Bladder Health after Childhood Cancer


Certain types of cancer, as well as its treatment, can damage your bladder. Here’s what you need to know to assess your risk for bladder problems.

Am I at Risk?

Radiation to the pelvic area and chemotherapy with cyclophosphamide, ifosfamide, or both increase risk for bladder problems.

What Bladder Problems Can Occur?

Bladder problems that can occur include bleeding into the bladder (hemorrhagic cystitis), scarring (fibrosis), and bladder cancer.

Hemorrhagic Cystitis 

In this condition, bladder irritation results in blood in your urine, making it slightly pink to bright red. Most people don't have pain, but some people feel an urgent need to urinate or like they can't release all the urine. Bleeding into the bladder can occur off and on for months to years after cancer treatment is completed.

Hemorrhagic cystitis is most often diagnosed after a person goes to the doctor because of blood in their urine. When the amount of blood in urine is very small and can't be seen, a lab test can identify if blood is present.

If you have hemorrhagic cystitis, follow these tips to help lessen symptoms:

  • Drink extra fluids to flush out the bladder. If you have kidney or heart problems, first check with your doctor to make sure it is safe for you to do this.
  • Avoid coffee, tea, cola drinks, and other drinks that have caffeine.

Bladder Fibrosis

In this condition, scar tissue forms in the bladder. The scar tissue can build up over time, causing the bladder wall to thicken. When this happens, pressure inside the bladder increases, which can affect how the bladder stores and empties urine. Over time, these changes can lead to kidney damage (see related Health Link: "Kidney Health after Childhood Cancer").

Some people with bladder fibrosis have no symptoms. For others, symptoms include:

  • trouble emptying the bladder
  • leakage of urine
  • blood in the urine

Bladder fibrosis can be diagnosed by ultrasound or a test where your doctor looks into your bladder with a thin, lighted tube (cytoscopy).

Bladder Cancer

Bladder cancer is a rare type of secondary cancer that can occur in people at risk for bladder problems. The most common symptom is blood in the urine. Other symptoms include an urgent or frequent need to urinate. Pain over the bladder, in the genital area, or in the bones may occur in people with advanced bladder cancer.

Bladder cancer is diagnosed most often by biopsy of bladder tissue. Sometimes cancer cells can be found in urine.

Should I Be Screened for Bladder Problems?

Call your doctor if you find blood in your urine or if you have fever, pain when urinating, trouble urinating, or the need to urinate urgently or often. If you have bladder fibrosis or if you are worried about bladder cancer, ask your doctor for a referral to a doctor who specializes in the urinary tract (urologist).

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