Symptoms of Bladder Cancer can be Confusing


Symptoms of bladder cancer can confuse

Published: Thursday, April 07, 2011, 11:12 AM     Updated: Thursday, April 07, 2011, 11:14 AM
Staten Island Advance
Risks of smoking
Associated Press
The risks leading to bladder cancer point to one of the biggest killers in the world: Smoking.

Tips from Staten Island University Hospital  

STATEN ISLAND, N.Y. — ALL SHORES — Bladder cancer symptoms may be broad and tough to pin down, but early and efficient action makes a world of difference in outcome, according to Dr. Nicholas Karanikolas, director of urologic oncology at Staten Island University Hospital.

Bladder cancer is a disease that has increased dramatically over the past 20 some years. Today, it is the fourth most prevalent cancer in men (ninth in women), taking a backseat only to prostate, lung, and colorectal cancer. In fact, statistics show that bladder cancer is more than three times as likely to affect men than women, although women have more than a 30 percent higher chance of dying from it.

Bladder cancer affects 71,000 people a year nationwide, but it doesn't get the attention that other major diseases do.

The term "bladder cancer" refers to any type of malignant growth in the urinary bladder. Over 90 percent of bladder cancers in the United States are urothelial (transitional cell) cancers. Most are papillary well (urothelial tumors of low malignant potential) or moderately (low grade) differentiated cancers.

The risks leading to bladder cancer point to one of the biggest killers in the world: Smoking.

"Just as it is for many other diseases and sicknesses in the world, smoking cessation is the most important step in preventing (bladder cancer)," said Dr. Karanikolas.

Exposure to environmental carcinogens contributes strongly to the development of bladder cancer as well.

"Cases associated with smoking or industrial exposures have similar proportions of indolent and aggressive cancers as those occurring in the unexposed population," said Dr. Karanikolas. "Recurrences are likely to be more aggressive in patients who continue to be exposed than those who stop the exposure."


Blood in urine is the most common sign of bladder cancer; more than 70 percent of patients experience this, which helps lead directly to a diagnosis. Frequent and painful urination is another symptom.

Blood in urine is a symptom of many ailments, though (urinary tract infections, kidney stones, prostate inflammation, trauma, etc.), so the standard for diagnosing bladder cancer is a procedure called a cystoscopy.

The treatment of bladder cancer depends on how deeply the tumor has invaded the bladder wall. Superficial tumors may be removed and treated with TURBT (transurethral resection of bladder tumor). This is performed to remove all visible tumors and to provide specimens for pathologic examination to determine stage and grade.

Advanced cases of bladder cancer may begin to infiltrate the muscular wall of the bladder. These tumors require more radical surgery; part or all of the bladder is removed (cystectomy) and the urinary stream is diverted.

"Generally, patients at high risk for progression should be considered for cystectomy after initial TURBT," said Dr. Karanikolas.

In addition to TURBT, Intravesical Chemotherapy (mitomycins), and for more severe cases, Immunotherapy (Bacillus Calmette-Guérin) may be used.


The most important part of preventing or fighting bladder cancer is reporting symptoms to your doctor immediately, especially if you are over the age of 60.

Bladder cancer can feel like other diseases, according to Dr. Karanikolas. "For women, it may feel like a urinary tract infection (UTI) and for men, it may feel like a prostate problem. Nevertheless, immediate attention should be paid to all symptoms," he said.

"I never really had any symptoms; no UTI or (visible) blood in urine, but then I started feeling this sharp, constant pain," said Irene Malfi, who was diagnosed by Dr. Karanikolas in the hospital's emergency department after the pain didn't subside for weeks. "By the time I made it to the hospital, it was already Stage III bladder cancer."

Dr. Karanikolas found a mass in her bladder and, after chemotherapy, performed surgery to remove the bladder. Mrs. Malfi has been in remission for over a year and has routine tests every three months to ensure the cancer is gone.

"I don't need to tell you how stressful everything was, but the most important thing is having a doctor that truly cares for you," she said. "That's what helped get me through it."
This report was provided to the Advance by Staten Island University Hospital as a community service.

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