Women and Bladder Cancer

February 6, 2022

Bladder cancer has long been considered a disease of older men. In 2023, the American Cancer Society estimates more than 82,000 will be diagnosed with bladder cancer in the United States. Of those, more than19,000 will be women. Though it is more prevalent in men, studies have shown that women are more likely to present more advanced tumors at diagnosis. According to a report published by the National Cancer Institute, the outcomes and survival rates for women with bladder cancer lags behind that of men at all stages of the disease. African-American women have poorer outcomes when diagnosed with bladder cancer. They present with the highest proportion of advanced and aggressive tumors when compared to African-American men and Caucasian men and women. You can learn more about about the statistics, treatment and survival differences in our webinar: Women and Bladder Cancer.

It is important for women to understand their risks for bladder cancer and know what to ask their doctors. Awareness is the key: in most cases, bladder cancer is treatable, but prompt diagnosis is critical.

Men are at a higher risk of developing bladder cancer. However, women present with more advanced disease and have more unfavorable outcomes. Research has shown that there is often a delay for women getting into treatment for bladder cancer. Men actually receive a cystoscopy (to look inside the bladder) a lot quicker, and then start treatment sooner in their diagnosis than women. To learn more, BCAN’s 2021 Bladder Cancer Think Tank featured presentations about biologic sex differences in bladder cancer.

Why is there a disparity between men and women with bladder cancer?

In many cases, there are significant delays in diagnosing bladder cancer in women. Many women ignore the most basic symptom—blood in the urine. They may associate it with menstruation or menopause and delay reporting this symptom to their doctors. Even after reporting the problem to their doctors, blood in the urine may be initially misdiagnosed. It may be seen as a symptom of post-menopausal bleeding, simple cystitis or a urinary tract infection. As a result, a bladder cancer diagnosis can be overlooked for a year or more.

What do women need to know about bladder cancer?

• Bladder cancer can affect women at any age.
• Smoking is the greatest controllable risk factor. Smokers get bladder cancer twice as often as non-smokers. However, up to 50% of bladder cancer patients may have no history of smoking. Learn more about the risks associated with bladder cancer.

• Bladder cancer symptoms may be identical to those of a bladder infection and the two problems may occur together. If symptoms do not disappear after treatment with antibiotics, insist upon further evaluation to determine whether bladder cancer is present.
• Bladder cancer has the highest recurrence rate of any form of cancer—between 50-80 percent.

What can you do?

The most important thing for you is to know the signs and symptoms of bladder cancer. Be sure to report them to your physician immediately. The most common sign—blood in the urine—can be visible (though it may sometimes appear dark brown or orange) but could also only be detected under a microscopic examination. It is important to visit your doctor for routine examinations. Most bleeding associated with bladder cancer is painless. Close to 30 percent of bladder cancer patients experience burning, frequent urination or a sensation of incomplete emptying when they urinate.

If you experience any of these symptoms, see your doctor as soon as possible. Many women may first go to a primary care physician or gynecologist if they have blood in their urine. Primary care and gynecology follow their own guidelines for assessing blood in urine. This can sometimes delay their diagnosis until the cancer is more advanced. A urologist is generally the medical professional that diagnoses bladder cancer. View the American Urological Association Guidelines for Microhematuria. Blood in urine is not normal and should be checked out.

Women and Bladder Cancer: Sharing Stories to Advance Research

BCAN was invited to share the experiences of women diagnosed with bladder cancer at the “Bladder Cancer in Women: Identifying Research Needs to Improve Diagnosis and Treatment” program sponsored by Johns Hopkins Greenberg Bladder Cancer Institute and the American Urological Association Translational Research Collaboration. Each of these women’s stories are memorable and unique. Sadly, their stories are repeated around the country because women are not the “typical bladder cancer patient.” Read the the transcript of their presentation.

Advice from women survivors

The good news is that in most cases, if caught early, bladder cancer is a manageable disease. There are tens of thousands of women surviving and thriving, even with bladder cancer today. Read some of their stories below.