Bladder Late Effects
Most survivors of childhood cancer do not experience problems with their urinary bladder because of their cancer treatment. But certain therapies can affect how the bladder functions.
How the Urinary Bladder Works
The urinary bladder is the organ that stores the body’s urine. The kidneys remove waste from the blood and make urine. The urine travels through tubes called the ureters to the bladder. Then urine leaves the body through the urethra.
The kidneys remove waste from the blood and make urine. The urine travels through tubes called the ureters to the bladder. Then urine leaves the body through the urethra.
Cancer Treatments That Can Cause Urinary Problems
- Chemotherapy with cyclophosphamide and/or ifosfamide
- Radiation to the pelvic area
- Surgical procedures in the pelvic area, including removal of the bladder (cystectomy)
Urinary Problems That May Occurr
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Bleeding into the bladder (hemorrhagic cystitis) can occur on and off for months to years after the completion of cancer treatment. Most hemorrhagic cystitis occurs during cancer therapy. But it may also become a chronic, recurring problem.
When it occurs, the urine color may be slightly pink to bright red. Some people may feel like they have to urinate frequently or that they cannot release all their urine. Most people do not have pain.
Sometimes tests are the only way to detect blood in the urine.
Patients should let their health care provider know when this condition occurs.
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Bladder fibrosis is scar tissue in the bladder. It may build up and cause the bladder walls to thicken. The pressure inside the bladder can increase and affect its ability to store and empty urine.
Symptoms may include difficulty emptying the bladder, leakage of urine, or blood in the urine. Sometimes the condition does not have symptoms.
Primary care providers may refer patients to an urologist if they have symptoms of the condition or are at risk for developing it.
An ultrasound may show the scar tissue. An urologist may perform a cystoscopy, which allows the doctor to look directly in the bladder with a thin, lighted tube.
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Bladder cancer as a result of cancer treatment is rare.
The most common symptom is blood in the urine. Patients may also experience a need to urinate urgently or frequently. Symptoms of advanced cancer are pain over the bladder, in genital area, or in the bones.
Survivors with these symptoms should see their health care provider.
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A neurogenic bladder is an abnormal function of the bladder caused by damage to the nerves that control the bladder’s function. The condition can cause the bladder to be underactive (not emptying completely) or overactive (emptying too frequently or quickly). People with neurogenic bladders also have a higher risk of urinary tract infections (UTIs) and kidney damage.
Know Your Risks and Monitor Your Health
Childhood cancer survivors should have annual physical examinations. They should share a copy of their survivorship care plan with their physician.
Report urinary symptoms immediately to a primary care provider. These symptoms include:
- Blood in the urine (pink or red urine)
- Frequent urination or urge to urinate
- Trouble urinating
- Incomplete emptying of bladder
- Pain during urination
Survivors should call their health care provider any time they see blood in their urine or have other problems with urination. The provider may perform urine tests to examine the urine and check for infection.
Drinking extra fluids can help flush out the bladder. But if you have kidney or heart problems, check with your physician before drinking additional liquids.
Avoid coffee, tea, cola drinks, and other drinks with caffeine.
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Reviewed: June 2018