It’s rarely in the news, but bladder cancer occurs in just as many people as skin cancer or lymphoma, although men are nearly three times more likely than women to be diagnosed.
The disease is highly curable when caught early, but treatments can become more involved with late-stage disease. So what can you do to lower your risk of bladder cancer, and what are your options if you face a diagnosis? Bladder cancer expert Sumanta Pal, M.D., assistant professor of medical oncology, enlightens us about this oft-overlooked form of cancer.
 Sumanta Pal (Photo by Thomas Brown) |
EHope: What causes bladder cancer?
Sumanta Pal, M.D.: It’s largely unknown what causes bladder cancer. Chronic irritation, such as traces of toxic chemicals or a urinary tract infection, appears to raise risk. Smoking is a big risk factor, also. The carcinogens from smoking can pool in the bladder, causing prolonged exposure.
EH: What are some of the early signs of bladder cancer?
SP: The most common symptom is blood in the urine. It isn’t always visible (we call this microscopic blood), but it turns up in lab tests. Other symptoms include painful urination and pain around the bladder and lower back. More advanced disease can cause fatigue and severe weight loss as well as difficulty urinating.
EH: Is there an easy way to screen people for the disease, such as a blood test?
SP: There currently is no screening test for bladder cancer.
EH: How do doctors diagnose bladder cancer?
SP: If we suspect bladder cancer, we test a urine sample. We also can look directly at the inside of the bladder with an instrument called a cystoscope. That’s the most reliable. We also might use a CT scan to check if a tumor has spread outside the bladder into surrounding tissues.
EH: Why are men more susceptible to developing bladder cancer than women?
SP: Historically, the belief was that men smoke more than women and may be more exposed to toxic chemicals in their jobs, increasing their risk. Recent studies point to gender-specific hormones, however, so it’s a bit up in the air.
EH: How is bladder cancer treated, and does treatment differ for men and women?
SP: Treatment, in general, is the same for men and women, and it depends on the stage of disease. If we catch it early, we can surgically remove the tumor. Or we might introduce anticancer agents into the bladder. If the cancer invades surrounding tissues, we remove the bladder and nearby organs that are at risk. If the disease is metastatic, spreading to distant sites in the body, we give chemotherapy.
EH: Following treatment, is recurrence a problem, and if so, how can a patient reduce the risk of recurrence?
SP: Risk of recurrence depends on stage, of course. To reduce recurrence, we will give chemotherapy before removal of the bladder or we may instill anticancer agents into the bladder. As always, we carefully assess each individual to give the right treatment and follow-up care for that patient.
