If you have been diagnosed with urinary tract cancer, we want to help you better understand the link between hematuria (the presence of blood in your urine) and this type of cancer. This blog post will give you insight into the role of cancer in hematuria, particularly:

  • Urinary Tract Cancers
  • Tumor Growth and Hematuria
  • Varieties of Urinary Tract Cancers

Once we provide insights regarding the above topics, we’ll move on to diagnostic procedures for cancer detection. These procedures include:

  • Urine Cytology
  • Imaging Studies
  • Cystoscopy
  • Biopsy
  • Blood Tests

Before concluding this post, we will explain why you should seek timely medical attention. We will make clear how your vigilance and understanding of urinary tract cancer, urinary tract cancer symptoms, and the strong connection to hematuria will make it easier for you to know what to expect when it comes to your treatment plan and hematuria episodes.

As always, thank you for joining us on the FKP Kidney Health blog series; your time and attention to this topic demonstrates your determination to acquire knowledge that can help you confront urinary tract cancer in a way that makes you feel resilient and empowered.

Unveiling Hematuria: Exploring the Link with Urinary Tract Cancers

Introduction

Embarking on the journey toward understanding hematuria leads us into the realm of underlying health conditions, including cancer. In this blog post, we will explore the role of urinary tract cancers in hematuria, discuss diagnostic procedures, and clarify how urinary tract cancer manifests through the symptom of blood in the urine.

Learning that you have cancer can be quite emotional, and you will surely have many questions surrounding your diagnosis and prognosis. “Cancer” is not a word that anyone wants to hear, but no matter what your cancer journey entails, try to remain patient, embrace all the ways you can protect your kidneys, and find strength within yourself so you can confront urinary tract cancer and the myriad challenges it may bring. 

Role of Cancer in Hematuria

Sometimes people develop hematuria because they have a urinary tract infection or a kidney stone. Others have hematuria because they have an underlying condition, including a type of cancer that is causing blood to leak into their urine. Sometimes people see the blood in their urine, while other times, there may only be microscopic blood in the urine without color change.

  • Defining Urinary Tract Cancers

    Urinary tract cancers are cancers that affect any part of the urinary system. Your urinary system includes your kidneys, ureters, bladder, prostate and urethra. Any of these cancers, can manifest with hematuria as a key indicator. This is why, throughout our FKP Health blog series on hematuria, we have emphasized the importance of seeking prompt medical attention if you see blood in your urine, or if you are told that you have blood in your urine following a urinalysis. If you have urinary tract cancer, early detection and timely intervention are crucial and can ultimately influence your prognosis.
  • Tumor Growth and Hematuria

    When a tumor forms in your urinary tract, it can put excess pressure on the urinary tract and its delicate lining. Tumors disrupt the normal structure and shape of the urinary tract and impede the normal flow of urine. When this happens, you may notice blood in your urine. As the tumor grows, it can also cause irritation, inflammation, or even a blockage, which can result in pain or kidney damage.
  • Varieties of Urinary Tract Cancers

    There are different types of urinary tract cancers. These include renal cell carcinoma, bladder cancer, prostate cancer, and ureteral and urethral cancers. While each cancer is distinct, a shared similarity between all is that they can cause hematuria—not just one episode, but recurring episodes. This is usually what prompts individuals to seek medical attention and eventually receive a cancer diagnosis. It is important to note that both gross hematuria (blood that is visible to the naked eye) and microscopic hematuria (blood in your urine that can only be detected under a microscope) can indicate urinary tract cancer.

    • Renal cell carcinoma (RCC) is also referred to as renal cell cancer or renal cell adenocarcinoma. According to American Cancer Society (ACS), RCC is the most common type of kidney cancer; ACS notes that “about 9 out of 10 kidney cancers are renal cell carcinomas.” Although only a single tumor tends to form within one kidney, it’s possible for two or more tumors to develop in one kidney or to have tumors in both. There are several types of RCC, including clear cell RCC and non-clear cell RCC; the latter has many subtypes, including papillary RCC.
    • Bladder cancer occurs when cells within the urinary bladder—a hollow, stretchy organ—start to grow out of control. Over time, a tumor can form and potentially even spread to other parts of the body. ACS states that hematuria is usually the first sign of bladder cancer. Their webpage on the topic states, “There may be enough blood to change the color of the urine to orange, pink, or, less often, dark red. Sometimes, the color of the urine is normal but small amounts of blood are found when a urine test (urinalysis) is done because of other symptoms or as part of a general medical check-up. Blood may be present one day and absent the next, with the urine remaining clear for weeks or even months. But if a person has bladder cancer, at some point the blood reappears.”
    • Cancer of the ureter (ureteral cancer) is an abnormal growth of cells on the inside lining of the tubes (ureters) that connect your kidneys to your bladder, according to Mayo Clinic. Ureteral cancer is closely related to bladder cancer because the cells that line the ureters are the same type of cells that line the inside of the bladder. It occurs most often in adults and those who have been treated for bladder cancer. Ureteral cancer is uncommon, but when it does form, please be aware that your risk of bladder cancer increases.

Even a single episode of hematuria, and all the more so persistent and/or recurring hematuria, must be evaluated by a healthcare professional. Recognizing the correlation between different types of urinary tract cancers and hematuria is crucial for early detection; early detection ensures that you receive the prompt treatment and necessary interventions to manage urinary tract cancer.

Diagnostic Procedures for Cancer Detection

When your doctor diagnoses you with hematuria, it is imperative for your doctor to determine if the hematuria is being caused by urinary tract cancer. The following diagnostic procedures can help verify urinary tract cancer so your doctor can deliver an accurate diagnosis and then create a personalized treatment plan.   

  • Urine Cytology

A urine cytology is a non-invasive test that involves a pathologist evaluating a sample of your urine under a microscope. The pathologist will be looking for the presence of cancer cells; urinary tract cancer tumors shed abnormal cells, and the identification of these cells is a crucial aspect of the diagnostic process.

  • Imaging Studies

Your doctor will also use imaging studies to visualize the urinary tract. CT scan, MRI, and ultrasound can identify the presence, size, and location of urinary tract cancer tumors. This will provide helpful information about the severity of your urinary tract cancer and will influence your care plan. Additionally, imaging may help find another cause of the hematuria.

  • Cystoscopy

Cystoscopy is a procedure that involves your doctor inserting a thin tube into the urethra. The tube—outfitted with a camera and a light—will examine the urethra and the inside of your bladder in order to help detect and assess tumors within the urinary tract.

  • Biopsy

A biopsy is a valuable diagnostic procedure that your doctor may ask you to undergo. During a biopsy, a needle will penetrate the area(s) where cancer is suspected. The purpose is to extract a small tissue sample that can be evaluated by a pathologist, who can confirm or deny the presence of cancer cells. Since a biopsy can cause bleeding, infection, or discomfort, your doctor will require a biopsy only if it is deemed necessary to definitively diagnose urinary tract cancer.

  • Blood Tests

Another diagnostic procedure for cancer detection involves undergoing blood tests, including a renal function panel. A renal function panel provides a snapshot of how your kidneys are functioning, while tumor markers can detect substances associated with certain urinary tract cancers. An example of a tumor marker blood test used to screen for urinary tract cancer is the Prostate Specific Antigen (or PSA), which is made by the prostate. High levels of PSA in the blood could indicate the presence of prostate cancer; it should be noted that there are benign causes of elevated PSA too, including benign prostatic enlargement, prostate inflammation and prostatic or urinary tract infection.

Seeking Timely Medical Attention

If you experience hematuria, please do not delay calling your doctor, especially if the blood in your urine is persistent and if you notice any other concerning symptoms including, but are not limited to, abdominal pain, painful and/or frequent urination, urinary incontinence, excessive fatigue and weight loss. Early detection and intervention are critical in the management of urinary tract cancers. The sooner you are diagnosed with urinary tract cancer, the sooner you can move forward with the interventions necessary to promote a favorable outcome.

Empowering Through Vigilance and Understanding

There is a strong link between urinary tract cancer and hematuria. Understanding the link between the two empowers you to take proactive steps toward preserving your kidney health and getting the prompt medical treatment you need. Furthermore, consistent communication with your healthcare provider facilitates early detection and enables you to receive personalized care, support, and guidance. Ongoing communication with your care team becomes especially crucial as you navigate the myriad physical, emotional, and mental challenges that accompany a cancer diagnosis.

This blog addressed the role of cancer in hematuria, specific urinary tract cancers such as kidney cancer and bladder cancer, urinary tract cancer symptoms, and diagnostic procedures for cancer detection. Education and informed decision-making can help you navigate the complexities of hematuria associated with urinary tract cancers.

If you have been diagnosed with urinary tract cancer, take comfort in knowing that your doctors will take a multidisciplinary approach to deliver the best and most effective care. Every step forward is a testament to your resilience during this challenging time. On behalf of all the kidney physicians at Florida Kidney Physicians, thank you for joining us on this blog and for wanting to remain vigilant about your kidney health.