Bladder Cancer in Women: Why Early Symptoms Are Often Misdiagnosed?
By Dr. Anup Ramani
Bladder cancer is frequently perceived as a male-dominated condition, yet thousands of women are diagnosed with this serious disease every year. Unfortunately, bladder cancer in women is often detected at more advanced stages due to the misinterpretation of its early symptoms. Common warning signs can mimic those of benign urinary conditions, leading to delays in diagnosis and treatment. For those seeking Bladder Cancer treatment in India, awareness and timely evaluation are essential.
This article explores the primary reasons bladder cancer symptoms in women are frequently overlooked and outlines how early detection can significantly impact treatment outcomes.
Common Early Symptoms Mistaken for Other Conditions
Blood in the Urine (Hematuria)
Visible blood in urine is the most common early symptom of Urinary Bladder Cancer. However, in women, it is frequently mistaken for menstrual bleeding, urinary tract infections (UTIs) or menopause-related issues. Even microscopic hematuria may be dismissed if a UTI is suspected, leading to repeated rounds of antibiotics without proper investigation.
Increased Urinary Frequency
Frequent urination, particularly at night, is often associated with urinary tract infections, overactive bladder or aging. This symptom may persist despite antibiotic treatment, yet bladder cancer is not always considered until the disease progresses.
Painful Urination (Dysuria)
Burning or pain during urination can be another indicator. Women often attribute this symptom to UTIs or inflammation. When pain persists despite treatment, further urological evaluation is warranted to rule out Urinary Bladder Cancer.
Pelvic Discomfort
Chronic or recurrent pelvic pain in women is sometimes misattributed to gynecological issues like ovarian cysts or endometriosis. However, bladder cancer can also present with persistent discomfort that does not respond to standard treatments.
Urinary Urgency and Incontinence
Sudden and frequent urges to urinate or unintentional urine leakage can be symptoms of bladder dysfunction caused by underlying malignancy. These are commonly dismissed as consequences of childbirth or aging, leading to delayed diagnosis.
Why Misdiagnosis Happens More Frequently in Women?
Bladder cancer symptoms in women often resemble more common and less serious conditions. Several factors contribute to delayed or incorrect diagnosis:
- Gender Bias in Diagnosis: Physicians may unconsciously prioritize more common female urological issues over cancer.
- Lack of Awareness: Many women are unaware that they are at risk for bladder cancer.
- Underreporting of Symptoms: Patients may not mention mild or intermittent symptoms, assuming they’re related to menstrual cycles or menopause.
- Ineffective First-Line Treatment: UTIs are commonly treated empirically without confirmatory urine cultures, allowing cancer to progress undetected.
These factors highlight the need for a higher index of suspicion and comprehensive evaluation when women present with persistent urinary symptoms.
When to Consult a Surgeon?
Women experiencing any of the following should seek evaluation by a urologist, especially if symptoms persist or recur despite treatment:
- Persistent urinary frequency or urgency
- Pain during urination
- Pelvic or lower abdominal pain without a clear cause
- Urinary leakage not linked to known causes
Prompt investigation can lead to early detection, improving the effectiveness of Bladder Cancer treatment.
Diagnostic Approach for Suspected Bladder Cancer
When bladder cancer is suspected, the following diagnostic steps are typically taken:
- Urinalysis and Urine Cytology: To detect blood or cancerous cells in urine.
- Imaging Tests: Ultrasound or CT urogram to visualize the bladder and surrounding organs.
- Cystoscopy: A thin camera is inserted into the bladder to directly observe the lining and collect biopsies if needed.
- Biopsy and Pathology: Confirms the presence and type of bladder cancer.
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Available Treatments for Bladder Cancer in Women
Surgery
Depending on the stage, surgical options may include:
- Transurethral Resection of Bladder Tumor (TURBT) for superficial cancers.
- Bladder Removal (Cystectomy) for invasive cancers. Robotic Surgery for Bladder Removal is increasingly used for precision and quicker recovery.
Chemotherapy
Administered before or after surgery to shrink tumors or reduce recurrence risk.
Radiation Therapy
Used as a primary treatment or in combination with chemotherapy for those who cannot undergo surgery.
Immunotherapy
BCG therapy (for early-stage cancer) or newer immune checkpoint inhibitors to stimulate the body’s defense mechanisms.
Patients considering Urinary Bladder Cancer Treatment in India have access to all these options, especially in leading cancer centers.
Conclusion
Bladder cancer in women is often under-recognized due to symptom overlap with more common conditions like UTIs or menopause-related issues. This misdiagnosis contributes to advanced-stage diagnoses and complicates treatment. By recognizing symptoms such as hematuria, painful urination and urinary urgency as potential warning signs, women can take timely steps toward diagnosis and treatment.
Raising awareness and promoting routine urological assessments, particularly in women with persistent symptoms, are key strategies in improving Bladder Cancer treatment in India and worldwide.
FAQs About Bladder Cancer in Women
Why is bladder cancer often misdiagnosed in women?
Because its symptoms – like blood in the urine, urgency and pelvic pain – are commonly attributed to UTIs or menstrual issues.
What’s the most telling early sign of bladder cancer?
Blood in the urine, even if it occurs just once, should always prompt further investigation.
Can bladder cancer be treated without removing the bladder?
Yes, early-stage cancers can be treated with TURBT and intravesical therapies. Advanced cases may require bladder removal.
Is robotic surgery a viable option for bladder removal in India?
Yes, several advanced cancer centers in India offer robotic cystectomy, which enhances surgical precision and reduces recovery time.
What should women do if they notice bladder cancer symptoms?
They should consult a urologist promptly for appropriate testing and diagnosis. Delaying evaluation increases the risk of late-stage detection.
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PARTIAL PENECTOMY
- Partial penectomy is done in cases where glans and distal penis is involved with carcinoma.
- Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
- Patients who develop stones in the kidney or ureter, often experience severe pain.
- This condition usually needs a procedure to remove the kidney stones.
- This procedure is called ureteroscopy and is performed very commonly.
- It does not require any cuts and hence it is painless.
- The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
- The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
- The procedure takes about 40-50 minutes.
- A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
- Patient is mobile and walking in the room the same evening.
- Hospital stay is one night and patient is discharged the next day after removal of the catheter.
- Patient has to come back after six weeks to remove the stent in the kidney.
- Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
- We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
- Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
- This procedure is called TURP and is performed very commonly.
- It does not require any cuts and hence it is painless.
- The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
- The overgrown prostate is dissolved with a laser bloodlessly.
- The procedure takes about 40 minutes.
- A catheter (urine pipe) is kept after the procedure to drain the bladder.
- Patient is mobile and walking in the room the same evening.
- Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
- Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
- We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR
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Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
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Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.
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The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
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Dr. Ramani then sits in the controlling console to perform the surgery.
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On an average, a robotic adrenalectomy takes one hour.
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The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
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A urine catheter and bag to drain the bladder is inserted during surgery.
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A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.
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Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
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The drain pipe, if kept, is removed in the room on day 2 after surgery.
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The catheter is removed on day two after surgery.
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Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).
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Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.
Heavy activities like running, weight lifting can be resumed after a month
FOLLOW UP AFTER SURGERY
Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
Local patients usually meet Dr. Ramani after two weeks to discuss report.Outstation patients are counselled on a phone consultation.
ROBOTIC SURGERY FOR BLADDER CANCER
- Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
- Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
- Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
- The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
- Dr. Ramani then sits in the controlling console to perform the surgery.
- On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
- The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
- A urine catheter and bag to drain the new bladder is inserted during surgery.
- Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
- Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
- The drain pipes are removed in the room on day 3-5 after surgery.
- Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
- Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
- On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
- Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY
Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.
Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.
Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.
If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.
ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
- Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
- relatively easier but still requires significant experience to consistently deliver results.
- Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
- The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
- Dr. Ramani then sits in the controlling console to perform the surgery.
- On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
- The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
- A urine catheter and bag to drain the bladder is inserted during surgery.
- A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
- Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
- The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
- Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
- Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
- On the day of discharge, patient is totally self- sufficient.
- They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
- Almost all patients are back to work within 2-3 weeks of surgery.
- Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
- Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
- Local patients usually meet Dr. Ramani after two weeks to discuss report.
- Outstation patients are counselled on a phone consultation.