagnosed with bladder cancer, you may also have other tests such as MRIs and PET scans to determine if the cancer has spread to other parts of your body.
Diagnosis of bladder cancer often involves microscopic examination of cancer cells.
Treatment options
Cancer treatment options have come a long way over the years. The choice of bladder cancer treatment depends on the individual’s specific stage and severity, as determined by a healthcare provider.
The treatments can come with side effects or long-term complications so you should discuss the options with your doctor and do your own research to ensure you’re making an informed choice about which treatment is right for you.
Chemotherapy (with or without radiation)
This is the primary treatment for bladder cancer. During chemotherapy, you’ll receive medication that helps kill the bladder cancer cells.
Neoadjuvant chemotherapy is when chemotherapy is administered before the surgical removal of your bladder cancer. The goal of neoadjuvant chemotherapy is to shrink your tumor before you receive further cancer treatment.
Transurethral resection
During a transurethral resection, your healthcare provider will remove superficial cancerous cells in your bladder. This treatment is only typical for early-stage bladder cancer.
Radical cystectomy
If you have a more aggressive muscle-invasive bladder cancer, the most common treatment is a radical cystectomy. During a radical cystectomy, your entire urinary bladder (and usually the prostate) is removed.
There are ways to allow you to urinate without a bladder after a radical cystectomy. One of the methods is through a urinary diversion, which is when urine flow is rerouted so it can exit your body. There are different surgical forms of urinary diversion, and your healthcare provider can discuss these with you.
While treatment options can be effective, it’s important to understand that complete remission is not guaranteed.
Because of this, you may be encouraged to take part in clinical trials to help find new cures for bladder cancer. The National Cancer Institute offers guidance as to what is entailed in a clinical trial.
Conclusion
Bladder cancer is a disease where malignant (cancerous) cells form in your bladder. Bladder cancer is more prevalent in men compared to women, and is often presented through urinary symptoms. Detecting bladder cancer early is crucial because this makes the bladder cancer treatment less invasive.
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