Bladder cancer starts when cells in the urinary bladder grow uncontrollably. While the disease can start growing in different cells of the bladder, most people are diagnosed with urothelial carcinoma, also known as transitional cell carcinoma (TCC). This type of cancer affects the urothelial cells that line the interior of the bladder and is the most common type of bladder cancer. 

Both men and women are affected by bladder cancer, although not always in the same way. There are important gender differences to understand as they influence your risk of developing the disease, the speed of its diagnosis, and the potential outcome after treatment.

Bladder Cancer Risk is Higher in Men

Bladder cancer occurs more frequently in men than in women, with men being three to four times more likely to receive a diagnosis. According to the American Cancer Society, the likelihood of men developing bladder cancer in their lifetime is about 1 in 27, compared to 1 in 89 for women.

This increased risk for men is thought to be related to higher exposure to cancer-causing substances. Generally, men are more likely to smoke tobacco and work in jobs that involve toxic chemicals found in products such as textiles, dyes, paint, fungicides, insecticides, metals, plastics, and motor vehicle exhaust.

Regardless of gender, quitting smoking is one of the most effective ways to reduce your risk of developing bladder cancer. Approximately half of all bladder cancers are linked to smoking, and smokers are at least three times as likely to get bladder cancer as non-smokers.

Other risk factors for bladder cancer include:

• Being over the age of 55
• Being White
• A family history of bladder cancer
• Long-term use of urinary catheters
• Chronic bladder problems and urinary tract infections
• Having previously received radiation or chemotherapy

How Do the Symptoms of Bladder Cancer Differ Between Men and Women? 

Men and women typically experience similar symptoms when it comes to bladder issues. The most common symptom is blood in the urine, known as hematuria. This blood may make your urine appear pink, orange, or dark red. While this can indicate bladder cancer in both men and women, it is often interpreted differently between the genders.

For women, blood in the urine might be initially overlooked because it can also be a symptom of urinary tract infections, which are more common in women, or postmenopausal uterine bleeding. If your doctor tests the urine and it’s negative for a UTI, or if your symptoms persist after taking antibiotics, it’s important to schedule an appointment with a urologist. Even though hematuria is usually painless, ignoring it can delay diagnosing the cause.

Other signs of bladder cancer include:

• Irritation, pain, or burning during urination
• Pain in the pelvic area, which women can mistake for gynecologic-related pain
• Unexplained weight loss
• A frequent urge to urinate, even when the bladder isn’t full

Related Reading: What Are Bladder Cancer Symptoms and 9 Other Common Questions

Be sure to discuss any of these symptoms, especially blood in your urine, with your primary care physician or urologist. The sooner you see a doctor, the sooner a diagnosis can be made. 

Diagnostic Challenges of Bladder Cancer

Diagnosing bladder cancer can be challenging because its symptoms often resemble those of other conditions, such as kidney stones and urinary tract infections (UTIs). Initially, tests like urinalysis and blood tests may be conducted to rule out these other issues before moving on to more specific tests for diagnosing bladder cancer. For women, a pelvic exam may also be recommended, while men might undergo a digital rectal exam and/or a prostate-specific antigen (PSA) test to exclude any prostate-related problems.  

If none of these other conditions are present and bladder cancer is suspected, your doctor will likely refer you to a urologist for a cystoscopy. In this procedure, the urologist examines the inside of your bladder and urethra (the tube carrying urine out of your body) to look for abnormal areas. A cystoscope— a thin, tube-like instrument equipped with a light and a lens for viewing— is gently inserted through the urethra into the bladder, allowing the doctor to see inside and perform a biopsy if necessary. Imaging may also be done, such as a CT scan or MRI, to see if there is a mass in the bladder and surrounding area.

Related Reading: Tests Used to Diagnose Bladder Cancer

Although men have a higher risk of developing bladder tumors, women tend to be diagnosed when the cancer is at a more advanced stage. Because of this, women are more likely to be diagnosed with muscle-invasive bladder cancer, which is more advanced and more challenging to treat.

Bladder Cancer Treatment Differences and Outcomes

In general, there is no difference in the types of treatments used for men or women with the same type of bladder cancer. However, because women are more likely to be diagnosed with muscle-invasive bladder cancer, there are usually more treatments needed.

Nonmuscle-Invasive Bladder Cancer

Non-muscle-invasive bladder cancer is confined to the bladder lining and has not spread into the muscle walls of the bladder. Typically, men and women with this diagnosis receive similar treatment. The initial approach usually involves surgery through transurethral resection of the bladder tumor (TUR-BT), followed by intravesical therapy, which delivers drugs like chemotherapy or immunotherapy directly into the bladder to kill any cancer cells that remain after surgery.

Muscle-Invasive Bladder Cancer

Muscle-invasive cancer refers to cancer that has grown into the walls of the bladder. In cases like this, a more complex treatment plan is needed.

A TUR-BT procedure is performed to remove as much cancer as possible before starting treatment. This is usually followed by intravenous chemotherapy over the course of eight to twelve weeks. Radiation therapy can be used if the cancer is not too deep into the bladder muscle wall. Immunotherapy may be recommended if there are still cancer cells circulating in the blood after chemotherapy is complete. 

Later-stage patients are likely to have the bladder surgically removed after chemotherapy. Nearby lymph nodes and organs may also be removed. For men, this often includes the prostate and seminal vesicles, while in women, the uterus, ovaries, and part of the vagina may be removed. An alternate way to drain urine from the body is then created.

Your bladder cancer doctor will evaluate various factors, including the stage of your tumor, its genetic makeup, and any previous treatments you've had, to determine the most effective therapies for you. 

Learn more about bladder cancer treatment options. 

Expert Bladder Cancer Care at Rocky Mountain Cancer Centers

If you or a loved one was diagnosed with bladder cancer, schedule a consultation with a urologic oncologist. We use a multidisciplinary approach to treating bladder cancer, working together with the urologist who will perform surgery, the radiation oncologist, and any other specialists involved in your care.

Request a consultation at one of our locations in Colorado, including the Denver area, Colorado Springs, Boulder, and Pueblo. We are also available to provide second opinions on a diagnosis and treatment plan for bladder cancer.