November 7, 2023

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 male bladder cancer. This may be a driver of worse outcomes for women.

The chance of developing male bladder cancer is 1 in 28, whereas the chance of developing female bladder cancer is 1 in 91.

Bladder cancer is the ninth most frequently diagnosed cancer worldwide. It more commonly occurs in male patients. For comparison, the chance of developing male bladder cancer is 1 in 28, whereas the chance of developing female bladder cancer is 1 in 91, according to the American Cancer Society. Raising awareness of female bladder cancer is crucial.

“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.”

Symptoms of female bladder cancer

The most common presenting symptom of female bladder cancer is hematuria, or 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, get evaluated.

Complicating matters is that hematuria, whether gross or microscopic, is also a common sign of a urinary tract infection, Chang added. UTIs are more common in women compared to men, and in older women when compared to younger women. Bladder cancer is also more common in older women. The average age of diagnosis for both men and women is 73. 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 may be missed or delayed.”

If you notice blood in your urine, get evaluated, he added. Indeed, the blood may be a result of a UTI. The bacteria indicative of a UTI can be detected on urinalysis and/or 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 for the evaluation.

Types of bladder cancer

There are two general stages of bladder cancer: either noninvasive or 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.

Bladder cancer 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 the majority of noninvasive bladder cancer treatment preserves the bladder, the cancer may reoccur, but 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.

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