Thursday, September 21, 2023

Recurrent Bladder Infections And Cancer

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How Many Is Too Many Utis

“What About These Recurrent UTIs?” with Dr. Melanie Crites-Bachert (360phi.com)

Three or more UTIs in one year indicates a recurrent infection, according to the ACOG.

Recurrent urinary tract infections are treated with antibiotics. A week or two after you finish the antibiotic treatment, your doctor may perform a urine test to make sure the infection is cured.

Your doctor may also ask you about factors that increase the risk of a recurrent UTI, including:

  • Young age at first UTI

When To Get Checked

Dr. Flores says difficulty urinating is a red flag symptom and recommends calling your doctor if you experience any of the above symptoms, particularly if you have been treated with an antibiotic for a UTI and these symptoms occur soon afterward.

There are two main types of bladder cancer:

Transitional cell carcinoma is the most common type of bladder cancer in the U.S. This low-grade cancer accounts for about 95% of cases. Typically its not life-threatening, but often its difficult to manage and lasts a long time.

Squamous cell carcinoma, which accounts for about 5% of bladder cancers, is a very aggressive, high-grade malignancy. The vast majority of bladder cancer patients seen at Roswell Park are treated for this type. However, at the national level, this particular diagnosis makes up a small portion of people who are diagnosed with bladder cancer.

Early treatment is key for bladder cancer. Half of bladder cancers are diagnosed at a very early stage called in situ. Patients diagnosed and treated at this stage have a five-year survival rate of 95.8%.

Why Roswell Park for Bladder Cancer?

Get more information on diagnosing and treating bladder cancer.

There Are Different Types Of Treatment For Patients With Bladder Cancer

Different types of treatment are available for patients with bladder cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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There Are Three Ways That Cancer Spreads In The Body

Cancer can spread through tissue, the lymph system, and the blood:

  • Tissue. The cancer spreads from where it began by growing into nearby areas.
  • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
  • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

Five Types Of Standard Treatment Are Used:

Manuka honey for chronic bladder infections

Surgery

One of the following types of surgery may be done:

  • Transurethral resection with fulguration: Surgery in which a cystoscope is inserted into the bladder through the urethra.A tool with a small wire loop on the end is then used to remove thecancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
  • Radical cystectomy: Surgery to remove the bladder and anylymph nodes and nearby organs that contain cancer. This surgery may bedone when the bladder cancer invades the muscle wall, or when superficialcancer involves a large part of the bladder. In men, the nearby organs that areremoved are the prostate and the seminal vesicles. In women, the uterus, theovaries, and part of the vagina are removed. Sometimes, when the cancer hasspread outside the bladder and cannot be completely removed, surgery to removeonly the bladder may be done to reduce urinarysymptoms caused by the cancer.When the bladder must be removed, the surgeon creates another way for urine toleave the body.
  • Partial cystectomy: Surgery to remove part of thebladder. This surgery may be done for patients who have a low-grade tumor thathas invaded the wall of the bladder but is limited to one area of the bladder.Because only a part of the bladder is removed, patients are able to urinate normally afterrecovering from this surgery. This is also called segmental cystectomy.
  • Urinary diversion: Surgery to make a new way forthe body to store and pass urine.

Radiation therapy

Chemotherapy

Also Check: New Treatments For Neurogenic Bladder

What Causes Chronic Urinary Tract Infections

  • Bacteria from the rectum and vagina
  • Bacteria entering the urethra during sexual intercourse
  • Urinary tract problems
  • Problems emptying the bladder completely due to blockage, muscle or nerve problems
  • Kidney or bladder stones
  • Altered estrogen levels during menopause
  • Genetic predisposition

Women are at an increased risk of getting urinary tract infections if they:

  • Have had a UTI before
  • Have had several children

Surveillance After Radical Cystectomy

A group from the University of Texas MD Anderson Cancer Center retrospectively reviewed their postradical cystectomy surveillance protocol for 382 patients and concluded that a stage-specific approach was most appropriate. With a median follow-up of 38 months, 25% of patients experienced recurrences, with a median time to recurrence of 12 months. The 4 most common sites of recurrence were the lung, pelvis, bone, and liver. Seventy-four percent of recurrences were asymptomatic, and 43 of the 72 asymptomatic recurrences were detected with chest radiography or liver function serum tests.

Only 5% of patients with pT1 disease had subsequent metastases, and all were identified with chest radiography or liver function tests. Among 10 patients who were found to have asymptomatic intra-abdominal recurrences based on CT scan findings, 9 had pT3 disease. Patients with pT2 and pT3 disease had recurrence rates of 20% and 40%, respectively. All recurrences in patients with pT2 or pT3 disease occurred within 24 months.

Based on these findings, the group recommended that surveillance should include the following:

  • History

The group recommended scheduling surveillance according to the patients disease stage, as follows:

  • pT1 disease – Annually

  • pT2 disease – Every 6 months for 3 years, then annually

  • pT3 disease – As with pT2 disease, but starting at 3 months, with CT scanning at 6, 12, and 24 months

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Changes In Bladder Habits Or Symptoms Of Irritation

Bladder cancer can sometimes cause changes in urination, such as:

  • Having to urinate more often than usual
  • Pain or burning during urination
  • Feeling as if you need to go right away, even when your bladder isn’t full
  • Having trouble urinating or having a weak urine stream
  • Having to get up to urinate many times during the night

These symptoms are more likely to be caused by a urinary tract infection , bladder stones, an overactive bladder, or an enlarged prostate . Still, its important to have them checked by a doctor so that the cause can be found and treated, if needed.

Facts About Bladder Cancer In Women

Professor James Malone-Lee’s Australian Interview on Chronic Urinary Tract Infection 2021

While bladder cancer typically hasnt been associated with women, it is important to understand the unique way that bladder cancer does affect women, and why its critical that bladder cancer isnt overlooked.

  • Approximately 50% of cases are diagnosed while the cancer is still in the bladder. However, that percentage is lower in women, because symptoms are often overlooked.
  • Women have a 1 in 89 chance of developing bladder cancer in their lifetime . However, bladder cancer in women is on the rise.
  • Approximately 90% of bladder cancer cases are in individuals over 55 years old, so it is important to be extra vigilant of early signs of bladder cancer as you age.
  • Bladder cancer has a high recurrence rate. If you have been diagnosed with bladder cancer, it is important to continue to receive regular exams in order to handle any potential recurrence.

Utis And Bladder Cancer Have Some Similar Symptoms

The most common symptoms of UTIs are also common symptoms of bladder cancer, such as blood in the urine, a burning sensation when urinating, and painful urination.1,2 Up to 80% of all UTIs occur in women, and roughly 50% of all women will experience at least one UTI with accompanying symptoms in their lifetime.3 Its also possible for a UTI to recur, as well as for an individual to have multiple UTIs throughout their life. Additionally, some individuals may experience chronic UTIs.

The Problem Of Misdiagnosis In Women With Bladder Cancer

While bladder cancer is more common in men than in women, women often present with more advanced tumors and their overall survival rate is lower.17

A major reason for women presenting with more advanced tumors is the delay that can occur before receiving a bladder cancer diagnosis. Reasons for this delay may include:

  • Blood in the urine, the most common symptom of bladder cancer, may be discounted by women as being related to menstruation or post-menopausal bleeding.
  • When blood in the urine and urinary irritation are reported to a doctor they may be initially misdiagnosed as a UTI. Additionally, if a woman subsequently presents after treatment failure for a misdiagnosed UTI, further antibiotics may be prescribed rather than carrying out a complete urological evaluation.
  • UTIs and bladder cancer can occur at the same time, in which case the UTI will be the logical first diagnosis.

Because of this diagnostic confusion, a definitive diagnosis of bladder cancer may be delayed in some women. Of particular concern in this case is the risk that bladder cancer has reached a more advanced stage that may be more difficult to treat.

And It Won’t Hurt To Try These

Like many women, you may have memorized the following age-old advice for preventing UTIs:

  • Wipe from front to back.

  • Urinate before and after sex.

  • Drink lots of water.

  • Avoid tight underpants and jeans.

These suggestions are directed at flushing the bladder and keeping E. coli from spreading into the urinary tract. Although studies have failed to show that they prevent either primary or recurrent UTIs, there’s no harm in trying them, Dr. Gupta says. “They can’t hurt, and if they help, you’re ahead of the game.”

Persistent Uti Symptoms May Signal Bladder Cancer

39+ Bladder Cancer Symptoms And Causes Gif

May 21, 2015 — Urinary tract infection symptoms that donât improve with time or treatment could point to bladder cancer, a new study suggests.

That finding applies to both men and women, said lead researcher Kyle Richards, MD, from the University of Wisconsin-Madison, during a press conference at the American Urological Association 2015 Annual Meeting.

Awareness is especially important when it comes to women, he said, because bladder cancer is more commonly associated with men.

“A lot of primary care doctors who are seeing these patients are less aware that bladder cancer is even a possibility in women,” he said.

And he said that because the most common symptom of bladder cancer is blood in the urine, also called âhematuria,â UTI-like symptoms donât always raise suspicion.

In their first-of-its-kind study, Richards and his colleagues looked at data on 9,326 men and 2,869 women who were diagnosed with blood in the urine or a UTI in the year before they were diagnosed with bladder cancer. The researchers found that bladder cancer diagnoses take longer and health outcomes are worse in men and women who have UTIs than in men with blood in the urine.

The average time from initial symptoms to bladder cancer diagnosis was longer in women than in men. A closer look at the data suggested that UTIs were the reason for this.

Also, both men and women who had a UTI were more likely to have more-advanced cancer at diagnosis than men who had blood in the urine.

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What Should I Do If Im Having Repeated Utis

It may be difficult to determine if repeated UTIs immediately preceding a bladder cancer diagnosis are accurately diagnosed UTIs or if they are manifestations of the underlying cancer. If you are having repeated UTIs and have not received any other diagnosis but are concerned about your cancer risk, ask your doctor or healthcare provider about other diagnostic tests. Tests of the urine, even after UTI treatment or after bleeding during urination has subsided, may help indicate that a different, underlying condition is causing your symptoms.5 If you are having repeated UTIs and have received a diagnosis of bladder cancer, consult your doctor or healthcare provider to determine if there are any treatment options available for your situation, and to determine if any symptoms you are having are related to your bladder cancer or its treatment.

Risk Factors Of Bladder Cancer

By far, smoking is the biggest risk factor to be concerned about when it comes to bladder cancer. According to the National Institutes of Health, about 50% of women diagnosed with bladder cancer are smokers. Because the rate of occurrence is so much higher for smokers, if you notice any of the above symptoms and you smoke, let your doctor know as soon as possible.

Another major risk factor is previously having bladder cancer. Bladder cancer has a 50-80% recurrence rate, which is among the highest of any form of cancer. This is why it is imperative to continue to see your physician and be on the lookout for any symptoms of bladder cancer if youve had it before. When in doubt, get it checked out.

Age is another major factor. The average age of diagnosis in women is 73. Any woman over the age of 55 years old should keep an extra eye out for symptoms.

Bladder Infections And Cancer

Schistosomiasis

Schistosomiasis is a condition affecting the bladder, caused by infection with a water bourne parasite commonly found in Egypt. Chronic inflammation of the bladder resulting from multiple Schistosoma infections can lead to more rapid cell reproduction. Repeated inflammation of the bladder can lead to a rarer form of Bladder Cancer known as Squamous Cell Carcinoma which makes up around 8% of Bladder Cancer cases.

Chronic Cystitis

Recurrent bladder infection, infections that happen repeatedly, are referred to as Chronic Cystitis. Risk factors for Chronic Cystitis include :

  • Long-term urinary tract infection
  • Catheterisation, a tube inserted into the urethra to drain urine
  • Urinary calculi or stones

A small number of catheterised paraplegics, estimates range from 2% – 10%, also go on to develop the rarer form of Bladder Cancer known as SCC.

Prostatitis

In men, there are links with Prostatitis, and blood in the urine in men is considered a more serious sign than in women. This is partly because men are less prone to infections in the bladder, but also because of the known causes of cystitis in men. For serious bladder infections in men, even if D’Mannose clears the symptoms, it is strongly advised to see a Doctor for a thorough check-up.

The Following Stages Are Used For Bladder Cancer:

Can Recurrent UTIs Be A Sign of Cancer? | Frequent Urine Infection | Burning and Frequent Urination

Stage 0

In stage 0, abnormalcells are found in tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the tumor:

  • Stage 0a is also called noninvasive papillary carcinoma, which may look like long, thin growths growing from the lining of the bladder.
  • Stage 0is is also called carcinoma in situ, which is a flat tumor on the tissue lining the inside of the bladder.

Stage I

In stage I, cancer has formed and spread to the layer of connective tissue next to the inner lining of the bladder.

Stage II

In stage II, cancer has spread to the layers of muscle tissue of the bladder.

Stage III

Stage III is divided into stages IIIA and IIIB.

  • In stage IIIA:
  • cancer has spread from the bladder to the layer of fat surrounding the bladder and may have spread to the reproductive organs and cancer has not spread to lymph nodes or
  • cancer has spread from the bladder to one lymph node in the pelvis that is not near the common iliac arteries .

Stage IV

Stage IV is divided into stages IVA and IVB.

  • In stage IVB, cancer has spread to other parts of the body, such as the lung, bone, or liver.
  • Why Some Women Get Recurrent Utis

    The infections are usually caused by Escherichia coli, a bacterium that lives in the intestinal system. If E. coli are carried from the rectum to the vagina, they can enter the urethra and infect the bladder.

    Risk factors for UTI vary with age. Before menopause, the most common risk factors are sexual intercourse and use of spermicides. It’s thought that sex increases the number of bacteria in the bladder, and many experts advise women to urinate after sex to flush them out. Spermicides may kill off Lactobacilli, beneficial bacteria in the vagina, making it easier for E. coli to move in.

    After menopause, certain physical changes help set the stage for UTIs. The numbers of Lactobacilli in the vagina naturally decline. The bladder also contracts less strongly than it once did, making it more difficult to empty it completely.

    In both premenopausal and postmenopausal women, genes play a role as well. Having a mother or sister who has frequent UTIs is also a risk factor.

    When Urinary Tract Infections Keep Coming Back

    Image: Thinkstock

    If you are prone to recurrent UTIs, you can head them off before they take hold.

    Unless you’re in the fortunate minority of women who have never had a urinary tract infection , you know the symptoms well. You might feel a frequent urgency to urinate yet pass little urine when you go. Your urine might be cloudy, blood-tinged, and strong-smelling. For 25% to 30% of women who’ve had a urinary tract infection, the infection returns within six months.

    If you have repeated UTIs, you’ve experienced the toll they take on your life. However, you may take some comfort in knowing that they aren’t likely to be the result of anything you’ve done. “Recurrent UTIs aren’t due to poor hygiene or something else that women have brought on themselves. Some women are just prone to UTIs,” says infectious diseases specialist Dr. Kalpana Gupta, a lecturer in medicine at Harvard Medical School.

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