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bladder cancer has typically affected older people who smoke, but now it's showing up in younger non-smokers. and we don't know why.

bladder cancer canada's cassie schooley says that even if you don't fit the risk profile for bladder cancer, there's one symptom that absolutely requires a doctor's appointment.

if you see red, see your doctor
bladder cancer is the fifth most common cancer in canada. getty

when jack moon was diagnosed with bladder cancer in 2005, he relied on his medical team to treat the disease that had invaded his body. but canada had very little in the way of emotional support, a critical component of recovery. the georgetown, ontario, resident wanted to connect with others going through the same journey, to share challenges, hopes, fears and the latest information. he discovered such a group in the u.s., the bladder cancer advocacy network , but there was no similar organization in canada.

the network told him about david guttman, another ontario bladder cancer patient, who was also in search of a support system in his own country. so, in 2009, the two formed bladder cancer canada (bcc) to ensure other patients had the support they never had, and to raise awareness about the disease.

according to bcc, bladder cancer is the fifth most common cancer in canada, fourth most common among men, and eighth most common among women. some 12,500 canadians are diagnosed each year. it’s the most expensive cancer to treat because it has a 60 to 70 per cent recurrence rate. smoking is the most common risk factor, as is age and exposure to certain chemicals.
the most common symptom is blood in the urine, but others include bladder spasms and increased frequency and urgency of urination. treatment depends on the stage of cancer and can include surgery to remove the cells, chemotherapy, radiation, immunotherapy and targeted therapy. the five-year survival rate is about 77 per cent, and the earlier the diagnosis the better the outcome.

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cassie schooley, communications specialist with bcc, sat down with healthing to tell us the rest of the story.
 

what are bladder cancer canada’s objectives since jack and david founded it in 2009?

today bcc is still the only patient advocacy organization for bladder cancer in canada. it provides a range of support services to the patients, their caregivers and families, which includes current information about their diagnosis, treatment options, a national help line, webinars, info sessions, support groups online and in person, as well as a discussion forum that’s moderated by bladder cancer patients themselves.
we’re a grassroots organization and very much connected to the bladder cancer community, the patients and families. we want to let people who may be facing this diagnosis know that they’re not alone — there’s a large community of volunteers and people we’re connected to who are willing to provide support and assistance.
the main three objectives that the organization always adheres to are support, awareness and research. we provide support to canadian bladder cancer patients and their teams. we also really want to increase awareness among the general population, because it’s not a disease you hear about often, even though it’s the fifth most common cancer.

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and we want to fund research. we’re hoping to improve diagnosis and treatment, as well as work toward the elimination of bladder cancer. unfortunately, bladder cancer, although a common cancer, is very underfunded in terms of research. it falls at number 21 on [a list of] 24 in terms of research funding, compared to some of the other diseases like breast and prostate cancer. it’s a challenge to encourage research funding, perhaps because people don’t want to discuss urinary issues.

what are some of the challenges facing people with bladder cancer?

bcg [bacillus calmette guerin] is a form of immunotherapy and typically the first line of treatment. but availability isn’t always 100 per cent; it depends on the province or area you live in, coverage and availability of the drug. also, the cost of supplies and catheters aren’t always covered by provinces or territories.

how did the pandemic affect the bladder cancer community?

many people were experiencing health-care shortages across the board, which also affected people living with bladder cancer, or people who may not have known they had it. a late diagnosis can cause an advanced stage of cancer. the pandemic exacerbated that a bit. luckily, we’re a virtual and remote-based organization so a lot of programs we offered remained unchanged.
 “hopefully, in five years we will be seeing more patients getting these treatments, so they can live beyond their diagnosis,” says cassie schooley, communications specialist with bladder cancer canada. supplied
“hopefully, in five years we will be seeing more patients getting these treatments, so they can live beyond their diagnosis,” says cassie schooley, communications specialist with bladder cancer canada. supplied

our in-person support groups moved to zoom, which actually turned into a good thing because they became available to a lot more people. our biggest fundraising initiative, the annual walk in september, was forced to go virtual, so we introduced a “walk where you are” format that was quite successful. [the 13 th annual walk for bladder cancer takes place this year on sept. 23 and 24.]

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what’s the biggest misconception about bladder cancer?

that bladder cancer will typically affect older caucasian males. we’re seeing a lot more patients in their early 30s and 40s, both men and women, reaching out to us for support. the biggest risk factor typically associated with bladder cancer is smoking, but we’re seeing a significant increase in healthy, active non-smokers who don’t fit that typical bladder cancer profile. the face of bladder cancer has really changed and we’re trying to make people aware of that. there is research into why we are seeing this change, but it’s in the initial clinical trial framework stage.
we’re focusing on promoting awareness around the most common symptom — blood in the urine — and really encourage people who notice this, even if they don’t fit the typical profile, to see their doctor to get it checked as soon as possible.

tell us about some of the initiatives you are working on.

we have a few campaigns, such as see red? see your doctor . a new initiative to increase awareness with the younger demographic is our bladder cancer sucks social media campaign. we’re challenging people to suck on a lemon and take a selfie and use the hashtag #bladdercancersucks. we want to make it a talking point and get younger people involved and aware.

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is there anything new in bladder cancer research?

there are three new immunotherapies that reduce the risk of recurrence and hopefully boost the immune system: bavencio, padcev and opdivo, which are all available in canada and covered by most provinces.
an exciting study is also underway, assessing different genders — why women who are diagnosed with bladder cancer have a higher mortality rate versus men.

lastly, earlier this year there was a new announcement regarding a simple urine test [called uroamp ] to detect bladder cancer much sooner than a traditional assessment would. typically, it’s a pretty involved procedure. cystoscopy requires the insertion of a camera in the bladder [to see inside and collect cells for biopsy], so the idea of a simple urine test is wonderful news. i don’t know how quickly we’ll see that though, as it’s currently pending health canada approval, as well as pending approval coverage in each province and territory.

what do you hope bladder cancer will look like in five years?

i think research and new treatments with limited side effects will improve the quality of life for patients and extend their life. hopefully, in five years we will be seeing more patients getting these treatments, so they can live beyond their diagnosis.

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may is bladder cancer awareness month. to find out more information, connect with others or to donate, visit bladder cancer canada.
robin roberts is a vancouver-based writer.

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