Managing Urinary Tract Infections (UTIs) and Breast Cancer
A urinary tract infection (UTI) is an infection in any part of your urinary system. The urinary system is made up of the kidneys, bladder, urethra (the tube that runs from the bladder to where urine comes out of the body), and the ureters (the tubes that run from each kidney to the bladder). E. coli bacteria are a common cause of UTIs, but several other types of bacteria and fungi may cause them as well.
Who gets UTIs?
Women are much more likely to get a UTI than men, and the risk of a UTI increases with age. Between 50% and 60% of adult women will have at least one UTI in their lifetime. Nearly 10% of post-menopausal women reported having a UTI in the previous year.
Research suggests that women get UTIs more often because a woman's urethra is shorter than a man's. This makes it easier for bacteria to get inside the bladder. The opening of a woman's urethra is also closer to both the vagina and the anus, both of which can harbor E. coli and other types of bacteria.
Breast cancer treatment and UTIs
Bacteria, and in rare cases yeast, are the causes of all UTIs. Once in the urinary system, they multiply and cause pain, swelling, and difficulty urinating.
Although breast cancer doesn’t directly cause a UTI, certain breast cancer treatments and side effects can affect the urinary system and raise the risk of developing a UTI.
Chemotherapy
Chemotherapy medicines can affect the urinary system in several ways that can increase UTI risk.
Chemotherapy reduces the number of white blood cells in your body. These are the cells that fight infection. So if any bacteria does get into the urinary system, your body is less able to fight any infection they may cause.
Chemotherapy also damages mucus membranes, the moist cells lining the urinary system and other parts of your body that are near entry and exit points. These membranes in the urinary system protect against acid and waste in the urine. So if the urinary system’s mucus membranes are damaged, it’s easier for bacteria to get in and cause infection.
Hormonal therapy
Hormonal therapy dramatically lowers the amount of estrogen in the body. Estrogen helps keep the walls of the bladder and urethra strong and elastic. When estrogen levels drop, the walls and muscles of the bladder and urethra become thin and weak. If the urethra muscles are weak, it’s easier for bacteria to get into the urethra and then up into the bladder.
Low estrogen levels also can cause thinning of the vaginal walls. If the vaginal walls are thin, any bacteria can more easily get through the vagina and into the urinary system and cause a UTI.
Menopause
Menopause, whether occurring naturally or caused by breast cancer treatment, also makes estrogen levels drop. This can lead to genitourinary syndrome of menopause, a group of symptoms that includes vaginal dryness and irritation, painful sex, and recurrent UTIs.
Other UTI risk factors
There are a number of other factors unrelated to breast cancer that can increase the risk of a UTI.
Sexual activity
During sex, bacteria can move from other areas, including the vagina and the anus, into the urethra. The pressure from intercourse can push the bacteria up the urethra and into the bladder.
Certain birth control methods
Using a spermicide — creams that kill sperm — along with a diaphragm or condoms increases UTI risk. This is because spermicides also kill good bacteria in the vagina that offer protection from UTIs.
Pregnancy
During pregnancy, changes in hormone levels can change the bacteria in the urinary system. Being pregnant also can make completely emptying your bladder harder. It’s easier for bacteria to multiply in a partially filled bladder.
Diabetes
Diabetes can cause nerve damage that makes it hard to completely empty your bladder. The disease also can weaken your immune system.
Kidney stones
Kidney stones can block the flow of urine between the kidneys and the bladder, which increases the risk of a UTI.
Having a catheter
Currently or recently having a a urinary catheter also ups UTI risk. A catheter, a thin tube that goes through the urethra into the bladder, allows your body to get rid of urine when you can’t pee on your own, such as during surgery.
UTI symptoms
Common UTI symptoms include:
pain or burning when you pee
frequently feeling like you urgently need to pee, but little or nothing comes out
pressure in the lower part of your belly
urine that smells bad or looks cloudy, milky, or reddish
blood in your urine
feeling tired, shaky, confused, chilled, or weak
having a fever
pain in your back or side, below the ribs
How can you prevent a UTI?
There are steps you can take to reduce your risk of developing a UTI.
Drink plenty of fluids to flush bacteria out of the bladder and urethra. Many experts recommend aiming to drink nine to 11 cups of water per day.
Pee when you need to; don’t try to hold it. The longer urine stays in the bladder the more time bacteria have to grow.
Try to pee before and after sex. This includes oral sex as well as intercourse.
Always wipe from front to back after you go to the bathroom.
Don’t use deodorant sprays, powders, douches, or other hygiene products in the vaginal area. These products can decrease the amount of helpful bacteria in that area.
Keep the area around the urethra opening dry and cool. Try to wear underpants with a cotton crotch. Don’t wear tight-fitting pants, which trap moisture. Change out of wet bathing suits and damp workout pants or shorts as soon as you can. Bacteria thrive in moist, warm areas.
Avoid using spermicides for birth control.
Talk to your doctor about ways to treat vaginal dryness, if you have it, including vaginal estrogen and moisturizers that don’t contain estrogen.
Talk to your doctor about cranberry juice or other cranberry products if you have frequent UTIs. Research suggests that cranberry products may help reduce the risk of UTIs in women who get them often. There’s little evidence that cranberry products can treat an existing UTI.
Treating UTIs
The first treatment for UTIs is usually an antibiotic. The type of bacteria causing the UTI and any other health conditions you have help your doctor decide which antibiotic is best for you and how long you need to take it.
Make sure you take all the antibiotics as prescribed, even if you start to feel better after a couple days.
A heating pad and over-the-counter medicine, like acetaminophen, can help ease back or side pain, if you have it. Drinking plenty of water will make you pee more often and can help you heal faster.
UTI complications
If a UTI is treated right away, it rarely leads to complications. But if left untreated, the infection can damage your urinary system and lead to serious health problems. This is why it’s important to talk to your doctor as soon as you have any symptoms of a UTI, especially if you have a history of breast cancer.
Serious complications include:
Long-term kidney damage. Without treatment, UTIs can permanently damage the kidneys.
Urethra narrowing in men. Frequent UTIs can cause scarring in the urethra. The scar tissue can make it harder for urine to leave the body.
Low birthweight in babies. A UTI during pregnancy can affect a baby’s weight and also cause the baby to be born early.
Sepsis. A prolonged UTI can lead to sepsis. Sepsis is a life-threatening condition that happens when the immune system overreacts to an infection and starts damaging healthy tissues and organs. Sepsis may develop into septic shock. This is a dramatic drop in blood pressure that can damage multiple organs, including the lungs, kidneys, and liver.
