Health. Bladder Cancer: Blood in the Urine, a Symptom That Should Alert You

"Bladder cancer is a disorder of the cells in the bladder wall that eventually form one or more tumors," explains Dr. Delphine Borchiellini, a medical oncologist at the Antoine-Lacassagne Center in Nice (Alpes-Maritimes). In France, there are more than 14,000 new cases per year, 80% of which are in men. The vast majority of cases are localized, and generally carry a relatively favorable prognosis.

Tobacco: the main risk factor

"The bladder concentrates urine before eliminating it, and the bladder mucosa therefore remains in contact with all the toxic substances that are eliminated from our body, such as tobacco derivatives," says Dr. Borchiellini. "This is why the main preventable risk factor for bladder cancer is tobacco. There are other factors such as certain chronic infections or certain situations of occupational chemical exposure (paint, dye, metal, oil, etc.)."

"It's the presence of blood in the urine," explains Dr. Borchiellini. "While other pathologies may be responsible (infection, urinary tract stones), they are often associated with other signs that allow us to differentiate. If in doubt, particularly if there are no other symptoms or in the case of recurring hematuria, you should consult your doctor or a urologist."

Aim for early diagnosis

A campaign initiated by MSD France, in partnership with the association Cancer Vessie France, will also focus on raising public awareness of the importance of monitoring their urine. This will be achieved through the distribution of a color chart to alert people about the color of their urine when it turns red. "Cancer Vessie France is the only patient association dedicated to bladder cancer in France," says Lori Cirefice, president of the association.

“We are working to raise awareness of the signs of the disease and promote early diagnosis. Too often, patients seek care late. A survey by the World Bladder Cancer Patient Coalition (2023) revealed that 54% of patients were unaware of the signs and symptoms of bladder cancer before their diagnosis, unaware that visible blood in the urine was a key symptom. This warning sign should never be taken lightly: even in isolation, it requires immediate consultation. Awareness remains essential in the face of this disease.”

This is all the more important because in the case of early detection, at a localized stage, "the objective remains cure", explains Dr. Borchiellini. "The more advanced the disease, the lower the chances of recovery, even though there have been many innovations in the treatments used over the past five years."

More rarely, other clinical or biological symptoms may raise suspicion of bladder cancer. "This is the case with persistent abdominal or pelvic pain, or kidney failure due to obstruction of the urinary tract," continues Dr. Delphine Borchiellini. "In the case of metastases, certain other symptoms should be a warning sign: fatigue, lack of appetite, weight loss, etc."

What support?

"In cases of superficial disease, tumors are removed endovesically, possibly with other local treatments," says Dr. Borchiellini.

"For invasive disease, treatment is based on total surgery or radiotherapy, sometimes combined with chemotherapy or immunotherapy. In cases of metastases, these drug treatments are preferred, as bladder removal is not recommended as a first-line treatment. Many innovations are improving treatment at all stages, particularly in robotic surgery, radiotherapy, and new targeted therapies."

An association that listens to the needs of patients

For Lori Cirefice, "Bladder cancer remains a little-discussed topic, so patients and their loved ones can feel isolated. Our association offers them a space for exchange and support among peers, facilitating their journey and improving dialogue with their doctor. A well-informed patient adheres better to their treatment, which is why we provide scientifically validated information. We also support research by relaying patient needs to healthcare professionals and the French Association of Urology. Patients can contact us via our website." www.cancer-vessie.fr , by email, or on Facebook.