Living With Bladder Cancer and Finding the Right Support, With David VanderWeele, M.D., Ph.D.

Bladder cancer is one of several types of urothelial cancers — cancers that arise from the lining of the urinary system, including the bladder, ureters, renal pelvis and sometimes the urethra. While these cancers may originate in different locations, they look and behave similarly, though there can be slight differences based on where they start.

As David VanderWeele, M.D., Ph.D., explains, bladder cancer is closely linked to exposure to toxins, most notably cigarette smoking, which significantly increases risk. Other less common causes include long-term exposure to certain industrial dyes and chemicals.

The most common early warning sign of bladder cancer is blood in the urine, also known as hematuria. While blood in the urine can often be caused by less serious issues like urinary tract infections or kidney stones, persistent bleeding — especially if it doesn’t resolve with antibiotics — should be followed up with further testing to rule out cancer.

Treatments for metastatic bladder cancer (cancer that has spread beyond the bladder) have improved in recent years. Some patients are now living longer than expected thanks to advancements in chemotherapy, immunotherapy and targeted treatments. However, metastatic bladder cancer is still very serious, and the best outcomes come when the disease is caught early, before it spreads. Early-stage bladder cancer can often be successfully treated with surgery, chemotherapy or radiation, depending on the specific case.

For patients diagnosed with bladder cancer, especially those facing bladder removal, support is essential. In some cases, surgeons can create a “neo-bladder” using part of the intestine, allowing patients to urinate similarly to before. However, others may require a urinary diversion with a bag, which can be a big adjustment. VanderWeele emphasizes the value of support groups, as connecting with others who have faced similar surgeries or treatments can offer not only emotional support but practical tips on managing side effects and maintaining quality of life.

Whether undergoing Bacillus Calmette-Guérin (BCG) therapy, chemotherapy or radiation, every treatment has side effects, and having others to talk to can help patients navigate this journey with more confidence and clarity.