There will be approximately 81,400 new cases of bladder cancer in the United States in 2020. The American Cancer Society has noted a slight decline in new cases and deaths related to bladder cancer, but it is still important to understand this illness. What are the causes of bladder cancer? Who is at risk? How can you spot the warning signs? Learn about bladder cancer and how to get help for yourself or your loved ones.
What Is Bladder Cancer?
Bladder cancer is a common type of cancer that affects the urinary system. Typically, bladder cancer will begin in the lining of the bladder, the organ that holds urine in the body. Cancer occurs when cells in this organ grow abnormally, eventually forming a tumor. It is possible for bladder cancer to spread to other parts of the body, such as the lymph nodes or other organs.
Thankfully seven out of 10 cases of bladder cancer are caught early, and when caught early, bladder cancer is very treatable.
What Are the Main Causes of Bladder Cancer?
The exact cause of most bladder cancers is not completely understood, but researchers are beginning to understand more. Certain gene mutations — changes in our DNA — can result in abnormal cell growth. The immune system may recognize some of these cells and destroy them, but mutated cell growth can get out of control. When this happens, the cells can form a tumor.
The cell mutations that lead to cancer are often related to oncogenes and tumor suppressor genes. Oncogenes are responsible for cell growth and division, while tumor suppressor genes help regulate healthy cell division. Mutations that turn on oncogenes or turn off tumor suppressor genes can lead to cancer.
People can also inherit certain genetic conditions that may cause bladder cancer. For example, Cowden syndrome and Lynch syndrome are associated with an increased risk of bladder cancer. Cowden syndrome is characterized by the appearance of noncancerous growths on different parts of the body. The syndrome is also associated with an increased risk of cancer in the breast, thyroid, uterus and bladder. Lynch syndrome is one of the most common inherited cancer syndromes and results in an increased risk of certain cancers, including colorectal cancer and bladder cancer.
While genetics can play a significant role in developing bladder cancer, many other risk factors can increase the likelihood.
Who Is at Risk for Bladder Cancer?
Bladder cancer risk factors can be related to your lifestyle, your environment and the medications you take.
1. People Who Smoke
The link between smoking and an increased risk of various kinds of cancer is well-established. Approximately 50% of bladder cancer cases in both men and women are due to smoking. Previous research indicated that just 20 to 30% of bladder cancer cases in women were caused by smoking. Overall, current smokers are four times more likely to get bladder cancer than nonsmokers. The toxic chemicals in cigarettes exit the body through the urinary tract, which means the bladder is in contact with those carcinogens.
2. People Over the Age of 55
The older we get, the higher the risk of bladder cancer. The American Cancer Society reports that approximately 90% of cases occur in people who are older than 55. Age is overall one of the most important risk factors for any type of cancer. As we age, our cells become more susceptible to the mutations that lead to cancer. Unlike lifestyle choices, like smoking, we cannot control our body's aging. Get to know your own body, watch for any changes, and discuss concerns with your doctor.
Men are about three times more likely than women to develop bladder cancer. This type of cancer is also most prevalent in white men. Caucasian men are twice as likely as African American men to have bladder cancer.
4. People With a Family History of Cancer
A family history of bladder cancer can increase your risk of developing the same illness. A recent study found a two-fold risk of bladder cancer associated with a family history. This risk increases in smokers with a family history of cancer. A family history of cancer can be related to both genetics and shared lifestyles.
5. People With Chronic Bladder Inflammation
Chronic bladder inflammation has been linked to an increased risk of bladder cancer. Chronic inflammation can be related to frequent bladder infections or cystitis, certain parasitic infections and prolonged use of a urinary catheter.
6. People Exposed to Certain Chemicals
Working in certain industries can expose people to carcinogenic chemicals. For example, certain chemicals used in textiles, leather, rubber, dyes and paints can increase the risk of bladder cancer. Chemicals referred to as aromatic amines have been linked to bladder cancer. Jobs associated with chemical exposure can include truck drivers, printers, painters and hairdressers. Exposure to arsenic, which can be found in drinking water, has also been associated with an increased risk of bladder cancer.
7. People Who Take Certain Medications
We sometimes need to take medication to manage an illness or chronic condition, and medication can come with side effects. For example, certain diabetes drugs containing pioglitazone were found to increase bladder cancer risk. Similarly, chemotherapy and radiation therapy for another type of cancer could increase the risk of developing bladder cancer.
What Are the Warning Signs of Bladder Cancer?
Any type of cancer, including bladder cancer, is easier to treat when it is caught early. If you are experiencing any of the symptoms of bladder cancer, talk to your doctor as soon as possible. Warning signs include:
1. Blood in the Urine
Blood in the urine, clinically called hematuria, is one of the most common symptoms of bladder cancer. You may notice that your urine is orange, red or pink in color. It is also possible to see blood clots in your urine. Hematuria can be a constant or intermittent symptom. You may notice it each time you go to the bathroom or only see blood on occasion. It could be days or even weeks between noticing visible blood in the urine. You may not feel pain when experiencing hematuria. Regardless of the frequency, this symptom means you need to be screened for bladder cancer.
While hematuria is a warning sign of bladder cancer, it is not a confirmation. Blood in the urine can be caused by several other conditions, including a bladder infection or a kidney infection. Most people with visible hematuria don't have bladder cancer. It is also possible to have hematuria that is not visible to the naked eye, which may be caught during a routine urinalysis. In the case of microscopic hematuria, people rarely have bladder cancer.
2. Frequent Urination
Frequent urination, including urinary leakage, may be another indicator of bladder cancer. Take note if you need more frequent trips to the bathroom during the day or even waking up multiple times during the night to urinate. This can be a symptom of a urinary tract infection or an overactive bladder in both men and women. It can also indicate an enlarged prostate in men.
While you may feel a more frequent need to urinate, you may have difficulty passing urine or a weak stream. Talk to your doctor if you notice an increase in urination or any difficulties urinating.
Bladder cancer can cause various types of pain. You may feel a burning sensation while urinating. You may also feel the uncomfortable sensation of urgently needing to urinate when you do not have a full bladder. These symptoms are also common indicators of an infection or kidney stones.
The later stages of bladder cancer may cause pain in the back and pelvic region. The pain may be localized to one side of the lower back or the mid-back. You may also feel pain in the perineum, which could be caused by pressure. Bladder cancer may result in a blockage of the ureter, making it difficult to void the bladder completely.
Advanced stages of bladder cancer can result in fatigue, bone pain and inability to urinate. If you experience any of the warning signs of bladder cancer, talk to your doctor as soon as possible.
How Is Bladder Cancer Diagnosed?
If you have any of the warning signs of bladder cancer, you should make an appointment with a doctor as soon as possible. Doctors have several different diagnostic tools to help diagnose the root cause of your symptoms, whether it is bladder cancer or another condition. When your doctors order diagnostic tests, they will give you any special instructions for preparation and answer any of your questions. Here is what to expect from some of the common diagnostic tests for bladder cancer28:
1. Urine Cytology
Urine cytology is a test to detect abnormal cells in the urine. Your doctor may order this test if you have noticed blood in your urine. Urine for the test is gathered in one of two ways. First, you may be asked to urinate into a sterile cup. Second, the urine may be collected via a urinary catheter. Once the urine is collected, the sample will be sent to a lab for analysis.
In the lab, a pathologist will analyze the urine sample. If the sample is contaminated or does not contain enough cells to analyze, the test may need to be repeated. The pathologist will be looking to confirm if there are cancer cells present in the urine or not. If no cancer cells are visually observed, the test is considered negative. The test may also uncover suspicious cells, which require further investigation, or find cancer cells, which means the test is positive.
Although urine cytology is typically a first-line diagnostic tool, the subjective nature of the test often leads to inconclusive findings. If abnormal cells are detected in a sample, your doctor may order further tests to confirm the presence of bladder cancer.
2. Imaging Tests
Several different imaging tests can be used to diagnose bladder cancer. An ultrasound, which uses sound waves, is a localized imaging test that can be used to view the bladder and kidneys.
Computed tomography (CT) scans and magnetic resonance imaging (MRI) scans are two commonly used tests. CT scans use x-rays to create a detailed image of the urinary system, including the kidneys, bladder and ureters. This image can help doctors determine the location and size of any cancerous growths. MRI scans also provide a detailed image, but this test uses radio waves instead of x-rays. CT scans and MRI scans may be used to confirm if the bladder cancer has spread to any other areas of the body.
Other imaging tests may involve the use of dye to help create a clearer picture. For example, your doctor may order an intravenous pyleogram. A special dye injected into the vein will help create a clearer x-ray of the entire urinary system and any potentially cancerous growths. A retrograde pyleogram works similarly, expect the dye is injected into a urinary catheter to reach the lining of the bladder.
Imaging tests may be performed in your doctor's office, at a hospital or at an outpatient imaging center. Your doctor will typically call you with the results and discuss next steps.
3. Cystoscopy and Biopsy
A cystoscopy is an invasive and potentially uncomfortable procedure. Your doctor, likely a urologist, will insert a thin, flexible camera called a cystoscope into the urethra to see inside the bladder. This test may be performed in the doctor's office, as it typically does not require any special dye or anesthesia.
If bladder cancer or any abnormal tissue is detected during a cystoscopy, the doctor may take a biopsy. A biopsy is a small sample of the tissue in question. The biopsy will then be sent to a laboratory for analysis. The biopsy can be a helpful tool in determining the grade and invasiveness of the cancer. Low-grade cancers are typically easier to treat, while high-grade cancers may spread to other parts of the body and be more difficult to treat. Non-invasive cancer grows on the inner cells of the bladder, while invasive bladder cancer cells grow deeper into the organ.
Test for Bladder Cancer With Cxbladder
Catching bladder cancer early saves lives, but many of the traditional diagnostic tools are invasive and intimidating for patients. Cxbladder is a non-invasive, accurate testing option that can help a wide variety of patients with symptoms that require investigation. Cxbladder offers three different urine-based laboratory tests — Cxbladder Triage, Cxbladder Detect and Cxbladder Monitor. Cxbladder Triage helps to rule out bladder cancer in low-risk patients. Cxbladder Detect can help inform a bladder cancer diagnosis in higher risk patients. Cxbladder Monitor helps catch any recurrence of the disease in patients with a history of bladder cancer.
Talk to your doctor about Cxbladder to see what makes the most sense for you. Cxbladder can help give you peace of mind and get you started on the road to the treatment you need.