Fears of Recurrence or a Second Cancer

Patients who have been treated for bladder cancer are often worried about the chance of recurrence, which means that the cancer cells begin to grow again after treatment is completed.¹

Recurrence is not uncommon among patients who have certain types of bladder cancer, especially non-muscle-invasive bladder cancer.

What are second cancers?

Bladder cancer survivors may also develop a second cancer, which happens when the patient develops a different type of cancer that is unrelated to their first bladder cancer. Survivors of bladder cancer have an increased risk of developing certain types of second cancers, including:

• A second type of bladder cancer, which is different than a recurrence of the first bladder cancer
• Cancer of the renal pelvis and ureters
• Pancreatic cancer
• Cancer of the larynx
• Lung cancer
• Vaginal cancer
• Prostate cancer
• Kidney cancer
• Acute myeloid leukemia (AML)

How is cancer recurrence monitored?

After completing treatment for bladder cancer, patients will continue to be monitored regularly by their healthcare providers for any signs and symptoms that their cancer has recurred or that a second cancer has developed.^1,2 What happens during these follow up visits will depend upon the patient and his or her specific type of cancer and treatment, but ongoing follow-up can include:

• Regular checkups and general physical examinations
• Urine laboratory tests
• Blood tests
• Cystoscopy
• X-rays

Recurrent bladder cancer and second cancers can generally be treated more effectively the earlier they are detected, so it is very important for patients to maintain their schedule of follow-ups and check-ups. You should let your healthcare provider know if you develop any new signs or symptoms, especially if you experience symptoms related to urination such as blood in the urine, frequent or urgent urination, or pain or discomfort during urination.

How can I reduce my risk of recurrence?

While there is nothing patients can do that will definitely prevent cancer from recurring or a second cancer from developing, there are steps patients can take that can reduce the risk and improve their overall health.^1,3 For example, smoking and tobacco use increases the risk of bladder cancer recurrence as well as the risk of developing many types of second cancers. Avoiding smoking and tobacco use can help lower this risk.

Other strategies to help maintain health include consuming a healthy, balanced diet, developing a routine of regular physical activity and exercise, and maintaining a healthy body weight. Limiting your consumption of alcohol can also help improve your overall health.

Some types of bladder cancer are more likely to recur than others. Patients who have those types of bladder cancers may receive maintenance therapy on a regular basis for a year or more after their initial treatment for cancer is completed. This is done in an attempt to lower the risk of recurrence.

Tips for coping with the fear of recurrence or second cancer

It is very common and completely natural for patients who have been treated for cancer to be worried, stressed, or anxious about the possibility that the cancer will recur or a second cancer will develop.⁴ However, there are steps you can take to help cope with those feelings and keep them from affecting your emotional health and quality of life.

Seek support

For example, strategies for coping with fear of recurrence may include recognizing and expressing your emotions and fears. Many people find that talking about how they are feeling helps them to understand more about the reasons for their fears, which can help to alleviate them. Some patients prefer to speak with family and friends, while others prefer taking part in support groups or working with a mental health professional one-on-one.

Find ways to de-stress

Reducing the amount of stress and worry you are experiencing is important for your physical and emotional health. There are a range of different strategies that patients can try in order to find what works for them. These may include spending time with loved ones, getting more physical exercise, making time for hobbies or other enjoyable activities, or using various relaxation techniques such as meditation, yoga, massage, or other complementary methods.

Many patients feel less anxious or worried when they are well informed about the chance that their cancer will recur. Your healthcare providers can provide information about your specific risk factors, about signs and symptoms of recurrence, and about strategies for reducing risk and relieving stress.