Bladder cancer

Bladder cancer

Bladder cancer

Definition

Bladder is a hollow organ that collects urine form kidney. Bladder cancer is the abnormal growth in of bladder cells. It is a very common cancer and men are at higher risk than women. The most common symptom is bleeding in urine. This cancer can be divided into invasive or non-invasive cancer.

Epidemiology and burden of Bladder Cancer

  • Bladder cancer is the ninth most common cancer in the world, approx. 430,000 new cases diagnosed in 2012. Belgium has the highest rate of bladder cancer, followed by Lebanon and Malta. About 59 per cent of bladder cancer cases occur in more developed countries. (Eur Urol.2017 Jan;71(1):96-108)
  • Five countries that had the highest age-standardized incidence were Belgium 17.5 per 100,000, Lebanon 16.6/100,000, Malta 15.8/100,000, Turkey 15.2/100,000, and Denmark 14.4/100,000. There was a positive linear relationship between the standardized incidence rate and HDI (r=0.653, p<0.001). (Asian Pac J Cancer Prev.2016;17(1):381-6)
  • Based on GLOBOCAN estimates, about 14.1 million new cancer cases and 8.2 million deaths occurred in 2012 worldwide. (Global cancer statistics, 2012)

Potential Research Targets

  • VAX-IP, a novel bacterial minicell-based biopharmaceutical can be a very good agent for the treatment of non-muscle invasive bladder cancer. (Mol Ther Oncolytics.2016 Mar 16;3:16004)
  • One study has shown that suppression of miR-1180-5p can significantly inhibit tumorigenicity bladder cells. This must be explored in future studies. (Histol Histopathol.2017 Jan;32(1):77-86)
  • miR-93 can play an important role in the chemo-sensitivity of bladder cancer (BC), and may be involved in regulating the LASS2 gene. (Onco Targets Ther.2016 Mar 29;9:1813-22)
  • Hyaluronan/Chitosan (HA/CHI) nanoparticles-aggregated HET are potential treatment for urothelial cancer in vivo. (Int J Nanomedicine.2016 Mar 29;11:1237-51)
  • Combining Bacillus Calmette-Guerin (BCG) with anti-estrogen has a potential to become a new therapeutic approach with better efficacy to suppress BCa progression and recurrence. (2016 May 10;7(19):27325-35)
  • RTKN2 can be a potential target in cancer therapy in bladder cancer. (Mol Med Rep.2016 Jun;13(6):4872-8)

Prevention of Bladder Cancer

  • High overall tea intake in smokers increases the risk of bladder cancer, and high black tea intake in female may reduce the risk of bladder cancer (RR= 1.77, 95%CI: 1.04-3.01). (Asia Pac J Clin Nutr.2013;22(1):128-37)
  • Intake of vegetables and fruits may significantly reduce the risk of bladder cancer. Risk decreased by 8% (RR=0.92; 95% CI: 0.87-0.97) and 9% (RR=0.91; 95% CI: 0.83-0.99) for every 200 g/day increment in vegetable and fruit consumption, respectively. (Eur J Cancer Prev.2015 Nov;24(6):508-16)
  • High vs. low levels of physical activity are related to decreased bladder cancer risk (RR=0.85, 95% CI=0.74-0.98; p-value <0.001). (Br J Cancer.2014 Apr 2;110(7):1862-70)s
  • Use of a narrow band imaging technique might provide greater detection of bladder tumours and subsequent treatment leading to reduced recurrence in low-risk patients. (Eur Urol.2016 Sep;70(3):506-15)  
  • Greater consumption of fluid may have a protective effect on bladder cancer. The overall OR for the highest vs. lowest fluid intake was 1.06 (95% CI: 0.88-1.27). The overall ORs for coffee, green, and black tea intake were 1.17 (95% CI: 1.03-1.33), 0.76 (95% CI: 0.66-0.95), and 0.80 (95% CI: 0.65-0.97), respectively. (World Journal of Surgical Oncology201412:223)

Risk factors for Bladder Cancer

  • Compared to never smokers, current smokers (OR = 2.87) have significantly elevated risks of bladder cancer. (Prev Med.2002 Aug;35(2):114-20)
  • Subjects who have worked for 10 or more years as hairdressers or barbers experience a 5-fold (95% CI = 1.3-19.2) increase in risk compared to individuals not exposed. (Int J Cancer.2001 Feb 15;91(4):575-9)
  • Patients treated with pioglitazone have a slight increased risk of bladder cancer compared to general population (hazard ratio 1.23; 95% CI 1.09-1.39). (Diabet Med.2013 Sep;30(9):1026-32)
  • A history of three or more urinary tract infections was strongly related to squamous cell carcinoma in particular (RR = 2.0). (Am J Epidemiol.1984 Apr;119(4):510-5)
  • Study suggested that high consumption of processed meat probably correlated with rising risk of bladder cancer (Risk estimate = 1.22; 95% CI: 1.04-1.43). (Int J Clin Exp Med. 2014; 7(8): 2100–2110)
  • Obesity is associated with linear-increased risk of bladder cancer. Compared to normal weight people, the pooled relative risks and corresponding 95% confidence intervals of bladder cancer are 1.07(1.01-1.14) and 1.10(1.06-1.14) for pre-obese and obesity patients. (PLoS One.2015 Mar 24;10(3):e0119313)
  • Disorder of Zn and Cu is closely associated with bladder cancer. Frequent monitoring and early intervention are recommended. (Biol Trace Elem Res. 2013 Jun;153(1-3):5-10)

Systematic reviews

  • A meta-analysis on the association between bladder cancer and occupation..more
  • Meta-analysis of studies on individual consumption of chlorinated drinking water and bladder cancer….more
  • Diet and bladder cancer: a meta-analysis of six dietary variables….more
  • Bladder cancer risk in painters: a meta-analysis...more
  • Milk and dairy consumption and risk of bladder cancer: a meta-analysis....more
  • Urinary Biomarkers for Diagnosis of Bladder Cancer: A Systematic Review and Meta-analysis....more
  • Adjuvant Chemotherapy for Invasive Bladder Cancer: A 2013 Updated Systematic Review and Meta-Analysis of Randomized Trials....more

Treatment with Medicinal Herbs

  • Thuja, White Cedar (Thuja occidentalis) – Dose – 1-2 g 3x/day; 2-4 ml liquid extract; taken only occasionally
  • Rhubarb, Da Huang (Rheum palmatum) – Dose – 0.5-1.5 g dry plant; 0.2-1.0 g root; 0.1-4 g root; 0.12-4.8 g root; 1-5 g root  
  • Parsley (Petroselinum crispum) – Dose – 100-150 g fresh juice; 6 g leaf; 1-2 tsp dry leaf/cup water; 1-2 tsp dry root/cup water 

Reference: Handbook of Medicinal Herbs (2006)

Herbals

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