A look at new research and discoveries in the field of bladder cancer By Kathryn E. Vinson, MS, CCRC Despite being the tenth most common
Despite being the tenth most common type of cancer worldwide in terms of new cases per year, not a lot is heard about bladder cancer in either the media or on social media feeds. Fortunately for those afflicted by bladder cancer (BC), lots of research has been conducted on this disease that had as many as 550,000 new cases and 200,000 deaths in 2018 alone. While men are about 4 times as likely than women to be diagnosed with this disease, its mortality rates are equal, indicating women are more likely to have an aggressive form of BC. Today, we’d like to take some time to talk about the different forms of bladder cancer, as well as current research into more effective bladder cancer treatments.
Bladder cancer is typically broken down into two subtypes – muscle-invasive bladder cancer (MIBC) and non-muscle invasive bladder cancer (NMIBC). The names are pretty self-explanatory, with the first type more likely to invade the musculature of the bladder than the second. While MIBC is a more aggressive and more lethal form of the disease, NMIBC is much more likely to have recurrences. MIBC represents approximately 20% of new diagnoses of all bladder cancers.
Differentiating the survival rates for the two sub-types of bladder cancer is tricky, as many cancer registries don’t list them separately. As such, the two types are lumped in as one under the blanket term bladder cancer. When caught early, either remaining in the bladder or only local spread, the five-year survival rates are 96% and 70%. As the disease progresses to regional spread and distant spread, the survival rates drop to 36% and 5%.
By far, the number one cause of bladder cancer is tobacco use. For more information on this link, please see “Smoking and Bladder Cancer.” It is important to note that this risk factor is for all types of tobacco use – smoking, dipping, chewing, vaping – even gums and patches – as the risk factor is a chemical in nicotine itself – not the tar or smoke.
Bray, et al (2020) tell us that the effects of nicotine are cumulative, the risk of bladder cancer increases with age. There is almost a zero incidence of the disease in people under the age of thirty, then it gradually increases as people age. Countries that have a high Human Development Index (HDI) tend to have lower rates of bladder cancer. This is attributable to policy initiatives in those countries aimed at lowering tobacco use. The opposite is true as well – countries with lower HDI’s see higher levels of bladder cancer. Sadly, the level of bladder cancer is expected to increase dramatically on the African continent over the next few decades. As the average life span of people on the African continent is expected to increase, their tobacco habits are also on the rise, leading to a projected rapid increase in bladder cancer incidence.
Some interesting research has come out this past year concerning certain stem cells found in bladder cancer tumors versus those found in healthy bladder cells. Abugomaa, et al (2020), found that these certain types of stem cells could potentially help doctors and treatment teams better understand not only how invasive a person’s bladder cancer is or will be, but also to tailor chemotherapies and immunotherapies to each individual. As bladder cancer is one of, if not the most expensive type of cancer to treat due to its high levels of recurrence and resistance to treatment, this ability to customize treatments all the way down to cancers genetic makeup has the potential to save not only thousands of lives but also billions of dollars.
While the above type of treatment may still be years away, current treatments for bladder cancer include surgery (either tumor removal or radical cystectomy), radiation, chemotherapy, and immunotherapy. The differing methods and combinations of treatment are determined by not only the type and stage of the bladder cancer that has been diagnosed but also the overall health of the patient. As bladder cancer typically affects older people, the presence of other diseases may be a barrier to certain treatment methods.
As funding levels for research into better understanding the biology of bladder cancer have increased over the last couple of decades, it is hoped that new, accurate, and more effective treatments for this common form of cancer are on the way.
As always, much love, many prayers, and abundant blessings to all of the warriors out there!!
About Bladder Cancer. (n.d.). Retrieved November 06, 2020, from https://www.cancer.org/cancer/bladder-cancer/about.html
Abugomaa, A.; Elbadawy, M.; Yamawaki, H.; Usui, T.; Sasaki, K. Emerging Roles of Cancer Stem Cells in Bladder Cancer Progression, Tumorigenesis, and Resistance to Chemotherapy: A Potential Therapeutic Target for Bladder Cancer. Cells 2020, 9, 235.
Bray, F., M. Ploeg, K., Ferlay, J., Cassell, A., Cumberbatch, M., P. Crow, A., . . . Lotan, Y. (1970, January 01). The global burden of urinary bladder cancer: An update. Retrieved November 06, 2020, from https://link.springer.com/article/10.1007/s00345-019-02984-4
Patel, V., Oh, W., & Galsky, M. (2020, August 07). Treatment of muscle‐invasive and advanced bladder cancer in 2020. Retrieved November 06, 2020, from https://acsjournals.onlinelibrary.wiley.com/doi/10.3322/caac.21631