Bladder Cancer and Blood Clots (Thromboembolism)
Bladder cancer develops when cells inside the bladder (often in the lining) become cancerous and start growing in an uncontrolled manner. The bladder is a hollow, flexible organ that is part of the body’s natural filtering system. This system, which also includes the kidneys, urethra, and ureters, filters impurities and extra water from the blood to produce urine.1
Bladder cancer represents 4.7% of all new cancer cases in the U.S. It affects men more than women and older people more than younger.2
Blood disorders in bladder cancer
One of the most common initial signs of bladder cancer is noticeable blood in the urine. In fact, about 85% of patients with newly diagnosed bladder cancer have visible blood in their urine. The rest have blood that is detectible through microscopic testing. Additionally, bleeding can be extreme in patients with bladder cancer both during and after surgery.3
Research also shows that clotting is a common and dangerous symptom of bladder cancer – both of the disease and as a side effect of treatment. Overall, about 2% of bladder cancer patients will have a blood clot at some point during their disease. That is a rate 5 times higher than in the general population.3
The highest risk occurs during the first six months after diagnosis. When people are diagnosed with late-stage, or metastatic disease, the risk of having a clot is as high as 15.3% during the first six months after diagnosis.3
Clotting linked with bladder cancer treatment
People undergoing treatment for bladder cancer are also more at risk for clots, as well. For example, after bladder cancer surgery, the chance of experiencing a clot doubles. This is a stark contrast to people who’ve had surgery for other cancers like breast or lung cancer, where the risk of clotting decreases. Additionally, people taking chemotherapy have a 3.3% to 21% chance of developing a clot, depending on the therapy regimen and other risk factors.3
Symptoms of blood clots
Common symptoms of clots in the lungs (pulmonary embolism) include:
- Shortness of breath
- Chest pain
Common symptoms of clots in the legs (deep vein thrombosis) include:
- Pain or cramping in the leg
- Red or discolored skin on the leg
- A feeling of warmth in the affected leg
Preventive therapy for clots
Because of the documented risks of clotting, the recommended care guidelines include using medications that prevent clotting for people hospitalized with bladder cancer who are not prone to bleeding.
For surgical procedures, recommendations vary, depending on the severity of the procedure. For minor surgeries, getting patients up and walking can help prevent clots. For more extensive surgeries, current guidelines call for the use of anti-clotting medications before surgery and for 4 weeks afterward.
Researchers and doctors note the importance of these preventive measures, since 20% of clots can be fatal in bladder cancer patients.3
The connection between bladder cancer and blood clots
Scientists have learned that some of the key molecular pathways that lead to bladder cancer also create disruptions in blood clotting. This helps explain why both clotting and bleeding can accompany the same underlying disease. In fact, the molecular changes that underlie these disruptions can be used to diagnose bladder cancer, and some are currently targets for therapy.3
Have your views towards bladder removal changed since you were diagnosed?