Can frequent UTIs be a sign of bladder cancer?

The symptoms of urinary tract infections (UTIs) and the symptoms of bladder cancer can be very similar. Both may involve pain while urinating, a feeling of urgency, frequent urination, and the presence of white or red blood cells in the urine.

So, how do you know which one you have or when to see a doctor? And, can recurrent UTIs ever be a sign of bladder cancer? We checked in with Arlene Siefker-Radtke, M.D., a medical oncologist specializing in genitourinary urothelium cancers, including bladder cancer.

Are there any symptoms that are unique to either UTIs or bladder cancer?

No. That’s one of the challenges of diagnosing bladder cancer. Many of the symptoms of bladder cancer are very similar to those of a UTI. Seeing blood in the urine is one of the most common symptoms of bladder cancer.

So, how is bladder cancer typically diagnosed?

Bladder cancer is typically diagnosed through cystoscopy. That’s when a urologist passes a small scope through the urethra to look inside the bladder. It’s an outpatient procedure that doesn’t require general anesthesia and can usually be performed at a doctor’s office.

Can frequent or recurrent UTIs ever be a sign of bladder cancer?

Most people who get frequent UTIs won’t develop bladder cancer. But there is a connection between the two. 

Some parts of the Middle East, for instance, have very high rates of bladder cancer, and those are areas where a parasitic infection involving the bladder called schistosomiasis is also very common. Schistosomiasis creates a lot of inflammation in the bladder, and UTIs are a frequent result.

Even here in the United States, we see higher rates of bladder cancer among patients who have chronic UTIs. 

The two conditions probably contribute to one another because inflammation causes damage to the protective layer of cells lining the bladder. This prompts the body to try to heal itself by replacing those cells. And each new generation of cells is another opportunity for mutations to arise that could someday lead to bladder cancer.

There’s also a reverse connection: people who have bladder cancer can also have more UTIs. Since the tumor breaks down the bladder’s normal protective lining, scientists speculate that it creates a safe haven for the cancer cells to hide out. And cancer’s natural ability to evade detection by the immune system may also help shield the bacteria. So, it’s possible that by promoting a very inflammatory environment, these two may work together, both protecting the cancer and making it more difficult to eradicate an infection.

Are there any medications or herbal supplements that can help prevent UTIs?

We haven’t seen any clinical data to back up claims that any product protects against UTIs.

Is there any way to reduce your risk of developing bladder cancer? 

Absolutely. There are a few things you can do:

1. Don’t hold your urine. I know it’s easy to get busy with desk work or put it off when you’re making a long drive. But don’t wait until your bladder is really full. Go to the bathroom as soon as your body lets you know it needs to. The colon clears out your solid waste, but once things are absorbed into the bloodstream, your main organs of excretion are the liver and kidneys. Emptying your bladder regularly helps get rid of all of the toxins your kidneys process during the day. 
   
   
2. Drink more water. This helps keep all those toxins flowing and gets them out of your system more quickly. This, in turn, decreases the amount of time they spend in the bladder, touching all of its surfaces. Toxins can contribute to the development of mutations, so you don’t want to expose the lining of your bladder to them any longer than necessary. When it’s hot outside, make sure you stay properly hydrated, too. Dehydration increases the risk of a UTI.
   
   
3. Avoid environmental toxins. Don’t smoke. And if you do, get help to quit. The best way to stop is with medication and counseling. Avoid other chemicals as much as possible, too. Wear gloves, for instance, when you’re using harsh cleaning agents in your house, as many chemicals can be absorbed through the skin. If you work in a refinery, use protective equipment. If you do chemical work, use a fume hood. If you’re a painter, work in well-ventilated areas.

Can anything other than bladder cancer cause frequent UTIs?

Yes. Some people have neurogenic bladders. That means the nerves controlling their bladders don’t function very well, so they can’t squeeze out the urine completely. 

People who use a catheter to empty their bladders also tend to get frequent UTIs, as the repeated insertion of the catheter can cause chronic inflammation and increase the risk of infection by introducing bacteria into the bladder.

People who have congenital abnormalities of the bladder that don’t allow them to excrete all of its contents are also subject to frequent UTIs, as are people who are prone to developing kidney stones and bladder stones. 

Do certain people get bladder cancer more frequently than others?

Yes. Men are more prone to develop bladder cancer than women, but the exact cause still isn’t known. Years ago, we thought it might be due to chemical exposure, since more men smoked and worked in factories or in particular industries, such as oil and gas.

But over time, as it became more socially acceptable for women to do the same things as men, we did not see a corresponding increase in the rate of bladder cancer among women. So, there appears to be some other reason for the difference. 

There’s also a higher risk of bladder cancer among people who are immunocompromised, or who need medication for autoimmune disorders like rheumatoid arthritis. Bladder cancer was one of the first diseases we successfully used immune checkpoint inhibitors against. So, while it’s hard to tease out the individual components and how they interact, there are clear associations between bladder cancer and the immune system.

What’s the most important thing to know about UTIs and bladder cancer?

Don’t ignore the symptoms and seek care early. Follow up frequently, and if your symptoms don’t improve, see a urologist as quickly as possible.

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