The risk for UBC is higher for men with diabetes mellitus; however UBC is more likely to occur after the age of 50. A positive family history of a first-degree relative with bladder cancer appears to be the strongest risk factor.
The symptoms of bladder cancer are many and varied. The most common complaints are pain/pressure with urination, blood/yellow in the urine or discomfort with urinating. Pain often occurs during coughing, straining or passing urine, or after having a bowel movement. Other symptoms include decreased urine output, feeling tired or constricted, needing to urinate frequently, pain with sitting/standing, and change in sensation or pain in the lower back.\n
UBC is a cancer of the urinary system that occurs in the bladder and can spread to other parts of the body. Although most patients will only have one disease, metastasia can also occur. Once urothelial carcinoma has occurred, the prognosis is poor unless the disease is diagnosed early and treated. See table for more information about cancer of the urinary bladder.
Bladder cancer is treated through chemotherapy, hormonal therapy, radiation therapy, surgical resection of bladder wall tumor or cytoreductive surgery. Androgen blockade and transurethral resection are also common treatments for bladder cancer.
In this series of patients, urinary bladder carcinoma was highly curable in 97% of cases. However, survival rates were significantly reduced in patients whose disease had recurred (p = 0.0001).
The average age someone gets urinary bladder cancer is 65.4 years. Most urinary bladder cancer is stage T1, and the majority are treated with a simple cystectomy.
It appears the increased risk for urinary bladder cancer in patients receiving alpha-blockers or the older age of men may affect development of non-muscle-invasive bladder cancer.
A high survival rate exists and is associated with high stage at diagnosis, node-negative status and low pathologic grade. The number of deaths per year due to bladder cancer is 7.2. The most deaths are due to metastatic node involvement and/or distant metastasis. Survival is best by a multivariable model of T stage (p = 0.03), N stage (p = 0.0001) and pathologic grade (p = 0.0001).
Patients with urinary [bladder cancer](https://www.withpower.com/clinical-trials/bladder-cancer) should have both pre and post surgery surveillance. A history of smoking should also be sought. Tissue in a cystoscopy specimen should be obtained from all patients, to search for microscopic disease on the bladder wall that has been seen in tissue from other cancers.
In a pooled analysis of Phase III clinical trials, no relationship has been demonstrated between treatment-related mortality and pembrolizumab use. The risk of cancer (cancer-related mortality and non-cancer-related mortality/morbidity) was consistently lower for all tumor types. pembrolizumab use was associated with prolongation of progression-free survival (hazard ratio [HR]: 0.76, 95% CI: 0.59, 0.97) and overall survival (HR: 0.86, 95% CI: 0.74, 0.95). Pembrolizumab is highly effective at prolonging survival of patients with metastatic urothelial carcinoma.
This preliminary report suggests that bladder cancer tends not to run in families, but needs to be further investigated to confirm these findings, because they suggest that bladder cancers of unknown etiology in patients with no family history of the disease may be related to environmental exposures. If these observations are reproduced in future studies, then bladder cancer should be considered a "heritable risk factor " for malignant bladder cancers.