Monique, an individual living with non-muscle-invasive bladder cancer
Monique has always been passionate about her health and wellness, so when she noticed blood in her urine (hematuria), she went to her gynecologist right away.1
A series of tests over the next few months ruled out a urinary tract infection (UTI) and pointed to possible causes such as post-menopausal bleeding or a cyst they’d found. But when the hematuria returned, Monique thought something deeper was going on. Her doctor eventually referred her to a urologist, where a cystoscopy (a procedure that looks inside the bladder and the urethra) finally provided an answer, one that would change her life: bladder cancer.2
The diagnosis was a complete shock to Monique. She’d never smoked, which is the leading risk factor for bladder cancer.3 She exercised regularly and carefully managed her nutrition. She’d recently lost a noticeable amount of weight but attributed her lighter appetite to the stress of going through a divorce, not realizing that weight loss was also a symptom of bladder cancer.1
Confused and in a state of disbelief, she tried to process what the urologist was saying: she would need surgery to remove two tumors discovered in her bladder.
Advocating for Herself Changed Monique’s Treatment Trajectory
Monique loves spending time with her dog, Grace
Monique, who works on AstraZeneca’s hematology team, began gathering her thoughts as she was ushered out of his office.
“I let my urologist schedule the surgery,” Monique said. “But I was wondering why he didn’t give me any options. I knew there should be more to this process, like finding information about the tumors and if the cancer had spread.” She decided to seek out an oncologist’s opinion on her own to learn more about her disease.
Her oncologist conducted a transurethral resection of bladder tumor (TURBT) procedure and confirmed a diagnosis of high-grade T1 non-muscle-invasive bladder cancer (NMIBC) with papillary tumors, which means the cancer had not grown into the thicker muscle wall of the bladder.4
Following the TURBT procedure, the oncology team evaluated potential treatment approaches for Monique, based on the grade/size of the tumors, her health and age.4
Monique’s oncologist explained her treatment options, which included tumor removal surgery and Bacillus Calmette-Guérin (BCG) treatment.5 The BCG treatment approach is a therapy infused into the bladder that helps the body’s own immune system attack the cancer cells, followed by a second TURBT to confirm if all the cancer cells were gone.6
NMIBC accounts for 75% of all bladder cancer cases, but approximately 25% of bladder tumors grow into or through the muscle wall of the bladder and become muscle-invasive bladder cancer (MIBC).7,8 MIBC means the tumors are more likely to spread further and be more life-threatening, making early detection key.3,9,10
“Despite the challenges I experienced to reach a diagnosis, I felt lucky to have a background – and a personality – that led me to ask more questions,” Monique said.
The Journey from Symptoms to Diagnosis is Often Uncertain
In women, symptoms of bladder cancer are often mistaken for other non-cancerous conditions such as UTIs and post-menopausal bleeding, as was the case for Monique.11 However, women are nearly 1.5 times more likely than men to experience a delay in their urology visit.12
Seeing a urologist is the right next step, but collaboration between urologists and oncologists can provide patients with more comprehensive care.13 Monique feels that more coordination would have been extremely helpful in her case.
Hematuria is the most common warning sign of NMIBC.1 Other symptoms include an inability to urinate, lower back pain on one side, loss of appetite and weight loss, fatigue or weakness, swelling in the feet or bone pain – all of which could be caused by something other than bladder cancer, but should be checked out.1
Monique Leaned on Others for Support
Monique with her best friend, Laurie, who enjoys going on walks together
Monique relied on the strong network around her. Her sisters, her “church family,” friends, colleagues and a professional counselor all played a role in gathering information about treatments, supporting her through medical procedures, including some fatigue and pain, and helping settle anxieties around the possibility of the cancer returning.
Bladder cancer has the highest recurrence rate of any cancer; about 60-70% of NMIBC patients experience recurrence following treatment.11,14 While Monique’s fears are not unfounded, she chooses to balance them by focusing on the present moment and what she can control, like the food she eats and the products she uses.
She also follows essential ongoing surveillance protocols recommended by her health care team, including a cystoscopy and urinalysis, originally every three months, now every six months, and frequent computerized tomography (CT) scans of the area.
Living with Bladder Cancer
Monique with her three sons, Alex, Jacob and Quinn, on a family vacation in Costa Rica
Monique has always served her community, volunteering in her church's food pantry and soup kitchen. Now, her challenges with bladder cancer have inspired her to help others in new ways.
She wants everyone impacted by the disease to be better educated about the diagnosis and treatment processes and to feel confident asking questions and advocating for themselves. Through the Bladder Cancer Advocacy Network (BCAN), Monique found guidance and connection, including being paired with a local peer buddy who had also experienced a bladder cancer diagnosis. She continues to stay involved in the BCAN community.
There is much work to be done, but AstraZeneca is making progress in later-stage bladder cancer treatments, and we are dedicated to finding new and better ways to treat all stages of bladder cancer, including early-stage disease.
For more information about bladder cancer, visit the BCAN website. If you have medical questions or want to discuss specific treatment options, please talk to your doctor.
Monique is an individual living with non-muscle-invasive bladder cancer and an employee of AstraZeneca who chose to share her personal story. No compensation was provided by AstraZeneca in connection with her participation.
References
1. American Cancer Society. Bladder cancer signs and symptoms. Accessed April 27, 2026. https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/signs-and-symptoms.html.
2. American Cancer Society. Cystoscopy. Accessed April 27, 2026. https://www.cancer.org/cancer/diagnosis-staging/tests/endoscopy/cystoscopy.html.
3. Dyrskjøt L, Hansel DE, Efstathiou JA, et al. Bladder cancer. Nat Rev Dis Primers. 2023;9(1):58.
4. American Cancer Society. Treatment of bladder cancer, based on the stage and other factors. Accessed April 27, 2026. https://www.cancer.org/cancer/types/bladder-cancer/treating/by-stage.html.
5. Urology Care Foundation. Non-muscle invasive bladder cancer. Accessed April 27, 2026. https://www.urologyhealth.org/urology-a-z/n/non-muscle-invasive-bladder-cancer.
6. American Cancer Society. Intravesical therapy for bladder cancer. Accessed April 27, 2026. https://www.cancer.org/cancer/types/bladder-cancer/treating/intravesical-therapy.html.
7. Wong VK, Ganeshan D, Jensen CT, Devine CE. Imaging and management of bladder cancer. Cancers (Basel). 2021; 13(6):1396.
8. American Cancer Society. Tests for bladder cancer. Accessed April 27, 2026. https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/how-diagnosed.html.
9. National Institutes of Health. Bladder cancer treatment (PDQ®)–health professional version. Accessed April 27, 2026. https://www.cancer.gov/types/bladder/hp/bladder-treatment-pdq.
10. American Cancer Society. Can bladder cancer be found early? Accessed April 27, 2026. https://www.cancer.org/cancer/types/bladder-cancer/detection-diagnosis-staging/detection.html.
11. Bladder Cancer Advocacy Network. Bladder cancer in women – signs, symptoms and treatments. Accessed April 27, 2026. https://bcan.org/women-bladder-cancer/.
12. Myers AA, Duan Z, Igel DA, et al. Disparities and temporal trends in referral for bladder cancer diagnosis: A worsening epidemic. Urol Oncol. 2026;44(2):120.e1-120.e11.
13. Mark JR, Gomella LG, Lallas CD, et al. Enhancing bladder cancer care through the multidisciplinary clinic approach. Can J Urol. 2023;30(3):11526-11531.
14. Aldousari S, Kassouf W. Update on the management of non-muscle invasive bladder cancer. Can Urol Assoc J. 2010;4(1):56-64.
US-111775 Last Updated 4/26