When Krysta Brkich noticed blood in her urine in 2021, she wasn’t overly worried. Her doctor figured it may have been related to a urinary tract infection. But when it happened again a month later, she became concerned and her physician ordered an ultrasound. Several weeks later, Brkich was shocked to find out that the cause was a mass in her bladder and that she had stage 1 bladder cancer. In early 2022, the Surrey, B.C., resident had surgery to remove the tumour.
“When you’re told the word mass, it’s horrid. That was really, really upsetting to hear.”
Thought of as a disease that affects mostly older, Caucasian men, Bladder Cancer Canada (BCC) has seen a significant rise in diagnosis of young, healthy women and men, of all ethnicities with no history of smoking – one of the main risk factors.
“When I first found out I had a tumor, I felt alienated because no one that I knew had ever dealt with bladder cancer,” says Brkich.
And although as Brkich says, she had little awareness of the disease, this type of cancer is the fifth most common in Canada, and experts say it’s time it received the level of attention that other cancers receive. May is Bladder Cancer Awareness Month, and this year alone, more than 12,500 Canadians will be diagnosed with the disease. Another 80,000 live with the disease.
“My urologist was kind of speechless. I’m 38 at this time, not a smoker…it was never on my radar, I thought maybe it was an infection or a UTI (a common medical misdiagnosis) but I never would have thought bladder cancer.”
“That scenario can happen,” says Dr. Madhuri Koti, an associate professor at Queen’s University Cancer Research Institute in Kingston, Ontario, “because blood in the urine is the main symptom and if a woman is premenopausal, menstruating, or has a history of UTIs it may be overlooked by physicians.”
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“In females, if you see blood, you don’t go to urologist. You think it’s a UTI. It adds to a delay in diagnosis.”
In most patients, 75 per cent, says Dr. Koti, the cancer is found in the early stages, called non-muscle invasive. That is, the cancer has not grown into the muscle around the bladder. In those cases, there are a variety of treatments, including surgery to remove the tumour, known as transurethral resection of bladder tumour (TURBT).
In 25 per cent of patients, bladder cancer is known as muscle-invasive cancer. That means the tumour has grown through the lining or the muscle of the bladder. In some of these cases, the recommended treatment is the removal of the bladder, known as a cystectomy. Patients in this case may also have chemotherapy and/or radiation, says Dr. Koti.
She says raising awareness about bladder cancer is critical, as few people know it is the fifth most common cancer in Canada, along with raising research dollars.
Another issue that people may not be aware of, says Dr. Koti, is that many patients require ongoing diagnostics and treatment. “The main issue with bladder cancer is its management. It is often lifelong, and treatment costs add up. It is the most expensive cancer to treat.” Dr. Koti says there are new, promising immunotherapies and trials that provide hope for the future of the illness, but more funding is needed.
Hasu Patel knows the routine of treatments well, living with bladder cancer for more than 20 years. She was first diagnosed in 2002 and the Mississauga, Ontario, resident has now had seven TURBT surgeries to remove tumours. She’s also had numerous rounds of BCG immunotherapy, developed by Canadian researchers and the most common intravesical immunotherapy using the same bacteria to treat tuberculosis, and has been used to treat bladder cancer since the 1970s.
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Patel says at the time, being diagnosed “was a big shock” as she had never heard of this type of cancer. Often, she said, at 44 she would be the only woman in a waiting room filled with older men. That has changed, she says.
As a non-smoker who didn’t think she had any risk factors, Patel urges women, no matter their age, not to ignore symptoms and go to their doctor.
And, over the course of her journey, Patel says patient support and advocacy has grown. “There was not much for information in 2002. I remember going to the library with my husband to see what we could find,” she says. She also sought a support group but couldn’t find one at the time.
But in 2021, she joined BCC and found a support group in her area. She found it reduced her anxiety about her illness and she connected with another woman virtually. She’s looking forward to her first in-person meeting.
For Brkich, joining BCC has also provided connection. She joined several groups and forums and did a podcast about her cancer journey. Because of that, a woman in the U.K. reached out and the two now talk regularly online and by phone.
Brkich urges others to access the resources that now exist.
“Don’t be afraid to reach out to people you may see on other forums or other support groups. I feel like a lot of the women are very open, the people are open arms… It’s a scary thing but you are not alone.”
Support BCC with a donation this month and join Canada Walks for Bladder Cancer each September.