What are the signs of bladder cancer in elderly females?

From the Guidelines

Bladder cancer in elderly women often presents with painless hematuria, which is the most common symptom, and other signs such as dysuria, frequency, and urgency, as noted in the most recent guideline 1. The presentation of bladder cancer can vary, but the most common signs include:

• Painless hematuria, which may be visible or only detectable under a microscope
• Irritative symptoms, such as dysuria, frequency, and urgency
• Bone pain or flank pain, which can be indicative of metastasis It's essential to note that these symptoms can also be indicative of less serious conditions, such as urinary tract infections or bladder stones. However, in women over 65, especially those with risk factors like smoking history or exposure to certain industrial chemicals, these symptoms should not be ignored. The diagnosis of bladder cancer is based on cystoscopic examination and histological evaluation of the tissue obtained through transurethral resection of the bladder tumor (TURBT) or cold-cup biopsy, as recommended in the recent guideline 1. Early detection significantly improves treatment outcomes, so any elderly woman experiencing these symptoms should seek medical evaluation promptly. A urologist can perform tests, including urinalysis, cystoscopy, and imaging studies, to determine if cancer is present. The management of bladder cancer is based on the pathological findings of the biopsy, with attention to histology, grade, and depth of invasion, as outlined in the recent guideline 1. In patients with high-risk non-muscle-invasive bladder cancer, upper tract imaging should be carried out to screen for synchronous upper urinary tract urothelial carcinoma (UTUC), as recommended in the recent guideline 1. Overall, it's crucial to prioritize the diagnosis and treatment of bladder cancer in elderly women, given the high incidence of the disease in this population, as noted in the recent guideline 1.

From the Research

Signs of Bladder Cancer in Elderly Women

• The most common clinical presentation of bladder cancer is asymptomatic hematuria, which should prompt evaluation with cystoscopy, renal function testing, and upper urinary tract imaging in adults 35 years and older 2
• Irritative voiding symptoms and risk factors for bladder cancer can also be indicative of bladder cancer in elderly women 2
• Gross hematuria at any age should also be evaluated for bladder cancer 2
• Cystoscopic examination remains the gold standard technique for initial diagnosis of bladder cancer (BCa) 3
• Enhanced cystoscopic techniques, such as blue light cystoscopy and narrow band imaging, can be used during initial staging of BCa if available 3

Diagnosis and Staging

• Transurethral resection of the bladder tumor allows for definitive diagnosis, staging, and primary treatment 2
• Multiparametric MRI could be an important imaging tool in local staging of BCa 3
• Molecular subtyping could become an essential part of initial histologic staging in the near future 3

Note on Relevance of Studies

• Study 4 is not directly relevant to the topic of signs of bladder cancer in elderly women, as it discusses the distinction between elastin and collagen in arteriosclerotic lesions.