This year alone, 80,000 Americans will be diagnosed with bladder cancer, and it will take the lives of 17,000. Here’s what you need to know to diagnose bladder cancer early and treat it promptly.
Men are at greater risk for bladder cancer
Men are four times more likely to receive a bladder cancer diagnosis in their lifetimes than women, and it’s the fourth most common cancer in men. Doctors aren’t completely sure why this is, but a study shows it might have something to do with a group of hormones known as androgens that seem to influence tumor growth in the bladder
At the same time, while men may be more likely to develop bladder cancer the mortality rate for women with bladder cancer is higher, according to the American Society for Clinical Oncology. That’s why it’s important for everyone to be aware of the signs and symptoms of bladder cancer, regardless of personal risk.
What signs and symptoms should I be looking out for?
Symptoms of bladder cancer can mimic those other conditions such as kidney stones or bladder infection—it’s vital to be aware of signs that something more serious may be going on.
For most people diagnosed with bladder cancer, the first symptom was visible blood in their urine. This can often be confused as menstruation or urinary tract infections, but it’s also possible for blood to be present in the urine without being detected by the naked eye. For this reason, it’s important to get any blood in the urine or other symptoms (such as pain or burning during urination and lower back, abdominal or pelvic pain) evaluated to ensure that your doctor can order the appropriate laboratory tests.
In 2013, David Dimick, a successful business man, husband and father of two children, noticed blood in his urine. A doctor confirmed that Dave had an aggressive form of bladder cancer and recommended treatment immediately.
“I was shocked to get that kind of news, but I knew we needed to act quickly,” Dave recalls.
According to the American Cancer Society, when bladder cancer is found at stage 0 (its earliest stage) the five-year survival rate is 95 percent.
I have some symptoms…what do I do?
If you have symptoms, your doctor will do a series of tests to first ensure there is no infection by doing a urine culture and, for men, to check for any prostate issues by doing a digital exam.
If those issues are ruled out, your doctor may perform further testing, such as examining the interior of the bladder (cytoscopy) or taking small biopsy samples to confirm diagnosis.
Typically, when bladder cancer is found, the most common form is urothelial carcinoma, comprising 90 percent of all cases.
For about 1 in 3 new bladder cancer patients, the cancer has spread into deeper layers of (but not left) the bladder. From here, the cancer can spread to the lymph nodes (known as locally advanced) or other, more distant parts of the body (metastasized).
“I try to remind my patients they are not statistics and every cancer case is unique,” says Dr. Marc Matrana, M.Sc., F.A.C.P., Senior Medical Oncologist at Gayle and Tom Benson Cancer Center. “There is a lot of hope out there for patients with advanced bladder cancer, and working closely with and being an active member of your healthcare team is critical to finding the best path forward.”
What’s the right treatment for me?
There are a variety of treatment options for bladder cancer. Your doctor will work with you to determine the best approach depending on the type and stage of your individual cancer, but treatment options generally include surgery (to remove all or part of the bladder), radiation, chemotherapy, and immunotherapy. Some treatments are done around the same time, such as surgery and chemotherapy.
Dave’s doctor determined chemotherapy and surgery would be the appropriate first course of action.
“When evaluating a patient* for treatment, I take the patient’s history and current disease status into account to determine the best treatment for their type of cancer,” says Dr. Matrana.
Multiple rounds of treatment are often necessary
A major concern for many people with early-stage bladder cancer is that new cancers often form in other parts of the bladder over time. And in cases of bladder cancer that are locally advanced or metastatic, the cancer almost always returns—up to 86 percent of locally advanced and metastatic cancers progress within two years.
Dave unfortunately experienced the persistence of bladder cancer firsthand despite multiple cycles of chemotherapy and bladder reconstruction surgery.
“Only three months after I had treatment and surgery, it was back,” Dave recalls. “One of the lymph nodes came back positive. I couldn’t believe I was already experiencing a recurrence. It was hard on my family, too.”
For many, the treatment journey can feel frightening and overwhelming, especially for those who have progressed after their first line of treatment. But it’s important to not give up. There are treatment options available after patients have progressed on their first line treatments and managing your disease is still possible.
Immunotherapy offers some patients new hope
Immunotherapy is a type of treatment that works with your immune system to find and attack cancer.
“After we knew chemo was no longer working, my son said he had been reading online about immunotherapy, so I looked it up myself. I read about how immunotherapy teaches your immune system to fight cancer, and that’s when I knew I wanted to try it. As of my last scan, there was no evidence of disease.” Dave recalls.
Currently FDA approved, at the time, Dave participated in a clinical trial for IMFINZI® (durvalumab), an immunotherapy medicine.
IMFINZI can cause serious side effects. Dave and his doctor had to pause treatment twice because of inflammation. Once those side effects were under control, he was able to resume treatment.
“If you’re diagnosed with bladder cancer, you should know you’re not alone,” Dave says. “There’s always a reason to hold onto hope. I encourage others with this diagnosis to be proactive and talk to your doctor about available treatments.”
If you think an immunotherapy such as IMFINZI might be right for you, talk to your doctor. It’s important to discuss all treatment options with your medical team— there are more therapy options available now than ever before.
Who is IMFINZI for?
IMFINZI® (durvalumab) is a prescription medicine used to treat a type of cancer in the bladder and urinary tract called urothelial carcinoma. IMFINZI may be used when your urothelial carcinoma has spread or cannot be removed by surgery, and chemotherapy containing platinum did not work or is no longer working. IMFINZI was FDA approved for this use based on a clinical study that measured how many patients responded and how long they responded. The study is ongoing to confirm clinical benefit.
It is not known if IMFINZI is safe and effective in children.
What is the most important information I should know about IMFINZI?
IMFINZI is a medicine that may treat a type of cancer in the bladder and urinary tract by working with your immune system.
IMFINZI can cause your immune system to attack normal organs and tissues and can affect the way they work. These problems can sometimes become serious or life-threatening and can lead to death.
Call or see your healthcare provider right away if you develop any symptoms of the following problems or if these symptoms get worse:
Lung problems (pneumonitis). Signs and symptoms may include new or worsening cough, shortness of breath, and chest pain.
Liver problems (hepatitis). Signs and symptoms may include yellowing of your skin or the whites of your eyes, severe nausea or vomiting, pain on the right side of your stomach area (abdomen), drowsiness, dark urine (tea colored), bleeding or bruising more easily than normal, and feeling less hungry than usual.
Intestinal problems (colitis). Signs and symptoms may include diarrhea or more bowel movements than usual; stools that are black, tarry, sticky, or have blood or mucus; and severe stomach-area (abdomen) pain or tenderness.
Hormone gland problems (especially the thyroid, adrenals, pituitary, and pancreas). Signs and symptoms that your hormone glands are not working properly may include headaches that will not go away or unusual headaches; extreme tiredness; weight gain or weight loss; dizziness or fainting; feeling more hungry or thirsty than usual; hair loss; feeling cold; constipation; your voice gets deeper; urinating more often than usual; nausea or vomiting; stomach-area (abdomen) pain; and changes in mood or behavior, such as decreased sex drive, irritability, or forgetfulness.
Kidney problems, including nephritis and kidney failure. Signs of kidney problems may include decrease in the amount of urine, blood in your urine, swelling of your ankles, and loss of appetite.
Skin problems. Signs may include rash, itching, and skin blistering.
Problems in other organs. Signs and symptoms may include neck stiffness; headache; confusion; fever; chest pain, shortness of breath, or irregular heartbeat (myocarditis); changes in mood or behavior; low red blood cells (anemia); excessive bleeding or bruising; muscle weakness or muscle pain; blurry vision, double vision, or other vision problems; and eye pain or redness.
Severe infections. Signs and symptoms may include fever, cough, frequent urination, pain when urinating, and flu-like symptoms.
Severe infusion reactions. Signs and symptoms may include chills or shaking, itching or rash, flushing, shortness of breath or wheezing, dizziness, fever, feeling like passing out, back or neck pain, and facial swelling.
Getting medical treatment right away may help keep these problems from becoming more serious. Your healthcare provider will check you for these problems during your treatment with IMFINZI. Your healthcare provider may treat you with corticosteroid or hormone replacement medicines. Your healthcare provider may delay or completely stop treatment with IMFINZI if you have severe side effects.
Before you receive IMFINZI, tell your healthcare provider about all of your medical conditions, including if you have immune system problems such as Crohn’s disease, ulcerative colitis, or lupus; have had an organ transplant; have lung or breathing problems; have liver problems; or are being treated for an infection.
If you are pregnant or plan to become pregnant, tell your healthcare provider. IMFINZI can harm your unborn baby. If you are able to become pregnant, you should use an effective method of birth control during your treatment and for at least 3 months after the last dose of IMFINZI. Talk to your healthcare provider about which birth control methods to use. Tell your healthcare provider right away if you become pregnant during treatment with IMFINZI.
If you are breastfeeding or plan to breastfeed, tell your healthcare provider. It is not known if IMFINZI passes into breast milk. Do not breastfeed during treatment with IMFINZI and for at least 3 months after the last dose of IMFINZI.
Tell your healthcare provider about all the medicines you take. This includes prescription and over-the-counter medicines, vitamins, and herbal supplements.
What are the possible side effects of IMFINZI?
IMFINZI can cause serious side effects (see above).
The most common side effects in people with urothelial carcinoma include feeling tired, muscle or bone pain, constipation, decreased appetite, nausea, swelling of your arms and legs, and urinary tract infection.
Tell your healthcare provider if you have any side effect that bothers you or that does not go away. These are not all the possible side effects of IMFINZI. Ask your healthcare provider or pharmacist for more information.
Call your healthcare provider for medical advice about side effects.
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