Bladder cancer is a common urologic cancer that has the highest recurrence rate of any malignancy. In North America, South America, Europe, and Asia, the most common type is transitional cell carcinoma. Other types include squamous cell carcinoma and adenocarcinomas.
Out of all the forms of cancer that we hear about and discuss, bladder cancer doesn’t really get much attention. And the reality is, it should, as bladder cancer is the fifth most common disease in the United States. In fact, 76,000 Americans will reportedly be diagnosed with it every year. And while older men are known to be the face of this disease (it favors men about two to three times more often than women), more than 17,000 women are diagnosed with it each year.
Bladder cancer occurs when malignant cells form in the tissue of the bladder. Risk factors for it include smoking, being exposed to paints, dyes, metals and more in the workplace, having a history of bladder infections, having urinary catheters for a long time, past radiation therapy to the pelvis with specific anticancer drugs, and drinking water from a source that is high in levels of arsenic or has had chlorine in it. With all that being said, how does one come to the conclusion that something isn’t right internally?
“The symptoms that are associated with bladder cancer are actually pain with urination, often with bleeding inside the urine,” said Arjun Balar, MD, medical oncologist and assistant professor of medicine at the Perlmutter Cancer Center at NYU Langone. “As it progresses to the more advanced stages, it can cause pain in the abdomen or pelvis or spread to other parts of the body. It can be associated with loss of appetite as well as weight loss. So in its more advanced stages, there are more systemic symptoms from this cancer.”
Still, these symptoms are common in another condition that women deal with: cystitis. It’s a urinary tract infection that can often be treated with antibiotics if patients don’t allow it to go on for too long before seeing a physician (otherwise, the infection could spread to the kidneys). The risk factors for cystitis and bladder cancer are similar in certain ways, including their links to use of a long-term catheter or a reaction to certain drugs and radiation therapy. These similarities make it even harder to distinguish between the two.
“It’s actually quite difficult to differentiate the symptoms of an infection such as cystitis from bladder cancer, which is why it’s extremely important to see your physician when you have these type of symptoms, such as bleeding in the urine or pain with urination,” Balar said. “These symptoms can often mimic one another. Often, patients who are treated with cystitis or presumptive diagnosis of cystitis with multiple courses of antibiotics can sometimes have symptoms that continue to persist, and then they eventually see their physician and get a more extensive workout.”
But as for those who are already being treated for bladder cancer, Balar stated that major advancements have been made in treatment thanks to a new medicine called Tecentriq. And the progression is welcomed, as until recently, people with bladder cancer were receiving the same sort of treatment they would have received in the ’80s.
“So this is a treatment that is unlike chemotherapy and other treatments that we’ve used in bladder cancer in that it harnesses the body’s immune system so that the immune system is able to fight cancer cells,” Balar said about Tecentriq. “What’s unique about this drug is that it appears to be extremely well tolerated compared to chemotherapy, far less in terms of side effects. However, every patient is different. There are some side effects that patients can experience with this treatment that are unique to it, but it’s certainly far better than chemotherapy. And the other thing that is unique to this type of treatment is that when cancers shrink they tend to stay that way, which is very unlike what we see with chemotherapy drugs.”
The best way to know if this treatment will work right for anyone with bladder cancer is obviously to speak with your doctor (as you should also do if your bladder has been acting and feeling different than usual), but as Balar stated, “this does represent a major leap forward in the management of this cancer.