By John Burns, MD
As you head to the bathroom during your commercial break of “Christmas Vacation” this holiday, a little indulgence is okay, but try to avoid the smoke from Uncle Eddie’s cigar or the toxic lime Jell-O mold that Aunt Bethany brought.
The point is that many of the things that we put in our bodies get metabolized, filtered through the kidneys and end up dwelling in the bladder until your next commercial break. Over time, the bladder becomes exposed to many of the toxic elements that we expose ourselves to, which can sometimes lead to cancer.
So, let’s break the seal on bladder cancer.
Bladder cancer is the fourth most common cancer in men and the fifth most common cancer overall. In the United States in 2018, about 81,000 new cases of bladder cancer and 17,000 deaths from bladder cancer are expected.
Bladder cancer typically presents with patients who have either visible or microscopic blood in the urine, called hematuria. Bladder cancer is found in roughly one-third of patients with visible hematuria, and up to 10.5 percent of patients with microscopic hematuria. It can present in patients who have pain with urination in the absence of an infection. If you are experiencing any of these symptoms or are ever told that you have blood in your urine, tell your doctor.
Bladder cancer is generally considered to be a disease of the elderly. Men over the age of 70 are more likely of developing bladder cancer compared to men in their 60s; is it less likely for men ages 40 to 59. Current smokers are also four times more likely to get bladder cancer, and former smokers are twice as likely as those who don’t smoke to get bladder cancer. Men are more likely than women, and working in certain industries, such as textiles, paints and rubber, puts some people at increased risk.
Treating bladder cancer is really dependent on which grade of tumor you have and the stage of your tumor. In general, there are two varieties: high-grade and low-grade.
High-grade tumors are more likely to invade the bladder wall and metastasize to other sites. These tumors are managed with an endoscopic procedure to scrape the tumor off the bladder wall, known as a transurethral resection of bladder tumor, and sometimes with more aggressive treatment. Depending on the stage, this treatment may be followed by putting medicine into the bladder to prevent recurrences or chemotherapy followed by removal of the bladder if it is more advanced.
The low-grade variety are more of a nuisance than a threat – 95 percent will grow within the urinary tract but rarely metastasize or cause death. They do have a high recurrence rate of about 50 percent and require surveillance cystoscopies to ensure they do not return.
So, how can you prevent bladder cancer?
Unfortunately, there is no Holy Grail vitamin supplement that can prevent bladder cancer. The best advice I can give you is if you are a smoker, get help to quit smoking. Make sure you eat a balanced diet and have regular follow ups with your primary care provider. And if you see blood in the urine, please tell someone. If it’s caught early, bladder cancer can be treated and cured.
Enjoy your holiday season – be well and be safe!
John Burns, MD, is a urologic oncologist at Mission Urology.