FAMILY MEDICINE® COLUMN
By John C. Wolf, D.O.
Associate Professor of Family Medicine®
Ohio University College of Osteopathic Medicine

MEN WITH BLOODY URINE SHOULD SEE DOCTOR QUICKLY

Question: My husband has been diagnosed with bladder cancer. His urologist has operated on the bladder and removed the cancer. He tells us that my husband is probably cured. Can that be true?

Answer: Cancer of the urinary bladder is relatively common. More than 51,000 people are diagnosed with this disease every year, and men are afflicted with it from two to three times more often than are women.

Smokers and those who work in the chemical, textile, rubber and related industries are at greatest risk. The reason these workers are at risk is probably due to exposure to chemicals used in these industries. One theory proposes that these hazardous products get into the body, often from skin contact or from inhalation, and are eliminated from the body by the kidneys. The concentration of the chemicals is increased in the urine, thereby exposing the bladder cells to carcinogenic substances for prolonged periods.

The individual usually becomes aware that there is some urinary problem because of blood in the urine. Often this bleeding is painless, but for some individuals it may be accompanied by discomfort. Bleeding, increased urinary frequency, and discomfort with urination are symptoms that suggest infection, but men rarely get urinary tract infections without having some underlying problem like bladder cancer. Therefore, any man who has blood in his urine should be examined by his doctor! This is not a problem that should be treated with home remedies for a few days to see if it goes away!

Bladder cancer comes in several different types, and the particular type, the amount of bladder tissue that is involved, and whether or not it has spread through all layers of the bladder or into other tissue are all important in determining the best treatment and establishing the likelihood of a cure.

Superficial cancer that involves a relatively small amount of the bladder is totally cured by surgery in 50 percent of cases. In the remaining 50 percent, the cancer may recur. In these individuals, 40 percent may be cured by additional treatment. Perhaps your husband had this type of cancer, and that is why his doctor is optimistic.

Cancers that have spread totally through the bladder wall or beyond to other tissues of the body have a less favorable prognosis. Those that have spread through the bladder layers but not to local lymph nodes or other tissues in the region are often treated with surgery to totally remove the bladder. Then, chemotherapy and radiation therapy are used to improve the chance of survival. Between 30 to 40 percent of individuals with this type of cancer are still alive in five years.

Almost all of the unfortunate individuals whose bladder cancer has spread to lymph nodes or to distant organs, such as the liver, lungs or bone, are dead in two years despite treatments. This is why it is so important to diagnose this disease early, before it has spread.

So again, I urge you men reading this to put aside that stoic male mentality. Any sign of blood in the urine should be promptly brought to the attention of your doctor. It doesn't matter if there is pain with urination or not. And, depending on the findings of initial tests, your family doctor may request that you see a urologist a specialist in urinary tract problems.

Family Medicine® is a weekly column. To submit questions, write to John C. Wolf, D.O., Ohio University College of Osteopathic Medicine, Grosvenor Hall, Athens, Ohio 45701.