Learn the symptoms, types and treatments for women.
Doctors want to raise awareness about female bladder cancer because it’s often diagnosed at a much later stage than the same type of cancer in men. This may be a reason why women have worse outcomes from this type of cancer than men do.
Bladder cancer is the sixth most frequently diagnosed cancer in the U.S. It is more common in men than women, according to the American Cancer Society. The chance of a man developing it is 1 in 28. But the chance of a woman developing this cancer is 1 in 91. Still, raising awareness of bladder cancer in women is crucial, because “Death rates for women with bladder cancer are worse,” said Dr. Sam S. Chang, chief of urological oncology with Vanderbilt Urology. “This may be partially explained by the delay in diagnosis. But there may be, and likely are, some intrinsic biological features that make bladder cancer more aggressive in women compared to men.”
Women’s bladder cancer symptoms
The most common symptom in women hematuria: blood in the urine. However, blood in the urine may not always be visible. When it’s visible, it’s called gross hematuria. When it’s invisible to the naked eye, it’s called microscopic hematuria, which can be detected under a microscope during a urinalysis.
If you notice blood in your urine, go to the doctor to be evaluated. The blood may be a result of a urinary tract infection (UTI).
Blood in the urine, whether gross or microscopic, is also a common sign of such an infection, Chang said. Urinary tract infections are more common in women compared to men, and more common in older women than younger women. Bladder cancer is also more common in older women. The median age of diagnosis for both men and women is 73 (meaning half of diagnoses happen at an older age than that, and half younger). And 9 out of 10 people are diagnosed after age 55.
“As a result, many women are repeatedly given the diagnosis of a UTI and don’t receive the proper evaluation,” Chang said. “Subsequently, their diagnosis (of cancer) may be missed or delayed.”
Bacteria that indicate a urinary tract infection can be detected on urinalysis and/or a lab culture. But what if you have unexplained blood in your urine? You need further evaluation.
Bladder cancer is diagnosed with a cystoscopy, which is a procedure that uses a small camera inserted through the urethra to look inside the bladder. Radiologic imaging of the kidneys, such as CT scans or renal ultrasounds, are also included in the evaluation.
Types of bladder cancer
There are two general stages: noninvasive and invasive. Noninvasive means the cancer is not in the bladder muscle.
Invasive cancer means the cancer is in the bladder muscle. This type is more likely to spread beyond the bladder, commonly to lymph nodes, the liver, the lungs and bones.
“About a quarter of bladder cancers are muscle invasive, and those are the ones that are more likely to metastasize and lead to bladder cancer death,” Chang said.
Types of treatment
The type of bladder cancer treatment you receive will depend on the type that’s present.
“Over the past five to 10 years, the amount of research on new therapeutics has increased dramatically.”
Noninvasive treatment may involve a transurethral resection of the bladder tumor, commonly called a TURBT procedure. Or treatment may involve placing medicines inside the bladder. Although most noninvasive treatments preserve the bladder, the cancer may come back. However it is less likely to spread outside the bladder.
Invasive cancer generally requires more extensive therapy, such as bladder removal, called a radical cystectomy, and often involves chemotherapy. Radiation may be an option as well.
“Over the past five to 10 years, the amount of research on new therapeutics has increased dramatically for both localized invasive and metastatic disease,” Chang said. “We’ve had multiple FDA approvals in an area where we haven’t had anything for a long time.”
Where to learn more
Chang recommended the Bladder Cancer Advocacy Network website as a place with reliable information on symptoms, diagnosis and treatment, as well as the American Urological Association website. “These sites provide unbiased and helpful information,” he added.
Personalized cancer care
Vanderbilt Health’s Urological Cancers team is dedicated to preventing, diagnosing and treating cancers that affect the kidney, bladder, prostate and testicles. The specialized team works together to provide a precise diagnosis and effective treatment options.
