The presence of blood in the urine, a warning sign of bladder cancer

Much less known than prostate cancer, bladder cancer affects 13,000 to 20,000 new people each year and is responsible for around 5,000 deaths. “This cancer, relatively common and sometimes aggressive, is too little known,” says Dr. Benjamin Pradère, member of the cancer committee of the French urology association (AFU), which is organizing a campaign throughout the month of May. awareness. If the typical patient is a male smoker (or ex-smoker) aged around 70, women are not spared. Around “a quarter of patients are women” and their “proportion is increasing”, according to the president of the Cancer Vessie France patient association, Lori Cirefice.

If this cancer is four times more common in men, “it is often more serious in women, because symptoms can be misinterpreted and delay the diagnosis,” warns Dr. Pradère. This is what Catherine, a 51-year-old former childminder, experienced. “After a bypass (bariatric surgery, Editor’s note), I often had blood in my urine. The treating doctor thought it was related to the operation. It didn't work. I was sent to see a gynecologist, who thought about micromenstruation - because I had an IUD,” she says. Over the months, the problem persists. “After a year, I couldn't stop myself from going to the bathroom. An MRI finally showed a large mass in the bladder,” recalls Catherine. Then, everything happened: “8 hours of operation” to remove “the mass”, announcement of an infiltrating cancer, removal of the bladder, uterus and lymph nodes, chemotherapy and immunotherapy.

Also read: Bladder cancer: warning signs not to be missed

“Red urine, I’m moving!”, urges the slogan of the awareness campaign, in reference to the most common first symptom. Indeed, in 80% to 90% of cases of bladder cancer, hematuria (medical term which designates the presence of blood in the urine) is the first visible symptom. “This does not automatically mean that the person has cancer, it could be simple cystitis,” says Professor Yann Neuzillet, urological surgeon at Foch hospital (Suresnes) and member of the cancer committee of the AFU. In men, benign prostatic hypertrophy can also cause bleeding.

Other signs should alert you, such as difficulty urinating, but also repeated urinary infections, especially when no infection is detected during ECBU (a cytobacteriological examination of urine). Knowing how to spot red flags as early as possible is crucial. “It must be detected as early as possible, it is a curable cancer when it is caught in time,” Dr. Pradère recently indicated to Le Figaro. In practice, 80% of patients survive if the diagnosis was made early enough. But when it intervenes too late, when the cancer has already metastasized, the 5-year survival rate is only 5%.

Although it is best known for its role in lung cancer, active smoking is the leading cause of bladder cancer. It alone would even be responsible for a little more than half of cases among men, and 39% of cases among women. “Once inhaled, the carcinogenic products resulting from the combustion of tobacco will pass into the blood then into the bladder, where they will stagnate in contact with the bladder mucosa before being evacuated in the urine, which will increase the risk of cancer,” explains Professor Yann Neuzillet. It is considered that a smoker is between 5 and 6 times more likely to suffer from bladder cancer than a non-smoker. And all the more so since he will have started smoking at a younger age, and his consumption will be high

In Europe, the frequency of this cancer has increased in recent years "not only due to an increase in detections, but also an increase in smokers", according to Dr Benjamin Pradère. Also be careful with cannabis, warned Professor Neuzillet: “young patients arrive for consultation after having been exposed to improbable carcinogens through the consumption of cannabis (...) combined with sometimes anything, tires, cement ...».

Other factors can promote this cancer, including: occupational exposure to certain chemicals, having already undergone radiotherapy to the lower abdomen, having received certain chemotherapies or even certain infections. “Certain exposures, particularly occupational, can lead to bladder cancer: rubber, dyes, paints, cosmetics, certain hydrocarbons, pesticides in large agricultural regions,” underlines Dr Pradère. Any urinary sign (hematuria, urination problems) in a smoker or a person exposed to occupational toxicants should therefore lead to consulting a urologist for an assessment.

If these carcinogens are less present than 20 or 30 years ago in the world of work, people previously exposed remain at risk, as do people who stopped smoking several years ago. “I was told that my cancer could come from cigarettes, but I also worked in a lot of factories - aluminum rims, baby wipes, cereals, heating and air conditioning for cars... -, so we don't will never know,” slips Catherine.