Page 207 - Urological Health

What you need to know about non-muscle

invasive (superficial) bladder cancer

Dr. Wassim Kassouf Dr. Bassel G. Bachir
Urologist Urologist
Program Director and Assistant Professor, Research Fellow
Department of Surgery, Division of Urology Department of Surgery, Division of Urology
McGill University Health Centre McGill University Health Centre
Montreal, QC, Canada Montreal, QC, Canada

The Canadian Cancer Society estimates that about half of Canadians will develop cancer at some point
during their lives; 25% of these people will die of the disease.

Bladder cancer is the 9th most common cancer in the world and the 6th most common cancer in
Canada. There were about 7800 new cases diagnosed in Canada in 2012 (5800 men and 2000 women).
Men are three times more likely to develop bladder cancer than women.
The risk of developing bladder cancer increases with age. Caucasians are at the highest risk of
developing this disease, followed by African-Americans and then Latinos. Although mostly older
people develop bladder cancer, it is still seen in young adults and even children.
UNDER REVIEW
About 75% of Canadians with bladder cancer reach the five-year survival mark. Despite advances
in diagnosis and treatment, this percentage has not changed in the last 10 years.

What are the risk factors?
There are various environmental, occupational, genetic and social risk factors associated with the
development of bladder cancer. You can be exposed to carcinogens (cancer-causing agents) by
inhalation, absorption through the skin and ingestion- see Table 1 for a quick list of risk factors.
Smokers have up to a six times higher chance of developing bladder cancer than non-smokers, and
smoking is widely regarded as the most common cause of bladder cancer. Among others, miners and
rubber workers have an increased occupational risk of developing bladder cancer. This is largely due
to exposure to compounds called aromatic amines, such as arsenic and benzidine. Patients with
chronic or recurrent urinary tract infections are also at an increased risk of bladder cancer
development. Previous pelvic or abdominal exposure to radiation also leads to a significantly higher
risk of developing bladder cancer. Cyclophosphamide, a chemotherapeutic agent used in the
treatment of certain cancers, may increase the risk of getting bladder cancer later in life. Although still
debatable, it is claimed that the long-term use of certain painkillers such as phenacetin, and artificial
sweeteners such as saccharine or cyclamates, may lead to an increased risk of bladder cancer
formation. Alcohol intake has not been shown to be related to bladder cancer formation. On the other
hand, a diet rich in fruits and vegetables, such as the Mediterranean diet, has been shown to be
associated with a decreased risk of developing bladder cancer. Hereditary forms of bladder cancer
have proven difficult to elucidate for researchers.

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