Bladder Cancer In Women

01 Bladder Cancer in Women

Bladder cancer develops when your healthy bladder lining cells begin changing and growing out of control, forming a tumor.

Your bladder is a lower abdomen balloon-shaped organ near the pelvis. It stores your urine from your kidneys until the urine passes out of your body.

For the longest time, a common thought surrounding bladder cancer was that it was a disease only older men get. But, is bladder cancer common in women? While it does occur more in men, research shows women are more likely to show up at the doctor's office with more advanced tumors than men and have a worse outcome at just about every stage of the condition.

This is because women might not recognize the disease's early symptoms. Blood in the urine is a common early bladder cancer symptom and the simplest one for women to overlook, mainly since it usually doesn't come with any pain and can go several weeks or months between occurrences. Women often ignore this symptom because they believe it's connected with their period or menopause.

According to a National Cancer Institute report, women's survival rate with bladder cancer falls behind that of men at all disease stages. When receiving a bladder cancer diagnosis, African-American women especially have a poor prognosis. They present with the greatest proportion of aggressive and advanced tumors when compared to Caucasian women and men and African-American men.

Statistics of Bladder Cancer for Women

About 90 percent of individuals with a bladder cancer diagnosis are over 55 years old.
Physicians discover 50 percent of all cases when the cancer is still in the bladder only, but 4 percent of individuals diagnosed have bladder cancer that's spread to their distant tissues.
Women have a one in 89 risk of getting bladder cancer.
Bladder cancer isn't among the 10 most common types of cancer in women.
For 2020 in the U.S., the American Cancer Society estimates are around 81,400 new bladder cancer cases (19,300 in women) and 17,980 deaths due to bladder cancer (4,930 women).
If you develop bladder cancer once, you have a high risk of it coming back, therefore being monitored regularly is typically recommended every three to six months. In some cases, bladder cancer doesn't go away but turns into a chronic condition. For this, you would require regular treatment to keep it in check.

Bladder Cancer Incidence - Men vs Women

Types of Bladder Cancer in Women

Women can develop one of several forms of bladder cancer. They are:

1. Urothelial Carcinoma

Also referred to as transitional cell carcinoma, urothelial carcinoma is a very common form of cancer of the bladder. If you develop bladder cancer, it's likely to be a urothelial carcinoma. The cancers begin in the urothelial cells lining the inside of your bladder.

Urothelial cells additionally line other areas of your urinary tract like your renal pelvis, urethra and ureters. Individuals with bladder cancer can, in some cases, develop tumors in these areas as well. Therefore all of your urinary tract should be examined for tumors.

2. Squamous Cell Carcinoma

In the U.S., around 1 to 2 percent of bladder cancer cases are squamous cell carcinomas. When you view the cells under a microscope, they look a lot like the flat cells found on your skin's surface. Almost all the bladder's squamous cell carcinomas are invasive.

3. Small Cell Carcinoma

Less than 1 percent of all types of bladder cancers are the small cell carcinoma type. These begin in your nerve-like cells. They often grow rapidly and typically require chemotherapy to treat them similar to the chemo doctors use for small cell carcinoma of the lungs.

4. Adenocarcinoma

Only around 1 percent of bladder cancers are adenocarcinoma. Adenocarcinomas have much in common with colon cancer's gland-forming cells. Almost all bladder adenocarcinomas are invasive.

5. Sarcoma

Sarcomas begin in the bladder's muscle cells. Physicians treat them similarly to transitional cell carcinomas, but if you require chemotherapy, the doctor may use different drugs.

02 Types Of Bladder Cancer in Women

Risk Factors for Bladder Cancer in Women

Certain factors increase your risk of developing bladder cancer. They include:

02 Workplace Exposures

1. Smoking

Smoking is the most common bladder cancer risk factor. Smokers are three times more likely to develop bladder cancer than non-smokers. Smoking is a causal factor in around half of all bladder cancers.

2. Workplace Exposures

Certain workplace chemicals are associated with bladder cancer. Chemicals known as aromatic amines, such as beta-naphthylamine and benzidine, which are sometimes used in the dye industry, can cause bladder cancer.

Workers in other fields using certain organic chemicals could also have a greater risk of bladder cancer. Industries that carry greater risks are textiles, leather, paint and rubber products and printing companies. Other workers have a higher risk of developing bladder cancer are printers, painters, hairdressers due to hair dyes and machinists and truck drivers who have exposure to diesel fumes.

Combining workplace chemical exposure and cigarette smoking can also act together to cause bladder cancer. Therefore, if you smoke and you also work with chemicals, you have a particularly high risk of bladder cancer.

3. Race and Ethnicity

Caucasian/whites are around twice as likely to develop bladder cancer as Hispanics and African Americans. American Indians and Asian Americans have a slightly lower rate of bladder cancer. Researchers don't fully understand all the reasons behind these differences.

4. Certain Herbal Supplements and Medications

According to the Food and Drug Administration, some diabetes medication is associated with a higher risk of bladder cancer.

Herbal supplements that contain aristolochic acid are also linked with a higher risk of bladder cancer and other urothelial cancers.

5. Arsenic in Drinking Water

Drinking water containing arsenic is associated with a greater risk of bladder cancer. However, this is not a large concern in the U.S. Where you live, as well as if you drink well water, or public system water will determine your risk. Most public water systems meet standards for low arsenic content.

6. Age

Your bladder cancer risk increases with age. Around nine out of 10 individuals with this cancer are over 55 years old.

7. Genetics and Family History

If you have family members who have bladder cancer, you have a higher risk of developing it yourself. This could also be that family members share exposure to the same chemicals that cause cancer or they share the same changes in certain genes (NAT and GST), making it harder for their bodies to break specific toxins down, increasing their risk of bladder cancer.

Signs & Symptoms of Bladder Cancer in Women

Blood in your urine is often the first and most common early symptom of bladder cancer you experience. It could be a slight amount, or it can turn your urine color to pink, orange or darker red.

You could notice blood one day and not the next day. The blood will eventually come back if you have bladder cancer. Sometimes you won't even see blood in your urine. The only way the doctor would be able to detect it is if they give you a urine test.

Other potential early signs of bladder cancer in women to look out for are:

Your urine changes color.
You need to urinate more frequently than usual.
You feel burning or pain when urinating.
You still feel like you need to urinate, despite your bladder not being full.
You urinate very little or can't urinate.

If you notice any of these symptoms, don't panic, but contact your doctor as soon as possible. These symptoms don't necessarily mean you have cancer. You could be dealing with a bladder infection, urinary tract infection or another less severe condition.

After bladder cancer has begun spreading, you might notice:

You can't urinate, even if you feel like you need to.
You're not as hungry as you usually are.
Your lower back hurts.
Your bones hurt.
You're not trying, but are losing weight.
You frequently feel very weak or tired.
You have swollen feet

Again, contact your doctor if you notice any of these symptoms. They most likely could indicate you have something else going on other than bladder cancer.

Bladder Cancer Treatment for Women

The primary types of treatment for bladder cancer are chemotherapy, surgery, radiation therapy and biological therapy. Or, the doctor may combine some of them.

04 Bladder Cancer Treatment for Women

Treatment depends on the stage and location of your cancer, your overall health, preferences, age and support system.

1. Chemotherapy

Chemo uses medications to target and shrink tumors or attack cancer cells so the surgeon can operate on them with less invasive surgery. Your doctor might apply chemotherapy as a cancer treatment before or after surgery, and you can take the medications orally, into your bladder with a catheter, or intravenously.

Doctors typically administer chemotherapy in cycles, and after every treatment period, there's a resting period to allow your body to recover. But, chemo can also affect other body cells and cause various side effects, including:

Fatigue
Nausea and vomiting
Diarrhea or constipation
Hair loss
Increased risk of infection
Increased bruising or bleeding
Mouth sores
Loss of appetite

The number of drugs you use and how you take them will determine the effects you experience. If the medications are administered directly into your bladder, you may experience milder effects. Once you finish your course of treatment, the side effects should generally resolve.

2. Surgery

All stages of bladder cancer have surgical treatment options. For instance, a transurethral resection treats stages 0 and 1. The surgeon inserts a cutting tool into your bladder and removes abnormal tissue and small tumors. They then burn away any remaining cancer cells.

If your cancer is prominent, or if it's spread deeper into your bladder, the surgeon can carry out a form of cystectomy. They can remove the part of your bladder containing cancer cells with a partial cystectomy.

A radical cystectomy removes the whole bladder and maybe even the neighboring lymph nodes, the ovaries, the uterus and part of the vagina.

You may need reconstructive surgery to provide your body with a new way of storing and removing urine.

The surgeon may use a piece of your intestine to create either:

A cutaneous continent urinary diversion: This is a small reservoir so your body can drain your urine using a catheter through a hole in your abdomen.
A urinary conduit: This is a tube that takes your urine from your kidneys and delivers it to a urostomy bag on the outside of your body.
A neobladder: A reservoir connected to your urethra that allows regular urination, sometimes with the aid of a catheter.

Side effects of surgery may include:

Bleeding
Pain
Fatigue
Bruising around the surgery site
Drainage around the surgery site
Swelling around the surgery site
Numbness
Loss of appetite

3. Radiation Therapy

Your doctor may advise you to receive radiation therapy, but this is less likely than other treatment options. You may benefit from a combined therapy of radiation and chemotherapy. It can help kill cancer that's invaded your bladder's muscular wall. It can also be helpful if you can't have surgery.

External beam radiation therapy targets high-energy radiation on cancer from a source outside your body. Typically, the treatment would consist of brief 30-minute sessions, five days a week for a few weeks.

The side effects you experience will depend on the area the beams targeted and the dosage. Side effects may include:

Diarrhea
Bladder symptoms like discomfort, blood in urine and frequent urination
Nausea and vomiting
Fatigue
Skin irritation in areas targeted

4. Biological Therapy

Biological therapy, also referred to as immunotherapy, treats early-stage cancer by encouraging your immune system to attack the cancer cells. Physicians can use several types of biological therapy, including:

Bacillus Calmette-Guerin therapy (BCG): The bacterium Bacillus Calmette-Guerin (BCG) is a highly common type of biological therapy. This bacterium is associated with the tuberculosis-causing bacterium. During BCG therapy, the surgeon uses a catheter to insert the bacterium into your bladder. The bacterium begins attracting and activating immune system cells that can then fight any cancer cells of your bladder that are present. You normally would receive this treatment once a week for six weeks.
Interferon: Another type of biological therapy is Interferon. Your immune system creates this protein to fight infection. Now, physicians may use a synthetic version to treat bladder cancer, in some cases, combined with BCG.
Tecentriq: A study in 2014 showed how Tecentriq (atezolizumab), an antibody drug, can make it simpler for your immune system to locate and destroy cancerous cells. The FDA approved this drug in 2016 as a therapy.

Side effects you may experience with BCG are often similar to flu symptoms and include fatigue, fever and a burning sensation in your bladder.

Cxbladder is a suite of non-invasive genomic urine tests optimized for bladder cancer rule out

Cxbladder is a suite of easy-to-use and non-invasive tests designed to help rule out urothelial bladder cancer in patients experiencing blood in urine (hematuria) and to monitor for recurrent disease in those who have been treated for non-muscle invasive bladder cancer. The test analyzes five biomarker genes to quickly and accurately rule out the disease, reducing the need for further invasive procedures.
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