Bladder cancer is not a widely known disease despite being the 6th most common cancer in the United States. As a urologist who diagnoses and treats bladder cancer, my patients often ask questions about how it develops. My patients also want to know about signs and symptoms related to the disease, and how to lower their risk.
Who is at Risk for Bladder Cancer?
Anybody can get bladder cancer, but it is most common in older adults (over 60-65 years old). There are also risk factors that raise the chance of getting bladder cancer such as:
- Radiation therapy in the pelvic area
- Arsenic in drinking water
- Chemicals in the workplace
Hairdressers, painters, printers and dry-cleaners are also at risk for bladder cancer due to the long-term exposure of harmful chemicals.
What are the Signs and Symptoms of Bladder Cancer?
The most common symptom of bladder cancer is painless blood in the urine. This may appear as pink, red or dark brown. Patients often confuse this with amber (or concentrated) urine which is not the same thing. However, if you are unsure, it is best to have your urine checked by your doctor. They can do a quick test of your urine (called a dipstick urinalysis), and if positive, can send it for a formal test (called a microscopic urinalysis) to confirm the presence of blood.
How is Bladder Cancer Found?
If your urine shows blood (or you have seen blood - even if only a single time!), you should be tested for bladder cancer. Many patients will have on and off blood in the urine, so just because the blood goes away, does not mean that you are cancer-free. Your urologist will find bladder cancer with two tests:
- Imaging test (usually a computerized tomography (CT) scan). Imaging looks at your kidneys which can be a source of blood in the urine.
- Cystoscopy (a small camera attached to a long, thin tube is put into the opening of your urethra and into the bladder). Cystoscopy looks at your bladder lining to detect tumors that can be another source of blood. The test is about 1-2 minutes and is well-tolerated by patients.
Can you Screen for Bladder Cancer?
Currently, screening for bladder cancer is not recommended because our tests are not accurate enough to diagnose the disease. However, for some patients who are very high risk, your doctor may want to perform a urine test (urinalysis) to screen for blood in the urine.
What Can I Do to Reduce my Risk of Bladder Cancer?
If you smoke (cigarette, cigar or pipe), it is never too late to quit! Smoking increases your risk of getting bladder cancer by at least 2-3 times that of people who do not smoke. When you quit smoking, your risk goes down (although it may never go back to zero).