What factors cause bladder cancer in women?

Question

Hi doctor,

I am 67 and was shocked to be diagnosed with bladder cancer after going to a urologist for blood in my urine. The cystoscopy showed a tumor in the bladder wall, and the biopsy confirmed transitional cell carcinoma. I never smoked cigarettes and always thought bladder cancer was mostly a man's disease. The urologist did a TURBT procedure to remove the visible tumor, but says I need BCG treatments to prevent recurrence. The scariest part is reading about side effects from BCG therapy, including bladder infections and flu-like symptoms. I am also worried because my sister had ovarian cancer, and I am wondering if there is a genetic connection.

The cancer is non-invasive, but the doctor says it has a high chance of coming back. I need surveillance cystoscopies every three months now, which is anxiety-provoking each time. I am afraid to drink lots of water because frequent urination is uncomfortable, but I know I need fluids. Can different factors cause bladder cancer in women than in men?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

I understand how overwhelming this diagnosis must feel, especially since you have never smoked, and bladder cancer is often thought of as a “man’s disease.” While it is more common in men, women can certainly develop bladder cancer, and sometimes it is diagnosed later because blood in the urine is misattributed to urinary infections.

The most common type, transitional cell carcinoma, often arises from long-term irritation of the bladder lining, exposure to certain chemicals, or sometimes without a clear risk factor. Although smoking is the strongest risk factor, it is not the only one—chronic bladder inflammation, occupational exposures (like dyes, rubber, or chemicals), and age all play a role. In women, delays in diagnosis may also contribute to outcomes rather than unique biological causes.

Regarding genetics, bladder cancer is not typically inherited in the same way as breast or ovarian cancer, but certain shared genetic predispositions to DNA (deoxyribonucleic acid) repair issues can increase risks across cancers, so it’s worth mentioning your family history to your doctor. The good news is that in your case, the cancer is non-muscle invasive, and BCG (Bacille Calmette-Guerin), despite its side effects, is highly effective at lowering recurrence and progression risk.

The surveillance cystoscopies may feel stressful, but they are an important safety net to catch anything early. Staying well hydrated is still beneficial, even if it increases frequency, because it helps flush the bladder. Sometimes spreading fluids throughout the day makes it easier. You are taking the right steps, and your team’s plan is in line with best practices for preventing recurrence.

I hope this information will help you.

Thanks.