Bladder Cancer and Younger Women: Symptoms You Shouldn’t Ignore!

Dragan Golijanin, MD

Did you know Rhode Island has the highest per capita rate of bladder cancer in the country?  Each year, between 350 and 400 cases are diagnosed in RI alone.

Facts and stats on bladder cancer

  • Men have a higher incidence of bladder cancer than women.
  • Older adults are particularly affected as the risk for bladder cancer increases with age.  Nine out of ten people diagnosed are over the age of 55.  The average age is 73.
  • Bladder cancer has the highest recurrence rate of any form of cancer.
  • Due to the incidence and recurrence, prevention, early detection and prompt treatment are imperative.

The signs and symptoms

Bladder cancer is often painless unless it is in an advanced stage of disease. The most common and sometimes the only warning sign of bladder cancer is blood in the urine.

  • Some individuals may have visible blood in their urine while others may have microscopic blood in the urine, meaning blood in the urine that is only visible while looking at it under a microscope.
  • The blood may be dark red, light red or pink, and may come and go.
  • Although blood in the urine is the most common symptom of bladder cancer, it could also be caused by kidney or prostate cancer, enlarged prostate, kidney stones, urinary tract infection, or trauma or injury to the urologic organs.  Because of the many possible causes, evaluation by a urologist is key to a quick, accurate diagnosis.

Less common symptoms of bladder cancer include:

  • frequency or strong urge to urinate
  • burning or pain while urinating
  • waking at night to urinate
  • night sweats
  • heat or cold intolerance
  • weight loss
  • decreased appetite
  • pelvic or flank pain

More younger women

Recently, there has been an increase in the number of women in their forties and fifties diagnosed with bladder cancer. Because it’s not commonly thought of as a disease that impacts this group, women in particular may tend to ignore the most common sign -- blood in the urine. Women may mistakenly assume blood in the urine is due to a more common condition, such as a urinary tract infection or menstruation, and disregard it.

Increasing numbers of women are treated and retreated with antibiotics for an alleged urinary tract infection. The antibiotics may actually resolve symptoms that could be associated with bladder cancer, but only temporarily.  When the symptoms return, and more antibiotic treatments fail, it results in a delayed referral to a urologist, and ultimately a delay in treatment.  Please, never ignore blood in the urine!  Evaluation by a urologist is key to diagnosis.

Reduce your risk

There are a few risk factors that may increase your risk for bladder cancer. You may lower your risk by making changes to your lifestyle.

  • Cigarette smoking: Smoking is the number one cause of bladder cancer. Most people diagnosed with bladder cancer have a history of cigarette smoking.  If you currently smoke, quit now. Free smoking cessation counseling and nicotine replacement therapy are available through the Rhode Island Department of Health QuitWorks program by calling 1-800-QUIT-NOW.  In addition, help is available through Lifespan’s Smoking Cessation Counseling program. Research has also shown hypnosis may be an effective method to help smokers quit.
  • Occupational exposure to chemicals, organic solvents: Those who have been exposed to certain chemicals, especially in jobs that involve chemicals made from arsenic, arylamines or aromatic amines.  Such jobs include working with dyes, textiles, pesticides, herbicides, tires, rubber, leather, and petroleum. Painters, printers, hairdressers and those who worked in jewelry manufacturing or the leather/tanning industries are also at increased risk, along with those who were exposed to Agent Orange.
  • Certain diabetes medications: Pioglitazone, also known as Actos, has been shown to increase the risk of developing bladder cancer by up to 63 percent when the medication is taken for more than one year.

There are other factors that increase your risk, but unfortunately cannot be modified. Those include aging, risk increases with age; and race, Caucasians are at a greater risk than other races.

If you experience blood in the urine, you should be evaluated by a urologist as soon as possible. No one should ignore this symptom, but especially women and those who are at higher risk. Prompt diagnosis and treatment are essential.

To evaluate for bladder cancer, a provider will assess for risk factors of urologic disease and order tests, such as a urinalysis, blood test, a urological procedure called cystoscopy, or diagnostic imaging with a CT scan.

The experts at the Minimally Invasive Urology Institute at The Miriam Hospital can help. Learn more about us on our website.

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