How i knew i had bladder cancer

You have bladder cancer. Four words that can instantly send your life spinning into uncharted territory. The emotions, dealing with the diagnosis, the doctor appointments, the treatment and uncertainty of the future.

What are the tell-tale signs that something is not quite right? Lets look at what the initial symptoms of bladder cancer are, that can lead to a bladder cancer diagnosis.

Symptoms and signs of bladder cancer

• Blood in urine: Blood in the urine is the most common symptom of bladder cancer in the early stages. This is typically the first sign of early stage bladder cancer, although some people don’t experience it. The scientific term for this is hematuria. Streaks of blood in the urine may be seen or the blood may turn your urine brown, pink or even orange, this is known as gross hematuria. Blood in the urine isn’t always noticeable and may be impossible to see with the naked eye, this is referred to as microhematuria. Microhematuria is only detected by a urine test
• Problems passing urine: This could include frequent urination, painful urination and a burning sensation on passing urine
• Unexplained weight loss: Unintentional weight loss can be an sign of bladder cancer
• Lower back pain or pelvic pain: Lower back pain on one side and pelvic pain are often signs the cancer has spread into the surrounding tissue
• Feeling tired and unwell: Some of the early signs of bladder cancer can be easy to dismiss as people may confuse it with other urinary problems like urinary tract infection (UTI) and kidney stones

🦠 Bladder cancer diagnosis

Different tests can be used to detect bladder cancer and are often used in combination.

• Urinalysis: Your GP can do a urine test for bladder cancer. This is a quick, straightforward test involving dipping a testing stick into a fresh sample of your urine. The urine sample can then be tested in a laboratory for traces of blood, bacteria or abnormal cells
• Physical examination: Your GP may also carry out a physical examination of your rectum and vagina, as bladder cancer sometimes causes a noticeable lump that presses against them. If you have symptoms and physical examination or lab results suggest signs of bladder cancer, you will be referred to a specialist urology team
• Cystoscopy: A cystoscopy is performed by a urologist by inserting a small thin tube (cystoscope) through the urethra. The cystoscope has a lens to see the inside of your bladder and urethra, to examine these structures for signs of disease. During cystoscopy, your doctor may pass a special tool through the scope and into your bladder to collect a cell sample (biopsy) for testing
• Imaging tests: A CT scan or an MRI scan may be carried out if the specialist feels they need a more detailed picture of your bladder. During a CT scan, a contrast dye injected into a vein in your hand eventually flows into your kidneys, ureters and bladder. X-ray images taken during the test provide a detailed view of your urinary tract and help your doctor identify any areas that might be cancer. Once these tests have been completed, it should be possible to tell you the grade and stage of your bladder cancer

What are the risk factors for bladder cancer?

Risk factors for bladder cancer include:

• Smoking: Smoking is the single biggest risk factor for bladder cancer. This is because tobacco contains cancer-causing (carcinogenic) chemicals. People who smoke may be up to four times more likely to develop bladder cancer than non-smokers
• Chemical exposure: This is the second biggest risk factor. Chemicals known to increase the risk of bladder cancer such as aniline dyes, xenylamine, benzidine and o-toluidine. Often people exposed to these chemicals are in manufacturing occupations
• Increasing age: The risk of developing cancer increases with increasing age. Cancer can develop at any age, but is rare in people under 40 years of age
• Being male: Men are more likely than women to develop tumours in their bladder
• Previous cancer treatment: Having had cancer treatment in the past may increase the risk of cancer
• Chronic bladder inflammation: Use of a urinary catheter and recurrent urinary tract infections such as cystitis can increase the risk of bladder cancer
• Family history of cancer: Those with a first-degree relative with cancer

🏥 Treatment options for bladder cancer

Bladder cancer treatment largely depends on the stage of bladder cancer. Bladder cancer treatment may include:

• Surgery: To remove the cancerous bladder cells by transurethral resection (TURBT), using heat to destroy small growths. Early bladder cancer can sometimes be treated this way. Bladder cancer usually begins in the cells of the bladder lining (non-muscle-invasive bladder cancer). It’s usually possible to remove the cancerous cells while leaving the rest of the bladder intact. If you have large or multiple tumours, your doctor may recommend surgery to remove the bladder (cystectomy). More advanced bladder cancer may also need the nearby lymph nodes to be removed (radical cystectomy)
• Chemotherapy: In the bladder or the whole body
• Radiation therapy: To destroy cancer cells. Given by a machine that beams the radiation at the bladder
• Immunotherapy: To trigger the immune system to recognise and attack cancer cells, often used for advanced bladder cancer. Your provider might recommend Bacillus Calmette-Guérin (BCG) or PD-1 or PD-L1 inhibitor immunotherapies to treat bladder cancer
• Targeted therapy: To treat advanced cancer when other treatments haven’t helped

In addition to various treatment plans, clinical trials are often suggested in efforts to offer patients latest advances in care, gain insight for future patients and to provide close monitoring.

Conclusion

The most common symptom of bladder cancer is blood in your urine, which is usually painless. Even if you don’t have blood in your urine all the time, you should visit your healthcare provider, so the cause can be investigated.

Sources

• Bladder cancer – NHS
• Bladder Cancer: Symptoms, Causes & Treatment
• Bladder cancer – Symptoms and causes – Mayo Clinic
• Bladder cancer | NHS inform
• Bladder cancer | Cancer Research UK