Bladder Cancer

Michael Hirsh, MD
Urology
Western Wisconsin Urology, Eau Claire

The most common symptom for bladder cancer is blood in the urine, medically known as hematuria. Two common types of hematuria are microscopic hematuria and gross hematuria (visible blood in the urine). Painless hematuria is the most common presenting symptom of bladder cancer and in 85% of patients diagnosed this is the presenting symptom. The second most common symptom is urinary irritation.

Once a bladder tumor is identified, the first step is to perform a resection under anesthesia to determine whether or not the tumor is superficial or invasive. Treatment differs significantly based on this distinction.

Most superficial tumors can be treated with a minor surgical procedure and/or medication (A). For most invasive tumors (B), it would be necessary for complete bladder removal and urinary reconstruction. Bladder cancer is a condition which does not receive a significant amount of attention in the media as a health problem. Each year in the United States, approximately 65,000 people develop cancer of the bladder. Another 13,000 people die from bladder cancer yearly and bladder cancer accounts for 7% of all new cases of cancer among men and 3% of cases among women. Caucasian men have the highest incidence of bladder cancer with a rate of approximately 32.2 cases per 100,000. The male to female ratio is at least three to one. Approximately 90% of cases of bladder cancer occur in patients 55 years and older.

Cigarette smoking is currently the primary environmental risk affecting the development of bladder cancer. Most people think that cigarette smoking only leads to lung cancer and other respiratory problems. However, people who smoke cigarettes have a two to five time increased risk factor for the development of bladder cancer over nonsmokers. Quitting smoking leads to an estimated 30-60% percent reduction in bladder cancer risk.

The risk falls markedly between the first two to four years after quitting, however, it never does return to the risk of a non-smoker. Using cigars, pipes or chewing tobacco has not been shown to be a significant risk factor for the development of bladder cancer. There have been studies trying to link coffee consumption and artificial sweeteners. Neither of these has been identified as a causative factor.

It is a well known fact that certain chemicals or environmental factors play a very strong role in the development of bladder cancer. In the 1950's, English dye workers were noted to have an increased risk of bladder cancer due to exposure of some of the chemicals that they were working with. To date, they have actually banned the two chemicals that were identified (2-napthylamine and benzidine). Certain other occupations have also been noted to be at increased risk for the development of bladder cancer; namely rubber workers, leather workers, truck drivers and aluminum workers.

Our recommendation is that if bothersome urinary symptoms persist, or blood is noted in the urine, make an appointment with your primary care provider or a urologist for further evaluation. Cure rates for bladder cancer are very high if caught early, however, if left alone the outlook is not extremely optimistic.

For more information or to schedule an appointment with Dr. Michael Hirsh » 715.835.6548, Western Wisconsin Urology, Eau Claire. Dr. Hirsh also sees patients in Arcadia, Baldwin, Durand, , Neillsville, Osseo,
Shell Lake and Wabasha and Lake City, Minnesota.