The prognosis for bladder cancer, a disease that is diagnosed in over 80,000 Americans each year1, significantly improves the earlier it's discovered. In this article we discuss the critical role of early detection, review factors that affect the prognosis of individuals with bladder cancer, and present current bladder cancer survival data.
- What Causes Bladder Cancer?
- What Is the First Sign of Bladder Cancer?
- How Is BladderCancer Diagnosed?
- Is Bladder Cancer Treatable?
- What Are the 5-Year Survival Rates for Bladder Cancer?
- What Affects Survival for an Individual Diagnosed With Bladder Cancer?
- Detecting Bladder Cancer Early Will Improve Your Outlook
What Causes Bladder Cancer?
Bladder cancer occurs when cells within the lining of the bladder wall begin to grow in a disordered, uncontrolled way.
Exactly what prompts this disordered growth is not fully known. However, several factors associated with ahigher risk of bladder cancerhave been identified, including:
- Age - most people diagnosed with bladder cancer are older than 55 years.
- Sex - compared to women, men are 4 times more likely to develop bladder cancer.
- Smoking - smoking is associated with around half of all bladder cancers in men and women.
- Race - in the United States, White Americans have the highest rate of bladder cancer.
- Previous bladder cancer - people who have had bladder cancer may have a recurrence.
- Workplace exposures - certain chemicals in some workplaces may contribute to higher rates of bladder cancer in workers. For example, painters, hairdressers, and truck drivers are at increased risk.
- Arsenic in drinking water.
- Certain types of medication.
What Is the First Sign of Bladder Cancer?
Blood in the urine, referred to as ‘hematuria’, is usually the first sign of bladder cancer. This is because early bladder cancer commonly causes bleeding without associated pain or other symptoms.
- Depending on the amount of blood present, urine may appear pink, red, or brownish in color.
- Blood may not be present all the time - there may be relatively long periods of clear urine (weeks or sometimes months).
If you have noticed blood in your urine it is important to speak to your doctor as soon as possible.
Otherearly symptoms of bladder cancerthat may be experienced are urinary irritation or changes in bladder habits, such as increased urination frequency and/or urgency, pain or a burning sensation during urination, or difficulty passing urine.
How Is Bladder Cancer Diagnosed?
Several different diagnostic tests and procedures may be used to detect or rule out bladder cancer, often in combination. They are selected based on a patient’s symptoms and risk factors and may include:
- Urinalysis:a quick test used to detect blood and other substances in urine.
- Urine cytology:urine is examined microscopically to see if cancer cells are present.
- Genomic urine tests: non-invasive molecular tests, such asCxbladder, which measure gene expression (sometimes referred to as ‘tumor markers’) to help rule out bladder cancer.
- Cystoscopy:a thin, flexible tube with a light and camera (a ‘cystoscope’) is inserted into the bladder through the urethra. If an abnormal area is seen, a small sample of tissue (a ‘biopsy’) is usually collected for laboratory examination.
- Imaging:several types of imaging test can be used to visualize the inside of the body, such as ultrasound, CT scan, MRI scan, and x-ray.
Is Bladder Cancer Treatable?
Many types of therapy are used totreat bladder cancer. In general, the treatment pathway chosen depends on the type and stage of bladder cancer present and a patient’s overall health and individual preferences. Common treatment options include:
- Surgery:to remove tumor cells and surrounding tissue. The type of surgery used depends on factors such as the size and progression of the tumor.
- Chemotherapy:(‘chemo’) which refers to the use of drugs to destroy cancer cells. Chemotherapy may be local (i.e., delivered directly into the bladder) or systemic (i.e., taken orally or by injection and delivered to the whole body).
- Immunotherapy:which uses naturally occurring or man-made substances to improve or bolster the body’s immune system function. Like with chemotherapy, immunotherapy may be delivered locally or systemically.
- Radiation therapy:which uses x-rays or other high-energy waves or particles to kill cancer cells.
Can bladder cancer be cured?
When detected at an early stage, bladder cancer can usually be treated successfully whereas later-stage cancers may present greater challenges for the patient and their healthcare team. As discussed later, people who have had bladder cancer are at risk for recurrence; for the best chance of successfully treating recurrent cancer, early detection is again important.
What Are the 5-Year Survival Rates for Bladder Cancer?
In 2020, approximately 17,980 deaths in the United States are predicted to be attributed to bladder cancer1. This represents the eighth most common cause of cancer deaths in men.
The general 5-year survival rate for people with bladder cancer(i.e., the percentage of patients who would be expected to survive the effects of their bladder cancer for 5 years or more)is 77%, while the 10-year survival rate is 70% and the 15-year survival rate is 65%1. Notably, as each patient and cancer are different, it is not possible to definitely know the disease course for an individual patient.
What Affects Survival for an Individual Diagnosed with Bladder Cancer?
The survival rate for patients with bladder cancer depends on many patient- and disease-related factors, including:
| Patient-related factors | Disease-related factors |
|---|---|
|
|
How do bladder cancer survival rates differ by disease stage?
Staging of bladder cancerprovides information on the extent (or amount) of cancer in the body and whether the cancer has spread beyond the bladder; this information helps predict how likely the cancer will respond to treatment.
Approximately half of bladder cancers are found at an early stage, when the cancer is in the surface layer of the bladder only (referred to as in situ or non-invasive).12About one third of bladder cancers have spread to the deeper layers of the bladder wall but are still only in the bladder; the remainder of cancers have spread into nearby tissues or lymph nodes or, rarely, to distant parts of the body.
The 5-year survival rate for bladder cancer varies by stage of the disease at diagnosis, which emphasizes the importance of detecting bladder cancer at an early stage.13
Note:
In situ = cancer is confined to the surface layer of the bladder
Localized = cancer has not spread outside of the bladder
Regional = cancer has spread to nearby structures or lymph nodes
Distant = cancer has spread to distant parts of the body (e.g., bones, lungs, liver)
How do bladder cancer survival rates differ by age?
Five-year survival for bladder cancer across stages is generally higher in younger individuals (i.e., <50 years of age) and decreases with increasing age.
| Stage at diagnosis | 5-year survival rates for bladder cancer by age | ||
|---|---|---|---|
| < 50 years of age | 50-64 years of age | 65 years and older | |
| Localized | 83% | 80% | 65% |
| Regional | 43% | 38% | 35% |
| Distant | 8% | 7% | 5% |
How does recurrence of bladder cancer affect survival rate?
Recurrent bladder cancer is cancer that has returned after initial treatment. Recurrence rates for bladder cancer depend on the stage of the original tumor, with 5-year recurrence rates of approximately 65% in patients with non-invasive or in situ tumors and 73% in patients with slightly more advanced disease at first diagnosis.16
Many patients with non-invasive bladder cancer have recurrences that are typically not life threatening; however, the prognosis is generally worse if the disease has spread into deeper layers of the bladder wall or beyond to the lymph nodes or other organs.
Monitoring for bladder cancer recurrence
Patients that have been treated for bladder cancer have unique monitoring needs to protect against thethreat of recurrence. After assessing a patient’s risk profile, doctors will recommend a regular ongoing schedule of cystoscopies to examine the inside of the bladder and urethra.
If you're recovering from non-muscle invasive bladder cancer and undergoing regular checks for recurrence, ask your doctor about Cxbladder Monitor.Cxbladder Monitoris non-invasive surveillance alternative that can help reduce the burden of cystoscopy.
Detecting Bladder Cancer Early Will Improve Your Outlook
The prognosis for bladder cancer is more favorable when the disease is detected early (i.e., when it is small and has not spread beyond the bladder), so it’s important to recognize and act on any symptoms, such as blood in urine, as soon as possible.
Cxbladder Can Help Rule out Bladder Cancer
If you're experiencing blood in urine and concerned about bladder cancer,speak to your doctor and ask if Cxbladder is right for you.
Cxbladder is a non-invasive genomic urine test optimized for the rule out of urothelial bladder cancer, the most common form of the disease. The test analyzes five biomarker genes to quickly and accurately rule out the disease, reducing the need for further invasive procedures.
Learn more about CxbladderContact us for more information
References
- Cancer.net. Bladder cancer statistics.https://www.cancer.net/cancer-types/bladder-cancer/statistics. Accessed September 26, 2020.
- American Cancer Society. What Causes Bladder Cancer?www.cancer.org/cancer/bladder-cancer/causes-risks-prevention/what-causes.html. Accessed September 27, 2020.
- Cancer.net. Bladder Cancer: Risk Factors.www.cancer.net/cancer-types/bladder-cancer/risk-factors. Accessed September 27, 2020.
- American Cancer Society. Bladder Cancer Risk Factors.www.cancer.org/cancer/bladder-cancer/causes-risks-prevention/risk-factors.html. Accessed September 27, 2020.
- Cancer.net. Bladder Cancer: Symptoms and Signs.https://www.cancer.net/cancer-types/bladder-cancer/symptoms-and-signs. Accessed September 27, 2020.
- American Cancer Society. Bladder Cancer Signs and Symptoms.www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/signs-and-symptoms.html. Accessed September 27, 2020.
- American Cancer Society. Tests for Bladder Cancer.https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/how-diagnosed.html. Accessed September 27, 2020.
- Cancer.net. Bladder Cancer: Types of treatment.https://www.cancer.net/cancer-types/bladder-cancer/types-treatment. Accessed September 27, 2020.
- American Cancer Society. Bladder Cancer Early Detection, Diagnosis, and Staging.https://www.cancer.org/content/dam/CRC/PDF/Public/8559.00.pdf. Accessed September 26, 2020.
- Cancer Research UK. Bladder Cancer.https://www.cancerresearchuk.org/about-cancer/bladder-cancer/survival. Accessed September 26, 2020.
- American Cancer Society. Bladder Cancer Stages.https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/staging.html. Accessed September 26, 2020.
- American Cancer Society. Key Statistics for Bladder Cancer.https://www.cancer.org/cancer/bladder-cancer/about/key-statistics.html#:~:text=Extent%20of%20cancer%20at%20the,still%20only%20in%20the%20bladder. Accessed September 26, 2020.
- American Cancer Society. Survival Rates for Bladder Cancer.https://www.cancer.org/cancer/bladder-cancer/detection-diagnosis-staging/survival-rates.html.Accessed September 26, 2020.
- National Cancer Institute. SEER Explorer.www.seer.cancer.gov/explorer. Accessed September 26, 2020.
- Cancer Council NSW. Understanding bladder cancer.https://www.cancercouncil.com.au/wp-content/uploads/2020/04/Understanding-Bladder-Cancer-2020.pdf. 2020.
- Chamie K, Litwin MS, Bassett JC, et al. Recurrence of high-risk bladder cancer: a population-based analysis. Cancer. 2013;119:3219-3227.
- National Collaborating Centre for Cancer (UK). Bladder Cancer: Diagnosis and Management. London: National Institute for Health and Care Excellence (UK); 2015 Feb. (NICE Guideline, No. 2.) 4, Managing non-muscle-invasive bladder cancer.https://www.ncbi.nlm.nih.gov/books/NBK356304/
