2010/02/22 00:00:00
Nanette Lavoie-Vaughan
Seniors often are reluctant to complain about pain or vague symptoms, which they might attribute to growing older. Our parents’ generation was taught to be stoic, to pull themselves up by their bootstraps and keep going. This might be fine when it comes to everyday life but not when you are dealing with health and illness.
I always have encouraged my patients and their family members to maintain an open dialogue about health concerns and new symptoms, but this often is easier said than done. You can keep the discussion going by asking what they ate for dinner or how they spent their day. If that does not elicit useful information, then you might have to be more direct and ask about specific concerns such as pain, fatigue, bowel function, incontinence, and decreased mobility.
As a health care provider, I try to practice what I preach, so when my father was recently diagnosed with bladder cancer I questioned how I could have missed the signs.
The most common symptoms of bladder cancer are blood in the urine, painful urination, frequent urination, and the urge to urinate with no results. My father had none of these symptoms; his only complaint was nighttime incontinence.
This is not surprising, because bladder cancer is an often-silent disease with vague symptoms that can be signs of other, more common conditions in older people. Men are two to three times more likely than women to have bladder cancer, and their symptoms might be attributed to an enlarged prostate.
To put the picture together, you first have to look at risk factors for bladder cancer:
- Age: Risk increases with age, starting at 40, with the highest incidence after age 60.
- Tobacco: Cigarette, pipe, and cigar smokers have two to three times the risk.
- Occupation: Workplace exposure to carcinogens increases the risk for those in the rubber, chemical, leather, textile, metal-working, painting, and printing industries. Hairdressers and machinists also are at higher risk.
- Race: White people get bladder cancer twice as often as blacks and non-white Hispanic people. The lowest rate is among Asian people.
- Family history: Individuals with family members who have bladder cancer are more likely to get the disease than those with no family history.
The likelihood of cancer increases dramatically when you combine these risk factors with the following symptoms:
- abdominal pain,
- anemia,
- bone pain or tenderness,
- fatigue,
- urinary incontinence, and
- weight loss.
In my father’s case, multiple risk factors and several of the less common symptoms were present. He also had not responded to treatment for an enlarged prostate and incontinence. A final diagnosis was made during a cystoscopy.
Cystoscopy involves placing a flexible tube with a light through the urethra into the bladder. Any suspicious lesions can be removed for biopsy. There are three types of bladder cancer: transitional cell, squamous cell, and adenocarcinoma. The cell type determines the degree of involvement and the treatment.
I am happy to report my father has transitional cell cancer, the most common and easily treatable type. He will be receiving chemotherapy.
As a caregiver, it is imperative you report any changes in your parent’s function or onset of new symptoms to his or her health care provider. If treatment begins, report if there is no improvement in your parent’s symptoms. Both are essential to early diagnosis and treatment.
Although cancer is a devastating diagnosis, early intervention and new treatments have increased longevity and improved quality of life for those affected. To learn more about bladder cancer, visit www.cancer.gov.
About the Author: Nanette Lavoie-Vaughan is an adult nurse practitioner and professional consultant. She is a featured speaker at national professional conferences and writes about geriatrics for multiple publications.
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Copyright Nanette Lavoie-Vaughan and Military Officers Association of America. All rights reserved.
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Captain Harris |
3/10/2010 5:50:23 PM |
Thanks for this article--I am a "that age" and appreciate the comments on symptoms. I have a friend who died of bladder cancer--didn't pay attention to symptoms until it was too late.
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3/10/2010 4:36:02 PM |
This is a great heads-up for all of us, care-givers and for ourselves. Thankfully, under today's healthcare system your father is being treated. Soon, that may not be the case!
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3/10/2010 2:02:57 PM |
I am a care giveeeee. I have an appointment with my urologist in April and this will be a good topic of discussion. Thanks
