Bladder cancer occurs when the cells in the bladder’s lining grow out of control. Symptoms can include urgency and frequency of urination, as well as irritation when urinating.

The most common symptom – blood in the urine, clinically known as hematuria – is often overlooked or mistaken as a symptom of a urinary tract infection or a kidney stone.

Common concern

“It’s a significant public health issue,” says Dr. Gary D. Steinberg, the chairperson for the Scientific Advisory Board for the Bladder Cancer Advocacy Network and the Bruce and Beth White Family Professor and Director of Urologic Oncology University of Chicago Medical Center. “There’s a lack of awareness.”

However, there has been a wealth of new clinical trials and the FDA approved two new treatments for bladder cancer in the past 2 to 3 years including the approval of Tecentriq and Opdivo, novel immunotherapies for bladder cancer.

“People with bladder cancer, especially celebrities, are very, very reticent to let anyone know,” says Dr. Steinberg, mentioning Frank Sinatra, Hubert Humphrey and former archbishop of Chicago Cardinal Francis George all had bladder cancer. “Patients don’t talk about it.”

Diagnosis                 

Bladder cancer is what Dr. Steinberg is a “diagnosis of the disease of aging,” explaining the average age of a bladder cancer patient in the U.S. is 73; however, bladder cancer can also occur in all age groups.

“Patients know to get mammograms, pap smears and colonoscopies, but they don’t get screened for bladder cancer.”

It’s three to four times more common in men than women. Still the disease does affect women and is associated with a higher mortality rate in women than men.

“Early diagnosis and detection does lead to better outcomes,” says Dr. Steinberg, encouraging patients and doctors to work together to understand why a patient has blood in their urine.

Often patients and doctors don’t take the potential warning sign seriously. Whether hematuria is microscopic or “gross,” meaning large or visible to the eye, a patient should get tested with urine culture, urine cytology, CT scan and cystoscopy. Newer detection methods include using enhanced cystoscopy techniques with Cysview and Blue light cystoscopy allow the urologist to more accurately identify, biopsy and remove the bladder tumor.

Risk factors

Patients know to get mammograms, pap smears and colonoscopies but they don’t get screened for bladder cancer. In part that’s because there’s no definitive, sensitive screening test to diagnose the disease.

Knowing who’s at risk may help patients and providers detect the cancer; however, all patients with blood in their urine should be tested, especially men over 50 and women after they enter menopause.

Smokers are at significant risk for developing the disease. They get bladder cancer at least 4 to 5 times as often as nonsmokers and smoking is the greatest modifiable risk factor for bladder cancer.

Others at risk may include people who work in heavy industry such as the rubber, petroleum or chemical industries. That’s because those jobs may expose workers to carcinogens in the workplace environment, such as petroleum products, aromatic amines and diesel exhaust.