TODAY’S issue of polkmd deals with some of the different types of cancers below the belt — prostate, colon, ovarian and kidney. Published: Friday, October 28, 2011 at 2:12 p.m. Last Modified: Friday, October 28, 2011 at 2:27 p.m.
LAKELAND | the correlation between smoking and bladder cancer keeps getting stronger and none of it is good news.
Facts Diagnosing Bladder Cancer
Blood in the urine is the first warning sign of most bladder cancers. the urine may be a very pale yellow-red or, less often, darker red. Blood can appear one day and not the next, usually reappearing with bladder cancer. Although the blood may come from other, non-cancerous causes, it needs to be checked by a doctor.changes in bladder habits or irritative symptoms: Bladder cancer can cause changes in urination, such as needing to urinate more often than usual, feeling pain or burning during urination; and feeling as if you need to go right away even when the bladder isn’t full. Conditions like infection, bladder stones, overactive bladder or enlarged prostate can cause this too, but it needs to be checked.if the cancer is large, people may have additional symptoms such as lower back pain or being unable to urinate.Source: American Cancer SocietyFor more on cancer, as well as other health-related articles, read Polk MD in Saturday’s Ledger.
The risk of bladder cancer among smokers is four times greater than in non-smokers, according to research findings released in August. Previous studies found a three-fold risk.
Women, previously believed to have a lower rate of bladder cancer directly linked to their smoking, now appear to have gained equal footing with male smokers. Roughly half of all bladder cancer cases in men and women now appear linked to their being or having been smokers, said an article in the August Journal of the American Medical Association.
That’s not exactly the kind of equality some cigarette ads aimed at women were meant to promote.
“It’s the only cancer other than lung cancer that’s directly causally associated with smoking,” said Dr. Graham Greene, a urologic oncologist at Lakeland Regional Cancer Center. “Smoking increases the risk of acquiring it and dying from it.”
Researchers have concluded there’s a cause-and-effect relationship, not just an overall increased risk.
Yet many patients and their doctors don’t realize the link, said Dr. Jens Carlsen, a urologist at Lakeland’s Watson Clinic.
“It’s not talked about in primary care very often,” Carlsen said. “Patients are even less aware.”
He said 80 percent of all bladder cancers are caused by environmental exposure — 50 percent by tobacco and 30 percent by different chemicals, such as those used in manufacturing and fabrics.
Smoking can cause cancer in the urethra and ureters, tubes draining the kidney and the bladders, Greene said.
Earlier detection improves the likelihood of successful treatment.
“There are many great treatments out there for superficial cancers that don’t invade the walls of the bladder,” said Dr. Faiyaaz Jhaveri, urologist at Urology Healthcare of Central Florida.
Bladder cancer is more easily managed if detected before it invades the bladder wall or escapes from the bladder, but Carlsen said in about one in four cases it has invaded the muscle of the bladder prior to detection.
The American Cancer Society and others haven’t recommended general screening for people at average risk.
Smokers, however, can consider themselves higher-risk individuals. and there are warning signs that should not be ignored, the urologists said.
Urinalysis can spot tiny bits of blood before it can be seen. if visible blood appears in the urine, the urologists said people need to see a doctor whether they’re smokers or not. In younger people, the blood is more likely to be kidney stones or some benign cause, Greene said, with the likelihood of it being bladder cancer increasing with age.
Surgery, chemotherapy and radiation can all help treat bladder cancer, depending on the severity of the cancer and the health of the patient. some tumors can be removed surgically with the bladder left intact.
In some cases, medical oncologists will be called in.
“We treat them with chemotherapy and radiation so they don’t have to have their bladder removed,” said Dr. Robert Cassell, medical director of Cassidy Cancer Center at Winter Haven Hospital.
Chemotherapy before surgery improves the survival rate, he said.
For some patients whose bladder cancer has spread, surgery to remove the bladder is essential.
“Muscle invasive bladder cancer can be lethal,” Greene said.
Even in those situations, however, there are options beyond the traditional practice of removing the bladder and redirecting urine flow to a bag outside the body.
One of them is taking a piece of the intestine and creating a bladder replacement inside the body.
It often needs more treatment and attention than the real bladder did, requiring someone who is highly motivated and able to take care of it, Carlsen cautioned, adding “If they really don’t take care of it, they will die.”
[ Robin Williams Adams can be reached at or 863-802-7558. Read her blog at robinsrx.blogs.theledger.com. Follow on Twitter at ledgerROBIN. ]