Bladder Cancer: Small State, Big Problem

Dragan Golijanin, MD

For a small state, we have a big problem! Rhode Island has the highest bladder cancer rate per capita in the country.  The disease is the sixth most commonly diagnosed cancer in the United States and has the highest recurrence rate of any form of cancer.  It’s the fifth most common cancer in Rhode Island.

Since 1950, the rate of bladder cancer has increased by 50 percent in the U.S.  In 2017, it is estimated that 77,000 new cases of bladder cancer will be diagnosed in the country and, of those, 16,000 people will die of the disease.  It is estimated that between 350 to 400 new cases of bladder cancer will be diagnosed in RI each year.

Signs and Symptoms

The most common sign – and often the only sign -- of bladder cancer is blood in the urine, referred to as hematuria.  In fact, 83 percent of patients with bladder cancer have visible blood in their urine while only 17 percent will have microscopic hematuria, meaning blood in the urine that is only visible under a microscope.  The blood may be dark red, light red or pink, and may come and go.  Women often mistake this as menstruation.

If blood in the urine is seen, your health care provider should be contacted for appropriate evaluation.  The provider may order a urinalysis (UA), blood test, imaging or a cystoscopy. 

Less common signs and symptoms may include increased frequency or urgency of urination, night sweats, flank pain, heat or cold intolerance, weight loss, decreased appetite, bone pain, pelvic pain or pain while urinating.

Risk Factors

There are a few risk factors that may increase your risk for bladder cancer.

  • Cigarette smoking: Smoking is the number one cause of bladder cancer. About 60 percent of men and 50 percent of women who are diagnosed with bladder cancer have a history of using tobacco.
  • Chemical exposure: Those who have been exposed to certain chemicals, especially in jobs where chemicals made from arsenic, arylamines or aromatic amines, are at increased risk for bladder cancer.  Such jobs include working with dyes, textiles, tires, rubber, leather, and petroleum.  Painters, printers and hairdressers are also at increased risk.  Those exposed to Agent Orange have been found to be at additional risk.
  • Age: The risk for bladder cancer increases with age.  Approximately nine out of 10 people with bladder cancer are over age 55.
  • Race:  White people have a greater risk than other races.
  • 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.

If you are diagnosed with bladder cancer, many treatments are available. Like other cancers, early detection is key.