What are the long-term impacts of Bladder Cancer?

Achieving a semblance of normalcy in life after bladder cancer treatment can be mentally, physically and emotionally challenging. Even though your bladder cancer treatments are done, you'll still need regular monitoring.

What happens after completing bladder cancer treatment?

It’s natural to wonder what comes after bladder cancer treatments and how life will look long-term.

"This is going to be highly variable based on how advanced the bladder cancer is,” said Shawn Dason, M.D., urologic-oncologist and an assistant professor of urology at Ohio State University.

Early diagnosis improves the outlook for patients with bladder cancer. The five-year survival rates are 96 percent for people diagnosed with bladder cancer in situ, according to information from The American Cancer Society.

In patients with localized bladder cancer, the rate is 70 percent, 38 percent if regional and 5 percent if distant (based on data between 2011 and 2017).

Your medical team will consider your health as they help you plan out next steps. As time passes, your after-cancer health plan may adjust as necessary.

Follow-up for bladder cancer

Physicians recommend regular surveillance due to the high risk of bladder cancer recurrence. Your checkup could occur every three to six months since early detection greatly improves chances of survival.

In this follow-up, you will undergo many of the same medical tests performed with your first diagnosis of bladder cancer. Your physician will use the test results to determine if there are any signs of cancer cells or bladder tumors.

Tests during your follow-up appointments may include:

• Cystoscopies
• Urine tests
• Lab tests
• Imaging tests such as Computed tomography scan (CT) or ultrasound
• Endoscopy

Following treatment for non muscle invasive bladder cancer

Most patients are diagnosed with common types of bladder cancer, such as non muscle invasive bladder cancer (NMIBC). Of all the types of bladder cancer, NMIBC makes up 75 percent to 85 percent of new diagnoses.

"Although recurrence can be common, often this can be handled with an endoscopic procedure that is well tolerated," Dason said. "Patients often have routine follow-up cystoscopies and CT scans."

In addition, your doctor may include blood and urine tests to check up on your body.

"It is a chronic condition given the follow-up and periodic recurrences, but quality of life tends to be quite good."

Following treatment for muscle invasive bladder cancer

Muscle invasive bladder cancer (MIBC) makes up 25 percent of bladder cancers. Part or full removal of the bladder is typical. People who had MIBC may experience more significant implications concerning long-term quality of life.

"If they have chemotherapy followed by surgery to remove their bladder, they will have a change in how they urinate and have to adapt to this," Dason said. Patients receiving chemoradiation as a primary treatment will undergo a major modification to urination.

When the bladder is removed, doctors look for the best option for urinary diversion.

"Most patients adapt to life after muscle-invasive bladder cancer diagnosis and do well with some adaptations," Dason said.

But regular checkups are required to help maintain your health long-term.

"Follow-up is generally with routine visits with their urologist along with CT scans, urine tests, lab tests and possibly endoscopy," Dason said.

These checkups help detect signs associated with the recurrence of cancer and monitor how related organs, such as the kidneys, are functioning.

Following treatment for metastatic bladder cancer

"Metastatic bladder cancer will have the most significant implications on quality of life," Dason said.

For that reason, many physicians place a high priority on clearly explaining the treatments, potential side effects and overall outlook.

Some patients choose not to have chemotherapy or radiation therapy. However, they may have access to treatments to control pain and other physical symptoms related to the disease.

"Patients often have symptoms from both their disease along with the therapy they are receiving," Dason said. "This is a significant focus of their oncologists and palliative care physicians in their overall care from the time of diagnosis until the end of life."

Can treatments cause changes in the sexual-reproductive system?

"Many patients with non-muscle-invasive bladder cancer should have preserved fertility and sexual function," Dason said.

However, a significant impact—on their fertility and sexual function will be experienced by patients with muscle-invasive and metastatic bladder cancer, he explained.

The risks depend on the type of treatment a person received to remove the cancer. It is common for men to experience erectile dysfunction after bladder cancer treatment.

Some associated conditions, which vary from patient to patient, include:

• Infertility
• Libido challenges
• Low testosterone
• Sexual dysfunction

"Despite these risks, there is a lot that can be done to help patients with these challenges," Dason said.

If you experience debilitating side effects, don’t hesitate to speak with your doctor.

Female sexual dysfunction

Both women and men can suffer from sexual dysfunction, but studies on erectile dysfunction and ejaculatory difficulties are more frequent. However, this may be changing to better provide timely information to women with bladder cancer.

"Female sexual dysfunction is also common for women that develop advanced bladder cancer and radical surgery for bladder cancer can require resection of gynecologic structures," Dason said.

Physicians typically provide pertinent information to help patients make decisions about their treatment options and what to expect during and after treatment.

"Sometimes these conversations are omitted in the whirlwind of a new cancer diagnosis, but these are critical conversations to have with your bladder cancer doctor as early as possible," Dason said.

Maintaining physical and mental health after bladder cancer treatment

Bladder cancer is the third most common cancer affecting men in the United States. Men are four times as likely to receive a bladder cancer diagnosis than women.

No matter their gender, emotional support is essential for bladder cancer patients and their families. Whatever the type of cancer, patients will experience emotional ups and downs—with moments of sadness, anger or anxiety.

Certain changes can help you deal with the effects of treatment. Always speak with a doctor before beginning a dietary program or engaging in a physical fitness routine.

Ways to cope with the aftereffects of bladder cancer include:

• A diet rich in fiber (a nutritionist can help).
• Find a therapist or counselor to help work through our feelings.
• Seek help to manage financial healthcare challenges.
• Join bladder cancer support groups to meet with others who understand what you’re going through.

Palliative support services can assist you if your cancer is not curable. Navigating the challenges of advanced stages of bladder cancer is almost impossible alone. A palliative care team can help manage pain and provide support.

The bottom line

Patients who have successfully completed treatments are often concerned about the possibility of bladder cancer recurrence. Stick to the testing schedule and aftercare plan. If you have trouble adjusting to your new routine or want to improve your lifestyle, contact your oncologist for help.

Life after bladder cancer isn’t easy. If you need a new mental health therapist to work through tough feelings, Giddy Telehealth can help. With an easy-to-use online portal, access hundreds of healthcare professionals. Many offer same-day appointments or video consultations.