Women and bladder cancer: no, women should not be able to get over-the-counter antibiotics for UTIs

Women and bladder cancer: no, women should not be able to get over-the-counter antibiotics for UTIs
Photo by Stephen Cummings, "Antibiotics." Used with permission of a Creative Commons License.

Last week, NPR reported on research by British physician Kyle Knox, who argues that women should be able to purchase antibiotics over-the-counter for UTIs. He argues that doing so would save unnecessary and expensive visits to clinicians, that urinalysis misses low grade infections while still causing discomfort, and that women would get quicker relief from the intense pain of UTIs.

What he doesn’t mention is that UTI symptoms are the same symptoms of bladder cancer. If a woman has UTI symptoms and does not have an infection, she should go immediately to a urologist. And, if a woman is treated for an infection, especially if it’s recurrent, she should have her urine checked after the course of treatment for microscopic blood in the urine. None of these will happen if women self diagnose.

In the United States (Knox’s research focuses on the UK), a significant number of women who are diagnosed with bladder cancer were treated for UTIs over 18 months, despite findings of blood in their urine. General Practitioners, and women themselves, assume that UTIs are, if not normal, a common occurrence for women. In fact, many GPs treat UTIs over the phone without testing.

I am one of those women. Despite being treated for three “UTIs” over 18 months, I was not referred to a urologist. One time, my doc just prescribed antibiotics over the phone. My symptoms continued and I eventually ended up in the ER with massive and very visible blood clots in my urine. I was admitted to the hospital and diagnosed with bladder cancer 24 hours later.

I interviewed Dr. Gary Steinberg of the University of Chicago in April. He is one of the top bladder cancer specialists in the country. Steinberg recommends that after being treated for a UTI, women should get another urinalysis to rule out microscopic blood in the urine. If blood is still there, you should see a urologist. Symptoms of UTIs and symptoms of bladder cancer overlap. Symptoms such as these can indicate a problem:

  • microscopic blood in the urine
  • visible blood in the urine
  • changes in urinating (frequency, persistent urge)
  • burning and pain when urinating

Just because UTIs are common in women and because it is more efficient and less expensive to self diagnose are not cause to make UTI antibiotics available over the counter. Instead both women and their General Practitioners need to take UTIs and UTI symptoms much more seriously. It could save your life, and it could save you a lifetime of expensive testing and treatment.

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Filed under: Bladder Cancer

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