Smoking is a Major Risk Factor for Bladder Cancer
By Bob Sherman
Bladder cancer is four times more likely to occur in current smokders than in ex-smokers.
Your bladder is like a small balloon in your lower abdomen that stores urine.
Bladder cancer affects the cells in the lining of the bladder. There are three types of bladder cancers that begin in different cells. These cancers are named for the types of cells that become malignant:
- Transitional cell carcinoma: Most bladder cancers begin in the transitional cells that are the in the innermost tissue layer of the bladder.
- Squamous cell carcinoma: The squamous cells are thin, flat cells that can form in the bladder after a long term infection or irritation.
- Adenocarcinoma: Gland-like cells in the bladder can become malignant after long term irritation and inflammation.
The symptoms of bladder cancer include:
- Blood in your urine
- Frequent urges to urinate
- Pain when you urinate
- Pain in your lower back
The greatest risk factor for bladder cancer is cigarette smoking. The risk increases with both smoking intensity (e.g., inhaling deeper, smoking more cigarettes) and duration (years smoking).
Bladder cancer affects nearly 4 times as many men as women. It is the fourth most common malignancy of Western men. It is the ninth most common cancer for both sexes combined.
Some dietary factors seem to help reduce risk of bladder cancer. Increased fruit consumption and increased selenium concentration in the blood are both helpful in reducing the risk of bladder cancer.
Around 65% of bladder cancers in men and 20 to 30% of bladder cancers in women can be attributed to cigarette smoking. The risk of bladder cancer is increased for current and ex-smokers if there is a family history of bladder cancer.
Cancer and Chromosomal Mutations
Damage to chromosomes and subsequent repair attempts is a key factor in the formation of malignancies. A complex ribonucleoprotein called a telomere functions to protect the ends of chromosomes. Telomere shortening causes chromosomal instability and is part of a multi-step process of malignancy formation.
Smoking has a negative effect on telomere length. One study found that every for every pack-year smoked, telomere length was reduced by about 5 base pairs (molecular bond pairs). Specifically, telomere length was significantly shorter in bladder cancer patients than in non-bladder cancer controls.
Some studies have indicated that smoking air cured (black) tobacco presents a higher risk of bladder cancer than smoking flue cured (blond) tobacco. The urine of smokers of air cured tobacco was found to contain twice as much mutagenic material as did the urine of flue cured tobacco smokers. This helps indicate why bladder cancer is 2.5 times more likely to be found in smokers of air cured tobacco.
Bladder Cancer and Smoking
In one study examining cases of 1219 patients with bladder cancer, researchers found an increased risk factor for bladder cancer among male smokers of 7.4 times that of non-smokers. Former smokers had an increased risk of 3.8 times that of non-smokers. The risk was higher for those who smoked black tobacco, and highest for former and current smokers who smoked both black and blond tobacco (6.0 time the risk of non-smokers).
The increased risk among women smokers was 5.1 time high than for non-smokers. Women who were former smokers had a 1.8 times higher risk than that for never smokers.
A study of 429,906 individuals, part of the European Prospective Investigation into Cancer and Nutrition (EPIC) found that current smokers had a 4 times greater risk of bladder cancer than never smokers. And, ex-smokers had twice the risk of bladder cancer than never smokers.
In addition, there is a clear indication that incidents of bladder cancer for current smokers increased dramatically with the number of cigarettes smoked per day. The relationship of incidents with cigarettes per day is weaker for ex-smokers. What is clear, though, is that the incidents of bladder cancer decreases for ex-smokers.
The EPIC study also found that risk of bladder cancer was higher when smoking or exposure to environmental tobacco smoke began at an earlier age. This is an indication that children and adolescents may be affected more by the carcinogens in tobacco smoke than are adults.
Bladder Cancer Treatments
Treatments for bladder cancer include:
- Surgery
- Radiation
- Chemotherapy
- Biological therapy
References
- Claudine Samanic, Manolis Kogevinas, Mustafa Dosemeci, Nuri Malats, Francisco X Real, Montserrat Garcia-Closas, Consol Serra, Alfredo Carrato, Reina Garcia-Closas, Maria Sala, Josep Lloreta, Adonina Tardon, Nathaniel Rothman & Debra T Silverman, Smoking and Bladder Cancer in Spain: Effect of Tobacco Type, Timing, Environmental Tobacco Smoke, and Gender; Cancer Epidemiology, Biomarkers & Prevention, 15(7), 1348-1354.
- Bine Kjøller Bjerregaard, Ole Raaschou-Nielse*, Mette Sørensen, Kirsten Frederiksen, Jane Christensen, Anne Tjønneland, Kim Overvad, Francoise Clavel Chapelon, Gabriele Nagel, Jenny Chang-Claude, Manuela M. Bergmann, Heiner Boeing, Dimitrios Trichopoulos, Antonia Trichopoulou, Eleni Oikonomou, Franco Berrino, Domenico Palli, Rosario Tumino, Paolo Vineis, Salvatore Panico, Petra HM Peeters, H. Bas Bueno-de-Mesquita, Lambertus Kiemeney, Inger Torhild Gram, Tonje Braaten, Eiliv Lund, Carlos A. Gonzalez, Goran Berglund, Naomi Allen, Andrew Roddam, Sheila Bingham & Elio Riboli; Tobacco smoke and bladder cancer--in the European Prospective Investigation into Cancer and Nutrition; International Journal of Cancer; 119(10); 2412-2416.
- Jie Lin, Margaret R Spitz, Colin P Dinney, Carol J Etzel, H Barton Grossman & Xifreng Wu; Bladder Cancer Risk as Modified by Family History and Smoking; Cancer; 107(4); 705-711.
- Eliane Kellen, Maurice Zeegers & Frank Buntinx; Selenium is inversely associated with bladder cancer risk: A report from the Belgian case-control study on bladder cancer; International Journal of Urology; v 13; 1180-1184.
- Monica McGrath, Jason Y Y Wong, Dominique Michard, David J Hunter & Immaculata De Vivo; Telomere Length, Cigarette Smoking, and Bladder Cancer Risk in Men and Women; Cancer Epidemiology Biomarkers & Prevention; 16(4); 815-819.
- C Malaveille, P Vineis, J Esteve, H Ohshima, G Brun, A Hautefeuille, P Gallet, G Ronco, B Terracini & H Bartsch; Levels of mutagens in the urine of smokers of black and blond tobacco correlate with their risk of bladder cancer; Carcinogenesis; 10(3); 577-586.
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