Bladder cancer is the fourth most common type of cancer. It is also the
tenth most common cause of cancer mortality overall and the fourth leading cause
of cancer deaths among men over 80 years of age.
suggest that the public health importance of bladder cancer is likely to
increase over the next few years. However, a recent review notes that treatment
The review suggests that 90 per cent of bladder
cancer cases are transitional cell carcinomas. Squamous cell carcinoma,
adenocarcinoma and rhabdomyosarcoma make up the difference. Moreover, around 70
per cent of patients present with "superficial" tumours, usually of the mucosa.
However, 70 per cent will recur and between 25 and 30 per cent will develop into
invasive disease affecting muscle.
Bladder cancer is linked to numerous
environmental and occupational carcinogens. Cigarette smoking, however, is the
most common environmental carcinogen and increases bladder cancer risk
four-fold. However, genetically determined metabolic factors -- such as rapid
acetylation -- are also influential.
In recent years, surgical advances
improved the quality of life of patients suffering invasive cancer.
Nevertheless, the five-year survival rates remain around 50 per cent.
For instance, transurethral resection is the standard treatment for
stage Ta disease. This cancer, however, recurs in between 50 and 70 per cent of
such cases. On the other hand, superficial muscle invasive tumours appear to
have the best prognosis, whereas the outcome associated with local or advanced
metastatic cancers is poor.
To date, the review notes, there is no way
to detect patients who will benefit from a specific treatment. But on-going
research aims to characterise molecular markers of the diseases' clinical
Indeed, the authors remark that the clinical challenge is now to
detect invasive disease while still confined to the kidney. Regional therapies
are more likely to be effective in such cases. However, they also called for
research to discover novel regimens for systemic disease that maintain quality