Health: Bladder cancer hits smokers more and does not spare women

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Much less known than prostate cancer, bladder cancer affects smokers and men more, but does not spare women, specialists warn.

Among the risk factors, tobacco comes first. The body expels toxins present in the blood via urine, stored in the bladder before evacuation (illustrative image).

KEYSTONE/CHRISTIAN BEUTLER

“This cancer, relatively common and sometimes aggressive, is too little known,” according to Benjamin Pradère, president of the French urology association (AFU), promoter of a “bladder month”.

Each year in France, it affects between 13,000 and 20,000 new people, mainly men over 60, and causes around 5,000 deaths.

In the absence of a valid systematic screening method, red flags are crucial. “Red urine, I’m moving!”, urges the slogan of the awareness campaign, in reference to the most common first symptom.

Recurrent cystitis – without infection detected when looking for microbes in the urine – or urination problems can also be a warning.

Bladder cancer “affects men more often but it is often more serious in women, because symptoms can be misinterpreted and delay the diagnosis,” points out Benjamin Pradère.

A scenario experienced by Catherine, “51 years old for a few days”. “After a bypass (bariatric surgery, editor’s note), I often had blood in my urine. The treating doctor thought it was related to the operation. It didn’t work. I was sent to see a gynecologist, who thought about micro periods – because I had an IUD,” she told AFP.

“It dragged on, until contractions and constant pressure on the bladder. Return to the gynecologist, ultrasound, always the hypothesis of micro periods, or urinary infections. After a year, I couldn’t stop myself from going to the bathroom. An MRI finally showed a large mass in the bladder,” recalls this Alsatian.

Then, everything happened: “8 hours of operation” to remove “the mass”, announcement of an infiltrating cancer, removal of the bladder, uterus and lymph nodes, chemotherapy and immunotherapy.

Tobacco, pollutants

The former childminder, who does not know “when and where” she will be able to work again “one day”, “no longer has the same life with a bag” (to replace the bladder) and, “not safe from escape”, “carries around with spare clothes and protection”.

“Daily life is fine, but a little too much physical effort triggers stomach cramps,” adds Catherine, who advises, “especially women,” to consult “if there is the slightest doubt.”

Around “a quarter of patients are women” and their “proportion is increasing”, according to the president of the Cancer Vessie France patient association, Lori Cirefice.

Among the risk factors, tobacco comes first. The body expels toxins present in the blood via urine, stored in the bladder before evacuation.

“This link between smoking and bladder cancer is little known,” testified Lori Cirefice.

In Europe, the frequency of this cancer has increased in recent years “not only due to an increase in detections, but also an increase in smokers”, according to Benjamin Pradère.

Also be careful with cannabis, warned Yann Neuzillet, surgeon and member of the AFU oncology committee: “young patients arrive for consultation after having been exposed to improbable carcinogens through the consumption of cannabis (…) combined with sometimes n ‘anything, tires, cement…’.

More widespread, “certain exposures, particularly occupational, can lead to bladder cancer: rubber, dyes, paints, cosmetics, certain hydrocarbons, pesticides in large agricultural regions,” underlined the president of the AFU.

Although these carcinogens are less present than 20 or 30 years ago in the world of work, people previously exposed remain at risk.

“I was told that my cancer could come from cigarettes, but I also worked in a lot of factories – aluminum rims, baby wipes, cereals, heating and air conditioning for cars… -, so we don’t will never know,” slips Catherine.

In the therapeutic arsenal, several innovations revolve around immunotherapy, which consists of strengthening the body’s defenses against disease.

For patients at a locally advanced stage or with metastases, antibodies targeting certain molecules of cancer cells (“antibody drug conjugates”, ADCs) also seem promising, in combination with chemotherapy and immunotherapy, according to recent studies.

© Agence France-Presse