Bladder Cancer

Healthy Lifestyle

Whether you are just starting treatment for bladder cancer, actively managing it or in maintenance, adopting a healthy lifestyle can benefit you in multiple ways. It may help you tolerate treatment better, lower the risk of a recurrence, help protect against secondary cancers and support your mental and emotional well-being. 

Diet and Exercise

Eating a nutritious diet, maintaining a healthy weight, limiting alcohol, exercising and avoiding tobacco use are all positive choices. Experts recommend a diet high in vegetables and fruits, whole grains, and lean protein. Weight can fluctuate during treatment. A dietitian can help tailor an eating plan for you.

Exercise and physical activity are effective for managing fatigue, maintaining a healthy weight, boosting muscle strength and endurance, and improving self-esteem and your mental health.

Moving Forward After Diagnosis

Your daily activities after bladder cancer may not be the same as before treatment. Certain adjustments will be needed. If you had bladder surgery, you may have to change how you urinate and bathe, especially if you have a stoma. You may find it valuable to connect with other people who have had the same type of surgery as you through peer-to-peer matching services and online or in-person support groups. They will have suggestions and ideas that are helpful. Following are possible issues you may face.

Incontinence is a common side effect of bladder cancer treatment. Difficulty with urination may happen when all or part of the bladder has been removed or with chemotherapy, radiation therapy and immunotherapy. Ways to make you more comfortable may include the following:

  • Pelvic floor exercises, commonly known as Kegels (pronounced KEE-gulz), can help reduce leakage from stress incontinence (see About Kegels).
  • Medications that can tighten or relax your muscles may be prescribed. These drugs can have side effects, so make sure to ask about them.
  • For incontinence caused by blockage of the urethra by scar tissue or by an enlarged prostate, a surgical procedure done through a scope can relieve the obstruction.

Sexual dysfunction may occur as a result of surgery, radiation to the pelvic area or hormone therapy that suppresses or removes reproductive organs. Some effects may include erectile dysfunction, infertility, lack of desire and painful intercourse, as well as fatigue, mood changes and feeling insecure.

For men, erectile dysfunction (ED), which is the inability to achieve or maintain an erection, is one of the most common side effects of cancer treatment in the pelvic area, including the bladder, prostate, rectum and urethra. ED can be caused by several factors:

  • Damage during treatment to nerves or blood vessels that supply the penis.
  • Reduced level of testosterone in the blood resulting from hormone therapy or other injury or damage to the testicles, which produce testosterone.

Multiple options are available to treat ED. These include oral medications, penile injections, urethral suppositories, vacuum constriction devices and penile prostheses or implants.

For women, removing the bladder as well as the ovaries can bring on premature menopause. As a result, lower hormone levels may lead to menopausal symptoms, reduced libido (sex drive), inability to achieve or maintain arousal, vaginal dryness, pain during intercourse or the delay or absence of orgasm.

Multiple remedies include hormone replacement therapy, moisturizers to relieve vaginal dryness, lubricants to reduce pain during intercourse and vaginal dilators to gradually stretch the walls of the vagina to increase comfort during intercourse.

Infertility is the inability to become or stay pregnant or to father a child. Although most people with bladder cancer are over 55, bladder cancer can develop in people of childbearing age. If having a child is in your future, consult with your medical team and a fertility expert before committing to any treatment options, if possible.

Emotional Effects

The physical effects caused by bladder cancer and its treatment may affect your mental and emotional health, self-esteem and body image. Physical changes may make you feel insecure, causing intimacy to be challenging. Cancer and its treatment can affect how you feel about yourself and your body and how you relate intimately to your partner. You and your partner should share your concerns and fears with each other.

Various holistic approaches may improve self-esteem and body image following bladder cancer, as well as reduce feelings of depression and increase the overall sense of well-being. These may include journaling, meditation and group therapy using guided imagery.

Follow-up Care

Keeping ongoing appointments is crucial. In addition to addressing the above concerns, it is important to be alert for recurrence. Early detection can improve prognosis. 

About Kegels: Exercises to help manage incontinence

Kegels are helpful before and after bladder cancer treatment. These exercises may not eliminate your bladder incontinence, but with consistent practice, you could see a marked improvement in just weeks. Do not

practice them if you have a catheter in place.

To get started, try to perform these exercises while you are standing. If you are not able to stand, try sitting or choose a position that is comfortable for you.

  1. Tighten your pelvic floor muscles. Ensure you’re flexing the correct muscles (not your abdomen, thighs, or buttocks). Tighten the muscles used to stop urinating mid-flow. 
  2. Hold the contraction for 10 seconds, and then relax for 10 seconds. Avoid holding your breath. Instead, breathe freely during the exercises.
  3. Aim for at least six sets of 10 repetitions a day. As your muscles get stronger, increase your repetitions daily.