The etiology of bladder cancer and its prevention

Abstract

Urinary bladder cancer (UBC), which rinks ninth in worldwide cancer incidence, is a type of malignant growth of abnormal cells. UBC can be caused by: (A) Inhalation of cigarette smoke, smoke from cooking fume hoods, industrial/environmental carcinogens, volatiles of coal tar, and diesel exhaust. (B) Drugs such as cyclophosphazine, chloronaphazine, phenacetin, nitrosamines, and herbal remedies like aristolochic acids. (C) Contact of chlorinated water or hair dyes. (D) Ingestion of bracken fern (Pteridium aquilinum) and/or arsenic. (E) Infections of Schistosoma haematobium (schizosomiasis), Enterobacteria (Cystitis) and Papilloma viruses. (F) Endogenous carcinogens such as tryptophan metabolites and other amines. (G) Hereditary factors such as acetylator of the N-acetyltransferase, and mutations or malfunction of oncogenes/suppressor genes. Prevention of bladder cancer should include cessation of smoking, minimization of exposure to cooking fumes, and elimination of industrial and environmental carcinogens. Other measures worth considering include: (A) Intake of fruits, vegetables, soy products, vitamins, green tea, and decrease of fat consumption. Ingestion of food that is rich in selenium, garlic, lycopene, linoleic acid, various vitamins, gallic acid, and betulinic acid, etc. (B) Intake of non-nutritional factors including astaxanthin, procatachuic, diosmin, hesperidin, 1,4-phenylene diisothiocyanate, crytoxanthin, indomechacin, and silibinin, etc. (C) Administration of drugs such as difluoromethylornithine (DFMO), no steroid anti-inflammatory drugs (NSAIDs), astorvastatin, oitipraz, and Bacillus Calmette-Guerin (BCG). Retinoic acid in combination with ketoconazole was reported to be helpful to bladder cancer patients. In conclusion, the management of interplay of multiple factors of cause, cure and prevention, is the major concern of UBC. © 2013 Chung KT.