Bladder Cancer (cont.)
Kevin C. Zorn, MD, FRCSC, FACS
Gagan Gautam, MD, MCh
Charles Patrick Davis, MD, PhD
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
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What are bladder cancer causes and risk factors?
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The most common type of bladder cancer, urothelial carcinoma, is very strongly associated with cigarette smoking. About 50% of all bladder cancers in men and 30% in women may be caused by cigarette smoking. The longer and heavier the exposure, greater are the chances of developing bladder cancer. The toxic chemicals in cigarette smoke, many of which are known cancer causing substances (carcinogens), travel in the bloodstream after being absorbed from the lungs and get filtered into the urine by the kidneys. They then come in contact with the cells in the inner lining of the urinary system, including the bladder, and cause changes within these cells which make them more prone to developing into cancer cells. Quitting smoking decreases the risk of developing bladder cancer but takes many years to reach the level of people who have never smoked. However, as time passes after the quit date, the risk progressively decreases. In view of the above, it is extremely important for patients with bladder cancer to stop smoking completely since the chances of the cancer coming back after treatment are higher in those people who continue to smoke.
People who smoke also have a higher risk of many other types of cancer, including leukemia and cancers of the lung, lip, mouth, larynx, esophagus, stomach, and pancreas. Smokers also have a higher risk of diseases like heart attacks, peripheral vascular disease, diabetes, stroke, bone loss (osteoporosis), emphysema, and bronchitis.
Age and family history are other risk factors as is male sex. Most bladder cancer is diagnosed in people over 60 years though in exceptional cases it may be seen in the third or fourth decade of life. Men are more prone to developing bladder cancer probably due to a higher incidence of smoking and exposure to toxic chemicals. A close relative with a history of bladder cancer may increase the predisposition for the development of this disease.
Exposure to toxic chemicals such as arsenic, phenols, aniline dyes, and arylamines increase the risk of bladder cancer and may be responsible for up to 25% of cases in some regions. Dye workers, rubber workers, aluminum workers, leather workers, truck drivers, and pesticide applicators are at the highest risk.
Radiation therapy (such as that for prostate or cervical cancer) and chemotherapy with cyclophosphamide (Cytoxan) has been shown to increase the risk for development of bladder cancer. Moreover, it may also delay the diagnosis of bladder cancer in patients presenting with symptoms of bleeding in urine since this bleeding may be incorrectly attributed by the patient and/or the physician to the bladder irritation caused by the chemotherapy or radiation (radiation cystitis).
Long-term chronic infections of the bladder, irritation due to stones or foreign bodies, and infections with the blood fluke prevalent in certain regions of the world (as mentioned earlier) are some other factors which predispose to bladder cancer.
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Bladder Cancer - Effective Treatment Question: What treatment has been effective for your bladder cancer?
Bladder Cancer - Share Your Experience Question: Please share your experience with bladder cancer.
Bladder Cancer - Causes or Risk Factors Question: What was the cause of your bladder cancer? Did you have any risks, like smoking?
Bladder Cancer - Symptoms Question: What symptoms did you experience with your bladder cancer?
Bladder Cancer - Diagnosis Question: What tests and exams did you have that led to a diagnosis of bladder cancer?
Bladder Cancer - Transurethral Surgery Experience Question: Please share your experience with surgery for bladder cancer.
Bladder Cancer - Chemotherapy Experience Question: Did you have chemotherapy to treat bladder cancer? Please describe what it was like.
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