Why Are Gender and Race Important in Bladder Cancer Treatment?

Lee Pearson wasn’t going to let anything delay the Caribbean summer vacation she and her husband had planned for years. Despite seeing blood in her urine for months and an increased urge to urinate, Pearson, who was 71 at the time and was Black, felt she could wait before contacting a healthcare provider (HCP).

“I said I’d check it out when I got back,” Pearson said. “But while we were there, the frequency and urge to urinate became almost unbearable. It almost ruined the trip.”

Pearson visited her primary care doctor a week after she returned. The doctor referred him to a urologist, who was also a cystoscopyor bladder scope that detects a tumor in your bladder. It was stage 4 bladder cancer.

Older adults have a higher risk of developing bladder cancer, a condition that occurs when cancer cells grow in the bladder. Although it can occur at any age, 90% of cases are in people over the age of 55, 73 is the mean age at diagnosis. Risk factors To involve to smokedue to a family history of bladder cancer and urinary tract inflammation urinary tract infections (UTI) or sexually transmitted diseases.

Although women are less likely to develop bladder cancer than men – 19,450 of 83,730 estimated new bladder cancer cases It was among women in 2021 – they may face worse outcomes after diagnosis. There are also African Americans lower bladder cancer survival rates although there are fewer new cases than white individuals.

As Pearson began to learn more about the disease, she realized she had multiple risk factors for developing bladder cancer. In addition to being over 55 when diagnosed, Pearson also had two brothers who died after developing multiple cancers, including bladder cancer.

Bladder cancer burden for black women

“Bladder cancer is the only cancer in which women are worse off than men after diagnosis,” he said. Armine K. SmithHe is the director of urologic oncology at the Kimmel Cancer Center at Sibley Memorial Hospital in Washington, DC, and an assistant professor of urology at the Johns Hopkins University School of Medicine. “Some of these may be related to biology and some may be related to women, on average, it takes longer to be diagnosed in the first place.”

Because blood in the urine is often one of the first symptoms at presentation, women who are used to seeing blood in their urine during menstruation or due to a UTI may not see it as a sign of something more serious. very often they prescribed antibiotics and sent home. When bladder cancer is diagnosed, it has reached a more advanced stage.

Men who detect blood in their urine may be more likely to view it as abnormal and tell their healthcare provider. More men, especially older men, have a relationship with a urologist because of past procedures or other conditions, making it easier to be diagnosed with bladder cancer early, Smith said.

This kind of relationship indirectly helped save Pearson’s life. Pearson’s husband is a prostate cancer He had developed a close relationship with the survivor and the head of the urology clinic where he was being treated. When Pearson tried to book an appointment with that clinic, she was told it was booked for weeks. Her husband called several times and was able to see a urologist the next day.

Pearson’s personal connections and physical location, close to top urology and oncology specialists in the Baltimore area, help improve long-term survival chances, while later diagnosis, less aggressive treatment, and lack of access to quality care generally have lower survival rates for Black bladder cancer patients. cited as contributing factors.

“There’s also a certain type of cancer — bladder adenocarcinoma — it’s a little more common in African Americans and usually occurs in the lower part of the bladder,” Smith said. “We don’t know if there is an anatomical or hormonal difference, but we do see that African American women are more prone to this cancer.”

Almost all adenocarcinomas invadermeans the cancer has moved to or outside the bladder wall and requires aggressive treatment.

The hollow shape of the bladder makes bladder cancer difficult to treat. This urothelial cells in the epithelial lining The bladder also covers the tubes leading to the kidneys, putting a larger area at risk of cancer spreading and making it harder to cut off cancerous cells. This is an important reason why bladder cancer is more likely to recur.

“I tell my patients that we will be friends because I will see them often,” Smith said. “The average oversight for these conditions is five to 10 years because you treat it many times and it comes right back.”

Second chance after bladder cancer

Amongst a urologist, bladder cancer specialist, husband, and even a savvy 16-year-old grandson who researched bladder cancer and its treatment online, Pearson had a strong team helping her along the way.

She started chemotherapy that fell through to shrink the tumor and had surgery to remove it the following February. A cystectomy It was also done to remove all reproductive organs to prevent cancer cells from spreading.

Pearson spent a week in the hospital after her wound became infected, but while there, her oncologist gave her the most positive news she’d heard in six months: She was cancer-free.

“It was March 3, 2016,” he said. “And here I am, more than five years later still cancer free.”

Pearson, now 76, works to raise awareness about bladder cancer through organizations such as: Bladder Cancer Advocacy Network (BCAN) and volunteered at a hospital before the Covid-19 pandemic. He sees his HCPs frequently and has gotten used to living with a woman. ostomyallows waste to pass into a pouch outside of his body.

Pearson often thinks of her friends and family, including her two brothers who have succumbed to bladder cancer, and feels grateful for the chance to spend more years with her husband, daughter, three grandchildren, and three great-grandchildren.

“When I heard I was in stage 4 I didn’t think they could do anything for me but God put me in the right hands,” Pearson said. “And thank God, I survived.”

This resource was created with the joint support of Astellas and Seagen.

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