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The only top 10 cancer where survival rates are falling

Of the top 10 cancers in the UK, bladder cancer is only one where survival rates have been shown to be getting worse. New figures published this month in the Journal of Clinical Urology confirm in a study of cases of bladder cancer in England over a 19 year period (from 1990 until 2009) that survival rates here in the UK are falling and are worse than in than in other European countries with similar incidence rates.

Shockingly, bladder cancer isn't a rare cancer that only affects a few people every year. In fact, bladder cancer is our 7th most common cancer (the 4th most common for men) with over 10,000 people diagnosed with it every year in the UK alone. Over 5,000 people in this country lose their lives to this little discussed disease every year.

That's more people than are affected by many well known cancers, including leukaemia, kidney cancer, ovarian cancer, liver cancer, pancreatic cancer, cervical cancer and brain tumours. Each year more people die in the UK from bladder cancer than die in road accidents. Yet, it is still a cancer that is hardly ever talked about.

Bladder cancer is generally easily diagnosed by urologists, but unfortunately most people are not aware of the key symptoms, so they don't go and see their GP as quickly as they should. In addition, some of the main symptoms of bladder cancer are also linked with other medical problems, resulting in GPs delaying the referral of patients on to urology specialists. This is a particular problem for women, who experience a greater amount of delayed diagnosis than men. There is also a common misconception that bladder cancer only affects older men which means that GPs often believe that the symptoms are not symptomatic of a cancer and instead diagnose problems such as recurring urinary tract infections when they occur in women, younger men and children.

Historically, there has been very little research into the causes and treatment of bladder cancer, with treatment of the disease hardly changing in the last 30 years. Despite being so common, bladder cancer receives just 0.6% of cancer research spend. This is for a cancer that is the most expensive for the NHS to treat and has the highest recurrence rate of any cancer. Simple evidence that the current treatments just aren't working as well as they should.

Very few members of the public will know that smoking is believed to be the main cause of about half of the cases of bladder cancer, or that others cases can stem from exposure to industrial chemicals and dyes. However, for many bladder cancer patients, the medical profession still cannot find a reason why they have succumbed to this disease.

The most common symptom of bladder cancer is blood in your wee. Sometimes this is clearly visible, but in many cases it can only be picked up when tested by your doctor. There are no accepted screening tests for bladder cancer, so it is really important that awareness of all the causes and symptoms are better known. If caught early, the 5 years survival rates for bladder cancer can be as high as 80%, but if treatment is delayed this can drop to as low as 15% or less for advanced cases.

This new research paper has also highlighted the need for a greater equality in treatment, regardless of age, gender, socio-economic status and which part of the country you live in. It also calls for improved, more radical treatment for some of the early stage cancers, to prevent them spreading further into the bladder and then into other parts of the body (which is when survival rates suddenly get worse).

The study authors highlight lack of awareness of the causes and symptoms amongst the general public and within primary care as a major problem, resulting in late diagnosis which, in turn, dramatically affects survival rates.

Every day, 28 people are diagnosed and 14 people will die of bladder cancer in the UK alone. Those affected, and their families, are demanding that money needs to be spent to reverse this fall in survival rates and to find new and improved treatments.

Contact: Andrew Winterbottom
SAGE Publications

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