If you’ve watched any news about medicine in the last few years, you’ll know the trend. Researchers have discovered that female bodies don’t respond to medicines the same as male bodies do. Disease risk differs by sex, as well as its impacts. Yet, for most of modern medical history, research has focused solely on diagnosing and treating men.
When it comes to bladder cancer symptoms, then, it should come as no surprise that they differ in men and women. (And, for clarity, we’re speaking broadly about differences related to biological sex, not gender. Disease risk can relate to hormones, reproductive organs, sex organs, etc. Since variations of these exist in each of us, risk is individual and should be assessed by a provider.)
It’s important to know how cancer can affect us. It can also help you spot warning signs and catch cancer as early as possible.
We talked to Terran Sims, ACNP, a UVA Health nurse practitioner who works with many bladder cancer patients. She shared some important facts about bladder cancer symptoms and risk to consider.
Fact #1 - Men & Women Have Different Kinds of Risk
Men and women share some risks. For example, the risk of bladder cancer goes up after age 55 for all patients. But sex can play a role, too. Men are more likely than women to have bladder cancer.
“We know that men are 4 times more likely to have bladder cancer than women,” Sims says. “But women who have bladder cancer have a higher risk of recurrence, regression, and possible fatality.”
Even though women are less likely to have bladder cancer, those that do are more likely to have a serious case. The cancer may be more advanced. Or, it might be more likely to return after treatment.
That’s why spotting the early signs of bladder cancer in females is so important.
Fact #2 – The Earliest Sign of Bladder Cancer Can Be Hard for Women to Spot
Some early signs of bladder cancer in females and males are:
- Blood in urine
- Changes in urination
- Lower back pain
Blood in urine is the most common. But this symptom can be hard to notice. You may think it’s related to your cycle, menopause, or a urinary tract infection (UTI). Sometimes, it can be hard for providers to notice, too.
“We do think that women are diagnosed late, and that can be because early signs are explained away by other diagnoses, like having menstruation or having a UTI,” Sims says. “We do meet a lot of women who have been treated for UTIs for a while without a solution.”
Blood in urine can be visible (growth hematuria) or invisible (microscopic hematuria). If it’s visible, it will turn urine an orange, red, or pink color. If not visible, we can still see blood under a microscope during a urine test.
Recurring UTIs?
Ask your doctor for a urine test. You’ll want to make sure there’s not an underlying issue at work.
If you’re not sure, Sims says a urine test is always a good idea. It lets providers know if there is blood or infection in the urine. Once they know what’s going on, providers can guide patients toward next steps.
Fact #3 – The Path to Diagnosis & Treatment is Largely the Same
While there are notable risk and early warning sign differences, the path to diagnosis and treatment doesn’t vary much by sex or gender.
If there is blood in your urine, a provider may:
- Order imaging of the kidneys or bladder
- Schedule a cystoscopy, a procedure where a thin tube with a camera attached is inserted into the bladder
“The cystoscopy is an office procedure and is very well tolerated, for both men and women,” Sims says.
A cystoscopy can check for and even remove growths or tumors.
After that, providers may recommend:
- Another cystoscopy to remove surface-level cancer
- Surgery to remove the bladder (cystectomy) if the cancer is invasive and has spread in the area
- Chemotherapy, radiation, and/or immunotherapy, if needed
Fact #4 – Bladder Removal Recovery Involves Different Parts, Same Challenges
For some bladder cancer patients, a surgery to remove surface-level cancer will be enough.
Some patients only have a superficial bladder cancer. Removing these growths treats the cancer. After the procedure, patients will see their urologist on a regular basis in case the cancer returns.
What Bladder Removal Can Mean
If your cancer has grown and spread, removing the bladder may be the best path forward. The procedure is called a cystectomy, or bladder removal.
During cystectomy, your surgeon may need to take out surrounding organs and tissue, which could include:
- Prostate
- Uterus
- Ovaries
- Parts of the vagina
Sims says that while different bodies have different surrounding organs, the potential challenges are the same.
“After cystectomy, patients may experience body image or sexual function issues,” Sims says. “But most patients do well, and the great news is that resources are available to help patients with both of those issues as they come up.”
Painful Urination?
It could be a bladder infection.
Fact #5 – Resources Make a Big Difference in Bladder Cancer Recovery
Sims says that resources and support are critical for bladder cancer patients.
“Patients who have family, caregivers, or resources at home or at the hospital do much better than those who are trying to recover alone,” she says.
UVA Health offers many key resources to help patients undergoing bladder removal or bladder cancer treatment, including:
- Certified ostomy nurses
- Enhanced Recovery After Surgery (ERAS)
- Interactive home monitoring program after surgery
- Clinical trials that offer approaches to support your healing
- A nurse navigator, to help manage logistics of cancer treatment
Sims is proud of the work UVA Health does to support bladder cancer patients – patients of all sexes and genders – through diagnosis and treatment.
“It’s very rewarding to be able to help patients through diagnosis and complex surgery,” she says. “It’s also rewarding because we have so many resources to offer patients — the work is satisfying, because I know we can make a difference in their quality of life.
