Severe bladder cancer course in smokers

Bladder cancer is more severe in smokers

14/01/2013

Smoking is not the only risk factor for bladder cancer, but a significant one. US scientists have identified a variety of biomarkers that can help determine the course of bladder cancer. They also found that smoking had an extremely negative influence on the course of the disease. Smokers are "significantly more likely to develop aggressive and deadly bladder cancers," report Richard J. Cote of the University of Miami and colleagues in the journal „Cancer“.

The US physicians have also sought in their study for biological characteristics that can determine the course of a bladder cancer disease. They determined a panel of new biomarkers that help physicians „can predict which particular cases have the highest risk of fatal outcome.“ In addition, they determined the effects of tobacco use on the course of bladder cancer. That smoking is a major cause of bladder cancer was already known. However, the effect of tobacco use on treatment has remained controversial. Now the US scientists confirm "the fatal relationship of bladder cancer with tobacco use, even in terms of the severity of the disease or disease progression".

Lethal bladder cancer more common in smokers
The research team led by Richard J. Cote of the University of Miami and Anirban Mitra of the University of Southern California's Keck School of Medicine has evaluated data on the course of bladder cancer in 212 patients in the context of his recent study, with possible associations with tobacco use Subjects checked. The data came from the years 1987 to 1996 and was originally part of the „Los Angeles County Cancer Surveillance Program“ levied. The scientists found that study participants, „who smoked intensely, more likely developed a deadly form of bladder cancer than those who did not or did not smoke much“, reports the journal „Cancer“ (doi: 10.1002 / cncr.27763). In addition, the age of the patients, the already reached stage of disease at the time of the diagnosis, the accompanying therapies and surgical aspects had a significant influence on the course of the disease. In smoking, however, the relationship was most noticeable.

Nine biomarkers discovered for the bladder cancer course
The researchers also identified biological features that will predict the progression of bladder cancer, regardless of tobacco use and other risk factors. If the bladder cancer takes on a deadly form, certain proteins are altered. „We have identified a group of nine molecular markers that can deliver a robust and reproducible bladder cancer prognosis regardless of clinical standard and smoking“, reports Anirban Mitra. For patients with changes in six to nine markers, there is a very poor prognosis. In their case, bladder cancer often leads to death. As the number of detectable altered biomarkers increases, the severity of the disease has steadily increased. This supports the thesis that the cancer is not caused by an individual trigger but by the interaction of several changes in the organism. Bladder cancer patients, with six or nine identified biomarkers altered, may benefit from more aggressive treatment for the cancer in the future.

Clinically relevant results
The scientists conclude that the current „Results of the study are clinically extremely relevant“, Not least because the treatment of bladder cancer causes extreme costs and is one of the most expensive cancer therapies, explained Richard Cote. Here is an urgent one „personalized patient management needed for this disease.“ Based on the current classification of the patients or the clinical classification, however, the course of the disease can not be predicted and no adaptation of the treatment can take place. The assessment based on the biomarkers could signify a significant step forward here. (Fp)

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