Bladder Cancer: Know the signs

Dennis Roscher served in the Army from 1972-1977 and is one of the 3,200 Veterans diagnosed with bladder cancer each year. Bladder cancer occurs when the cells in the bladder start to grow out of control. Most tumors develop on the inner layer of the bladder, the urothelium. As the cancer grows into deeper layers, it becomes more difficult to treat. Since early diagnosis is critical to successful treatment and recovery, VA is encouraging Veterans to talk to their doctors about the signs and symptoms of bladder cancer.

Bladder cancer is the 4^th most common cancer among Veterans. Symptoms of bladder cancer include:

• Blood in the urine; painful or urgent urination; inability to urinate
• Abdominal pain; lower back pain
• Fatigue
• Appetite or weight loss

“Early diagnosis of bladder cancer leads to good outcomes,” said Dr. Chong-Xian Pan of the VA Boston Healthcare System. “Two out of three bladder cancer cases are related to smoking. Even electronic cigarettes are linked to bladder cancer. Quitting smoking is the best way to prevent bladder cancer from occurring.”

According to the Centers for Disease Control and Prevention (CDC), a history of bladder cancer, certain gene mutations, taking some kinds of chemotherapy drugs, and chronic urinary tract infections are risk factors.

Agent Orange and Bladder Cancer

Chemical exposure, such as Agent Orange, also increases a Veteran’s risk of bladder cancer. Thanks to the passage of H.R. 6395, the William M. Thornberry National Defense Authorization Act for Fiscal Year 2021, VA added bladder cancer to its list of presumptive conditions linked with exposure to Agent Orange. Presumptive conditions are certain health problems that are automatically considered by VA to be connected to a Veteran’s military service.

If a Veteran was exposed to Agent Orange in Vietnam and was diagnosed with bladder cancer, they or their survivors can file a VA disability compensation claim at VA.gov. If a claim was previously denied, it will be automatically reviewed. VA encourages Veterans diagnosed with bladder cancer to choose VA, like Roscher, for their cancer care to receive best-in-class treatment.

Bladder Cancer care at VA

VA’s National Oncology Program (NOP) is with cancer patients every step of the way for their treatment. Through the National Precision Oncology Program (NPOP), NOP can identify which cancer treatment strategies will work best for a Veteran’s bladder cancer.

With best-in-class molecular testing through Next-Generation Sequencing (NGS), NOP providers can recommend a course of treatment that targets a tumor’s specific mutation. Pharmacogenomics further tailors a patient’s dosage and options for commonly used medications. NGS enables VA clinicians to leverage the right tools when treating cancer and improve Veterans’ quality of life.

In summer 2021, VA is launching a Clinical Pathways program for bladder cancer. This program will standardize the best practices for bladder cancer diagnosis and care at VA to improve patient outcomes.

Know the signs, seek treatment

Roscher’s healthcare team at the Kansas City VAMC are keeping a close eye on his cancer. Since Roscher noticed the signs and spoke up about them immediately, his doctors caught his cancer very early. The former military policeman encourages all Veterans to see their doctor if they notice symptoms like blood in the urine.

“I know it can be embarrassing to talk about blood in the urine, but just go ahead and do it,” Roscher said. “Use language that you are comfortable with and tell them how it is so you can find out what’s going on. Everyone at VA who I have seen has been genuinely caring. They take the time to listen.”

If you notice any of the signs of bladder cancer, talk to your doctor. Ask your provider to rule out bladder cancer if you see blood while urinating. Identifying bladder cancer signs early is important!

If you are a current smoker, quitting is one of the best ways to reduce your risk of bladder cancer. VA can help. Visit www.mentalhealth.va.gov/quittobacco/howtoquit.asp or call 1-855-QUIT-VET to learn more about smoking cessation at VA.

For more information on how VA works shoulder to shoulder to provide best-in-class cancer care, please visit cancer.va.gov, or contact cancer@va.gov.

Boyd Loehr is a program manager with VA’s National TeleOncology (NTO) program.