Why Canadians can’t ignore this sign of bladder cancer, even in the COVID-19 pandemic

Brad Hornseth made sure to call his family doctor right away when he spotted specks of blood in his urine.

It was early in the summer of 2018 and the then 61-year-old was unsure of the cause. He thought he better get examined. 

Now, two years later, Hornseth says he’s lucky that he decided to see a doctor right away, even though he wasn’t too alarmed about the blood at the time.

In July 2018, Hornseth, who lives in Edmonton, was diagnosed with non-invasive bladder cancer. He says he’s glad they caught the cancer at the first sign that something was wrong because he didn’t let symptoms fester.

But the stress of fighting the illness has thrown off how the now-63-year-old thought he’d be spending his retirement, he said. 

“Your whole life just turns upside down,” he said. “You think: oh, today’s a lovely day, and the sun’s shining. And then it’s like the shark in Jaws. All of a sudden there’s that shark music that plays in the background, and you’re told that you’ve got cancer. It’s really hard.”

This year, 12,000 Canadians will be diagnosed with bladder cancer, according to Bladder Cancer Canada, a charity organization that advocates for patients.

The coronavirus pandemic is also impacting those who do have bladder cancer and those who haven’t received the diagnosis yet, the organization said in a statement to Global News.

4:18 Raising awareness for bladder cancer

Hospitals experiencing a delay in cancer-related surgeries, coupled with some Canadians not seeking help for health concerns during this time, is troubling, the organization notes. It’s important to be aware of the signs and symptoms of bladder cancer,

“Bladder cancer awareness is a critical first step to a successful diagnosis and a positive outcome for this disease that was responsible for the deaths of almost 200,000 people around the world in 2018,” said Dionne Duncan, executive director of Bladder Cancer Canada in a press release. 

Despite concern about the pandemic it’s crucial to seek a doctor’s advice if blood is found in your urine, a symptom of bladder cancer, said Duncan. 

Hornseth agrees that early detection made all the difference for him. He used a treatment option that wasn’t available a decade ago called BCG, short for bacillus Calmette-Guérin. This involves introducing bacteria into the bladder which prompts the immune system to attack the cancer.

He says he really benefited from this therapy and has been in the clear with recent check-ups. Still, he fears its return especially, when there’s a known shortage of BCG treatment in Canada since 2018. 

Merk Canada, the only supplier of BCG in Canada, has faced challenges in supplying the therapy and the shortage of the drug is continuing into 2020. 

Hornseth says he understands why many may be hesitant to seek treatment for issues like blood in their urine, as it may not seem pressing during this time. 

“You have to take it seriously, even if it just happens once. You need to go and get it checked,” he said.

“I’ve probably been into the doctors’ offices since COVID-19 has started, and it’s not that scary to go … they’re taking a lot of precautions. Don’t put it off.”

Bladder cancer can be recurrent, and expensive to treat

In terms of personal risk, a visit to the hospital is likely safer than other crowded public spaces like grocery stores due to the amount of new protocols in place, said Dr. Alexandre Zlotta, a professor specializing in urology in the department of surgery at the University of Toronto. 

“Bladder cancer is like any disease. The earlier you pick it up, the earlier you diagnose … the better the outcome,” he said. 

Blood in the urine is the most common symptom of bladder cancer, explained Zlotta. 

2:58 Raising awareness about bladder cancer

Risk factors for developing bladder cancer include smoking and working in industries that cause exposure to toxic fumes, he said. While bladder cancer has traditionally impacted more men than women, in recent years doctors have seen an uptick in women over 80 with the disease, and it is not thoroughly understood why.

For women, it may be even more crucial to be seen by a doctor as many may connect blood in their urine to a urinary tract infection (UTI), which are more common for them, said Dr. Peter Black, a professor of urologic sciences at the University of British Columbia in Vancouver. 

“Women tend to be under diagnosed, or there’s a delay in diagnosis,” said Black. Doctors may first assume it’s a UTI and treat for that first, he said.  “That’s another big issue we have in diagnosing bladder cancer.”

It’s important to note bladder cancer can impact any age group and younger people, as well, should contact their doctor if they see blood in their urine, said Zlotta.

“It’s the little known cancer. It’s the fourth or fifth most common in men. But about 7,000 to 8,000 Canadians are diagnosed every year,” he said.

“On top of that, it’s the most expensive cancer to treat because it requires a long follow-up. So not only it is common, it’s under-estimated, and it also incredibly costly and has a serious impact on health.”

Bladder cancer is comprised of two separate diseases, one that is only invading the superficial layer of the bladder where the tumor cells are not as aggressive. This is called non-invasive bladder cancer, he said. 

Other forms are more aggressive and go deeper into the bladder, are higher grade, and can move from the bladder into other organs, he said.

The less aggressive tumors have a tendency of coming back again and again, requiring the patient to be treated multiple times, said Zlotta.

‘You can’t ignore it’

Life expectancy for a patient who has been diagnosed with bladder cancer depends whether they have non-invasive bladder cancer, or the more aggressive form called muscle-invasive that occurs in less than half of patients, explained Black. 

Patients who are diagnosed with muscle-invasive bladder cancer, the mortality rate is about 50 per cent within five years, said Black. 

In terms of watching for signs, because blood in the urine can be a one time occurrence, it’s easy to assume nothing bad is happening, said Black. 

“When you add the COVID-19 layer on top of that… it’s more important now than ever to get out the message that bladder cancer can be life threatening,” he said. “You can’t ignore it because of COVID-19.”

Questions about COVID-19? Here are some things you need to know:

Symptoms can include fever, cough and difficulty breathing — very similar to a cold or flu. Some people can develop a more severe illness. People most at risk of this include older adults and people with severe chronic medical conditions like heart, lung or kidney disease. If you develop symptoms, contact public health authorities.

To prevent the virus from spreading, experts recommend frequent handwashing and coughing into your sleeve. They also recommend minimizing contact with others, staying home as much as possible and maintaining a distance of two metres from other people if you go out. In situations where you can’t keep a safe distance from others, public health officials recommend the use of a non-medical face mask or covering to prevent spreading the respiratory droplets that can carry the virus.

For full COVID-19 coverage from Global News, click here.