Bladder Cancer 

Bladder-Sparing Therapy For Muscle-Infiltrating Bladder Cancer (Yahoo News-19/07/2008)

Muscle infiltrating bladder cancer is a life-threatening disease. Despite diagnostic and surgical advancements in the last decade, after cystectomy 5-year disease recurrence rate is 30-40% even in referral centers. The introduction of orthotopic neobladder has greatly improved the quality of life and self-perception of patients undergoing cystectomy. To date, radical cystoprostatectomy is the standard treatment of muscle-infiltrating bladder cancer. Although less aggressive cystectomy surgical techniques have been proposed, like seminal- and sexual-sparing cystectomy, they have been criticized for oncological risks. However, with radiotherapy and chemotherapy protocols improvement, some authors have explored the possibility of preserving the bladder in muscle-infiltrating disease. These studies should still be considered investigational, though some long-term data are now available. 

Can we select patients who are likely to benefit from a conservative approach? Optimal candidates to bladder sparing protocols are patients with a single lesion, no extravesical extension, no hydronephrosis, with no or minimal residual tumor after Transurethral Resection of the Bladder (TUR) and/or after neo-adjuvant chemotherapy, and with no p53 overexpression. However, bladder sparing studies can also deal with patients in very poor conditions, unfit for surgery. Just a few series have reported results after repeated aggressive TUR alone for infiltrating bladder cancer. Partial cystectomy with or without chemotherapy/radiotherapy can be a feasible option, but only a very small number of patients meet the criteria for this surgical approach. Today the best option for bladder sparing in muscle infiltrating cancer is probably chemoradiotherapy. With the combined use of external beam radiotherapy and chemotherapy protocols, at 5 years disease specific survival approximates 50%. About forty-five per cent of surviving patients will retain the bladder. 

Two major points must be strongly underlined:
1) The results of bladder sparing cannot be compared to cystectomy series, since patients entering bladder sparing protocols are usually either with very favorable prognostic factors or with very poor performance status. 
2) No randomized trial has ever been performed to evaluate the results or cystectomy versus bladder sparing for infiltrating bladder cancer. 
Patients undergoing a bladder sparing approach must be aware to enter a very strict surveillance protocol, that on long term may affect their quality of life. The psychological burden of repeated controls must be considered when offering bladder sparing to patients with infiltrating bladder cancer. Chemoradiotherapy bladder sparing studies should be done in selected centers only, with a well tested experience in different team collaboration. Again it must be emphasized that radical cystectomy, when feasible, should be the first option offered to a patient with infiltrating bladder cancer. 

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Prognostic Value Of Re-TURB Of High Risk Non Invasive Bladder Cancer- (Yahoo News-28/06/2008)

The authors evaluated the usefulness of second TURB and whether pathological outcomes of ReTUR have a prognostic impact on recurrence and progression of primitive T1G3 bladder cancer. In this study patients with newly diagnosed T1G3 Transitional cell carcinoma of bladder underwent ReTUR 4-6 weeks following the initial TUR. Patients with muscle invasive disease underwent radical cystectomy; those with superficial residual (SRT) and those with no residual tumor (NRT) received a intravesical BCG therapy. In order to evaluate the prognostic significance of ReTUR outcomes, the authors compared recurrence rate, progression rate and recurrence free survival in SRT patients and NRT patients at restaging TUR. From January 2002 to March 2007 91 patients were enrolled in the study. Restaging TUR revealed residual cancer in 48% of patients. At mean follow up of 27.2 19,8 months, there was statistically significant difference in recurrence rate, progression rate and disease-free survival between no residual tumor patients and patients with non-invasive residual disease. The authors conclude that ReTUR of T1G3 TCC allows identification of patients with residual and understaged tumors. The outcomes of ReTUR have a prognostic impact on recurrence rate and disease-free survival. 

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MicroRNA Expression In Bladder Cancer: A Ratiometric Approach Identifies Invasive Potential (Yahoo News-14/06/2008)

One third of recurring non-invasive bladder cancer will be invasive. To date, there is no way of identifying those patients who will have this clinical outcome. The goal of this study was to identify a microRNA (miRNA) signature in bladder cancer capable of differentiating non-invasive from invasive disease and to determine the prognostic value of such an expression profile. Expression profiling of 343 miRNAs was performed in a microarray format using 2 non-invasive and 2 invasive bladder carcinoma cell lines. The differential expression of miRNAs was confirmed using a single molecule detection platform assay within a panel of 14 bladder carcinoma cell lines. Mir-21 and mir-205 expression levels were determined in 53 bladder tumors, (28 non-invasive and 25 invasive) and analyzed using a ratiometric approach. Sensitivity, specificity and a ROC curve were calculated to determine the discriminatory power of the mir-ratio to predict invasion. Knockdown and forced expression of miRNAs was performed to confirm their role in invasion. 

Microarray analysis identified 9 miRNAs differentially expressed between non-invasive and invasive cell lines that were confirmed in the platform assay. In an extended cell panel, differential expression involving high mir-21 and low mir-205 expression levels were identified associated with invasive cells. Although expression levels of these miRNAs could not discriminate between non-invasive and invasive tumors, the ratio of mir-21:mir-205 displayed excellent discriminatory power. The analysis of this quotient in 53 bladder tumors, representing non-invasive and invasive bladder lesions, showed an area under the ROC curve of 0.89 with 100% sensitivity and 78% specificity using a cutoff = 1.79 to predict an invasive lesion. Of 6 non-invasive lesions displaying a high mir-21:mir-205 ratio, 5 progressed to invasive disease. Knockdown and forced expression of mir-21 modified the invasive behavior of bladder tumor cell lines in in vitro invasion assays. The investigators had identified a novel miRNA signature that can be used to generate a mir-21:mir-205 ratiometric score differentiating between non-invasive and invasive lesions. In addition, 5 of 6 patients with non-invasive tumors displaying a high ratiometric score presented at a later time with invasive lesions. Alterations in the expression level of mir-21 in vitro modulated the invasive behavior of bladder tumor cells. 

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Firefighters May Face Higher Risk of Bladder Cancer (HealthDay News-19/05/2008)

Firefighters may be at increased risk for bladder cancer and should be considered for routine annual screening, say University of California, San Francisco, researchers. The team tested 1,286 active and retired San Francisco firefighters, whose mean age was 45, and found that 93 tested positive for blood in the urine (hematuria), and six tested positive for nuclear matrix protein 22 (NMP-22), which is released by bladder cancer cells. Those 99 patients were referred for upper tract imaging, cystoscopy and urine cytology. Of those 99 patients, one tested positive for both NMP-22 and hematuria. Two of the patients -- both retired firefighters -- were diagnosed with bladder cancer. The age- and sex-adjusted incidence for bladder cancer among the firefighters was 36 per 100,000, which is higher than that of the general population. 

The findings suggest that retired firefighters may be at high risk for bladder cancer, the researchers said. They were expected to present their findings at a press conference Monday at the annual scientific meeting of the American Urological Association, in Orlando, Fla. It has long been known that prolonged exposure to certain environmental pollutants and chemicals increases the risk of bladder cancer, according to background information in a news release about the study. As the body absorbs cancer-causing chemicals, they're transferred to the blood, filtered out by the kidneys, and expelled from the body in urine. High concentrations of chemicals in urine can damage the endothelial lining of the bladder and increase the risk of cancer. Because firefighters are regularly exposed to smoke and chemical fumes, they may be at increased risk for bladder cancer. Currently, there are no guidelines for regular bladder cancer screening.

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Advanced Age Associated With Poorer Bladder Cancer-Specific Survival In Radical Cystectomy Patients (HealthCare News -22/04/2008)

Traditional wisdom taught in urological residency has been that healthy octogenarians with bladder cancer may be offered radical cystectomy without a significantly increased incidence of postoperative complications. While these patients may leave the hospital at a reasonable time, however, few studies have specifically evaluated the long-term survival and quality of life of these patients after cystectomy. In the March issue of European Urology, Nielsen and colleagues from the Bladder Cancer Research Consortium present multi-institutional data evaluating the relationship between patient age, pathological characteristics, and survival in bladder cancer patients after radical cystectomy. The association between age and disease-specific survival was analyzed as a continuous and categorical variable in a cohort of 888 patients treated with radical cystectomy. Of this group, ages ranged between 70 and 80 years in 266 patients and above 80 years in 51 patients. Increasing age was associated with a higher risk of extravesical disease and pathological upstaging after cystectomy (p < 0.02). Despite these differences, elderly patients were less likely to receive adjuvant chemotherapy after cystectomy, utilized in 32% of patients 60 years old or younger and in only 14% of patients older than 80 years old (p < 0.01). Disease-specific survival was significantly decreased for elderly patients after adjusting for confounding variables in multivariate analysis including pathologic stage, nodal status, and adjuvant therapy. These data show that elderly patients exhibit a higher risk of pathologic upstaging after radical cystectomy and are more likely to die of bladder cancer. How do we explain these findings? Are elderly patients more likely to have a delay between the time of diagnosis and cystectomy because of their more extensive preoperative evaluation? Is decreased immune surveillance responsible? An in depth evaluation of these data may result in a re-evaluation of our treatment paradigm for these patients.

Nielsen ME, Shariat SF, Karakiewicz PI, Lotan Y, Rogers CG, Amiel GE, Bastian PJ, Vazina A, Gupta A, Lerner SP, Sagalowsky AI, Schoenberg MP, Palapattu GS, for the Bladder Cancer Research Consortium (BCRC) , Stoeckle M, Brausi MA, Nielsen ME, Palapattu GS, Shariat SF, for the Bladder Cancer Research Consortium

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Survivin Expression Is Associated With Bladder Cancer Presence, Stage, Progression, And Mortality ( UroToday.com -7/05/2007)


Survivin is a member of the Inhibitors of Apoptosis (IAP) groups of proteins, which are known to contribute to the cell death 'escape' mechanisms of various cancer cells, including bladder cancer. The expression of survivin in urine has been shown to correlate with bladder cancer presence, as well as grade and stage. Conflicting reports have emerged regarding its association with pathologic and clinical outcome in non muscle-invasive bladder cancer. In the March issue of Cancer, Shariat and colleagues examine its association with clinical and pathologic features in invasive bladder cancer. Archival tumor specimens from 9 'normal' bladders and 222 bladder cancer patients were examined for survivin expression using immunohistochemistry. 'Altered' expression of survivin was defined as the presence of more than 10% of cells expressing the protein. None of the 9 'normal' bladders or lymph nodes without tumor expressed survivin compared to 64% of the bladders from patients and 94% of the nodes with metastatic tumor. Survivin overexpression was associated with advanced pathologic stage (P = 0.032), metastases to lymph nodes (P = 0.028) and lymphovascular invasion (P =0.011). Survivin was also associated with increased tumor recurrence, bladder cancer-specific mortality and all-cause mortality (p=0.044). These data provide support to incorporating survin expression as one of the potential risk-stratification markers in pathologic nomograms being developed. It also supports the rationale for various therapies being directed targeting the IAP family of proteins.

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How Immunology Research Drives Treatment Of Bladder Cancer-(UroToday.com-26/05/2007)

Dr. Michael O'Donnell, University of Iowa presented "How Immunology Research Drives Treatment of Bladder Cancer" in the session "Target Selection in Renal Cell Carcinoma and Bladder Cancer". Dr. O'Donnell started by citing the some history relating to immunotherapy and cancer. He stated that in 1891 Coley fist injected cancers with bacterial toxins and saw tumor shrinkage. In 1929 Pearl noted that lower cancer rates in tuberculosis patients by autopsy series. In 1976 Morales used intravesical BCG in bladder cancer patients. Use of BGC resulted in decreased tumor cells in cytology specimens, but more neutrophils, suggesting an immune response. Cytokine production of interleukins is central to the immune response. T cells are stimulated to the bladder after BCG therapy and are present for months thereafter. Interferon-gamma (IFN-gamma) is upregulated and participates in cellular immunity. IFN-gamma is always the last cytokine to come up and may be influenced by more proximal cytokines in the pathway. IL-10 knockout experiments showed that IFN-gamma is critical to the response. IFN-gamma production is from BCG-stimulated human peripheral blood mononuclearcytes. Cox-2 inhibitors or indocin also inhibit IFN-gamma expression. BCG + IFN-gamma accentuates a type I cytokine response, suggesting that IFN-gamma may suppress IL-10. Response to BCG was increased if IFN-gamma was added. In fact, adding IFN-gamma and decreasing BCG maintains effectiveness. 

TRAIL, an apoptosis inducing ligand was found to have higher urine levels in BCG responders vs. non-responders. TRAIL is strongly associated with neutrophils and is increased by IFN-gamma and alpha. BCG promoted cleavage of soluble TRAIL: from neutrophils and a Phase II trial using BCG + IFN-alpha. However, for those who have failed BCG twice, there does not seem to be benefit using the BCG-IFN-alpha. Other trials underway include adenoviral cytokine gene therapy and new gene polymorphisms that affect BCG anti-tumor response are being identified. Useful markers of BCG response are needed to help stratify patients and the basis for BCG failure needs to be better identified. This is an exciting area of research that will improve outcomes for patients in the future. 

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Bladder cancer more likely to kill women-(Yahoo News-17/11/2007)

Bladder cancer is more likely to kill female sufferers than men, a major new study has found. The Australian researchers are at a loss to explain the trend but suggest women may be getting different treatment to their male counterparts, negatively affecting their survival. Men are also twice as likely to develop the disease. The Cancer Institute NSW analysed bladder cancer cases statewide from 1980 to 2003 and presented their findings at the Clinical Oncological Society of Australia's Annual Scientific Meeting in Adelaide on Friday. Five years after diagnosis, a male patient was significantly more likely to be alive than a female patient, senior epidemiologist Elizabeth Tracey said.

"We tried to see why this was happening, but when we controlled for age at diagnosis, extent of cancer at diagnosis, period of diagnosis, country of birth and coding differences, women continued to have significantly poorer survival with a 16 per cent greater likelihood of dying compared to men," Ms Tracey said. She said they could not identify an obvious reason for the difference. "More research is needed to investigate issues such as whether women are receiving the same treatment as men and whether a history of urinary track infections - more common in women than in men - is a factor," Ms Tracey said.

Studies in the United Kingdom have produced similar differences in survival between men and women with bladder cancer. More than 2,200 Australians are diagnosed with bladder cancer each year, and most are aged over 55. Men are twice as likely to develop the disease. Meanwhile, the cancer conference was also presented with new research showing that cells found deep in bone marrow may be responsible for the growth and proliferation of cancerous tumours.Results from a brain cancer trial found that longer courses of radiation treatment were more effective in reducing the growth of tumours without disadvantaging quality of life. And a breast cancer study comparing two drug regimes found that a tablet-only treatment was most effective in prolonging life and had fewer severe side-effects than a therapy combining tablets and injections.

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Bladder cancer biomarker is investigated-(UPI-18/06/2006)

U.S. medical scientists have moved closer to developing a test for urinary bladder cancer and for monitoring patients after treatment. Steve Goodison at the University of Florida-Jacksonville, along with colleagues at the University of Michigan, note urinary bladder cancer is among the five most common malignancies worldwide. Early detection and treatment dramatically increases patient survival rates. However, the scientists said the existing urinalysis test has serious drawbacks. Consequently, the development of non-invasive urinalysis assays using reliable diagnostic markers would be of tremendous benefit. The researchers have moved toward that goal by identifying potential biomarkers for bladder cancer, including a protein present in the urine of patients with bladder cancer, but not other individuals. It is the same protein linked with liver and ovarian cancer in previous studies. Although the protein appears promising as a biomarker, the researchers cite the need for further studies in large groups of bladder cancer patients to determine the biomarker's usefulness.

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New Test Spots More Recurrences of Bladder Cancer-(HealthDay News-17/01/2006)

A new study further validates the use of a simple, in-office test to catch recurrences of bladder cancer. The test, which measures a urinary protein called NMP22, is already approved by the U.S. Food and Drug Administration and is used in conjunction with another test called cystoscopy. "This is real evidence that there is a benefit to using NMP22 plus cystoscopy," said Dr. Michael A. Palese, director of minimally invasive urology at Mount Sinai Medical Center in New York City. "This study should help the test gain more widespread use, in combination with cystoscopy."

"This is the first major publication of this test used in this setting," added study author Dr. H. Barton Grossman, deputy chairman of the department of urology at M.D. Anderson Cancer Center in Houston. "This test performs pretty well, it's cost-effective, and the results are available on short order. It's good for physicians to be aware of the information to see if they want to use it." Bladder cancer is the fifth most common type of cancer in the United States and also has high recurrence rates, ranging from 50 percent to 90 percent, the study noted. Because individuals who have had bladder cancer need to be followed for the rest of their lives, the expense of the disease from diagnosis to death is the highest of all cancers in this country, ranging from $96,000 to $187,000 per patient. "Overall rates of recurrence in bladder cancer are at least 50 percent, one out of two," Grossman said. "It doesn't mean it's necessarily going to be fatal or life-threatening, but it's important to detect it reasonably early so it can be treated. If it's not picked up early, it has the potential to turn into a life-threatening disease."

Currently, different tests are used to check for recurrences. Cystoscopy, a visual inspection of the bladder with a medical instrument usually done in the doctor's office, can miss some cancers. It is often used with cytologic analysis, or analysis of cells voided in the urine, but this is also not perfect. NMP22 is a protein produced in higher concentrations by malignant cells. The current study was a fairly large one, involving 668 patients at 23 different practice centers. All participants had a history of bladder cancer. The actual tests used were provided by Matritech Inc., the manufacturer.

Cystoscopy on its own identified 91.3 percent of the cancers. When the NMP22 test was added, 99 percent of the cancers were picked up. The NMP22 test found eight out of nine cancers that were not picked up during the initial cystoscopy, including seven that were high-grade. The NMP22 test has the advantages of being simple, easy and cost-effective. "It's easier in that you can do it in a physician's office," Palese said. "We use a dipstick and you can get an answer right away, as opposed to sending the cytology test to a lab." In addition, cytology tests are more likely to come back positive when the cancer is high-grade, and it's more useful to find recurrent bladder cancer when it's low-grade and can be more easily treated, Palese pointed out. The NMP22 test is also used as a screening tool to see if people have first-time bladder cancer and performs better than cytology, Grossman added.

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Drug offers bladder cancer hope-(Yahoo News-24/07/2005)

A drug used to treat breast cancer may also help bladder cancer patients, research suggests. Scientists found elevated levels of a protein called HER2 - targeted by the drug - in more than half of patients with advanced bladder cancer. These patients were given herceptin and traditional chemotherapy - and in 70% of cases their tumours shrank. The study, by the University of Michigan, was presented at an American Society of Clinical Oncology meeting.Herceptin, given along with chemotherapy, has been shown to cut the risk of a recurrence of disease by a half in women with HER2-positive breast cancer. The drug is associated with fewer side effects than standard chemotherapy drugs. This is because it seeks out specific molecules known to play a role in cancer development, and leaves normal cells unharmed. Researcher Professor Maha Hussain said: "While we are still in the beginning, I think this trial provides an approach for metastatic (spreading) bladder cancer that has not been previously explored."

Pay Attention to Bladder Cancer's Warning Signs-(HealthDay News-24/07/2005)

People need to pay attention to the early warning signs of bladder cancer and get prompt medical help, says a University of Michigan Health System bladder cancer expert. "It's very important for patients to pay attention to the symptoms that they may experience. For example, if someone has blood in the urine, they may have a tendency to dismiss that or ignore that. I cannot emphasize enough that it is very important for patients with that symptom to be evaluated by a physician," Dr. Cheryl Lee, director of the bladder cancer program at the U-M Comprehensive Cancer Center and assistant professor of urology at the U-M Medical School, said in a prepared statement.

Along with blood in the urine, other symptoms of bladder cancer include: urgency to urinate; frequent urination in small amounts; back or abdominal pain; painful urination; loss of appetite or weight. Tests to diagnose bladder cancer include: checking urine samples for cancer cells; X-rays of the kidney and urinary system, including the bladder; and cystoscopy, in which a small flexible tube with a camera on the end is inserted into the bladder. Bladder cancer strikes men three times more often than women. Treatment for bladder cancer is most successful in the early stages, when the tumor is smaller and on the surface of the bladder. "If a patient unfortunately has had a delay in diagnosis, or has not responded to some of the signs such as blood in the urine, the tumor has the opportunity to grow, to invade the wall of the bladder and even to extend beyond the bladder, or metastasize, to other organs. In that scenario, we're looking at much more aggressive and radical treatment plans," Lee said. This year, about 63,000 Americans will develop bladder cancer, which kills about 13,000 people in the United States each year, the university said.

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Drinking Doesn't Appear to Raise Bladder Cancer Risk-(Reuters Health-20/09/2004)

New research suggests that drinking alcohol does not increase the risk of bladder cancer. In fact, the investigators found that beer may actually reduce the risk, according to their report in the September 15th issue of the Journal of the National Cancer Institute. Previous studies have yielded conflicting results regarding the link between alcohol and bladder cancer. While most studies have not shown an association, other studies have revealed a possible link.

Dr. Luc Djousse, from Boston University, and colleagues addressed the issue by analyzing data from 10,125 subjects enrolled in the Framingham Heart Study. For each subject who developed bladder cancer during follow-up, the researchers selected five study participants who did not develop bladder cancer, but who were similar for other risk factors. During an average follow-up period of 27 years, 126 subjects developed bladder cancer, the investigators note. Total alcohol consumption was not significantly associated with bladder cancer risk nor was drinking wine or spirits in particular. In contrast, beer seemed to reduce the risk. Subjects who consumed more than four drinks of beer per week were 50 percent less likely to develop the malignancy than were non-drinkers.

As to why the present findings differ from previous reports, the authors note that
differences in the number of participants who had other risk factors for bladder cancer -- heavy drinking or smoking -- may have played role. The results support previous studies showing no link between alcohol intake and bladder cancer, the researchers conclude. Further research, however, is needed to confirm that beer really has a protective effect, they add.

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GM bacteria boosts cancer therapy-(Yahoo News-05/07/2004)

Designer bacteria have been genetically engineered to bolster the body's immune response against tumours. Researchers in Leeds added a gene to a strain of bacteria that is harmless despite being related to the bugs that cause tuberculosis. The extra gene makes the bacteria produce a molecule that boosts the immune system's ability to identify and kill cancer cells. The research is published in the International Journal of Cancer. In mice, the modified bacteria worked much better against tumours in the bladder than existing treatment. The researchers say that, although the research is still at an early stage, this enhanced bacterial strain could become a safer and more effective therapy for bladder cancer.

Current treatments for bladder cancer include BCG, the bacteria best known as a vaccine against tuberculosis. A neutralised strain of the bacteria is injected close to the tumours, and is thought to stimulate the local immune system, which then kills both cancer cells and the bacteria. However, BCG does not work in about a third of patients with bladder cancer - despite being the most effective immunotherapy yet developed against any form of cancer. It can also cause significant unwanted side effects. Researchers in the Cancer Research UK Clinical Centre at St James's University Hospital, Leeds, aimed to improve both the safety and effectiveness of the treatment. They took harmless bacteria - Mycobacterium smegmatis - and added a gene to produce a protein called tumour necrosis factor alpha (TNFa). TNFa is a part of the immune system, with a crucial role in killing unwanted cells, including cancer cells, and is produced in response to BCG.

In mice with bladder cancer, the new treatment led to a reduction in the size and number of tumours. Eight out of 10 of the animals had no tumours by the end of the treatment. Professor Peter Selby, Director of the Clinical Centre, said: "BCG works by enhancing the immune response. "We've shown that by modifying a related bacterium, we can boost the immune system in such a way that it kills cancer cells even more effectively. "Our report suggests important avenues for future clinical research. "The safety of these bacteria would need to be formally verified before they could be tried in people, but the prospects are exciting." Promising approach Professor John Toy, Cancer Research UK's Medical Director, says: "Using the patient's own immune system to fight cancer is becoming an increasingly promising approach. "This research combines genetics with immunotherapy to offer the hope of a new way to treat bladder cancer more safely and effectively." Each year bladder cancer affects more than 12,500 people in the UK and accounts for nearly 5,000 deaths. It affects about two and a half times as many men as women, most cases developing after the age of 50.

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Vitamin E May Curb Cancer Risk-(Associated Press-29/03/2004)

Getting plenty of vitamin E by eating such foods as nuts and olive oil appears to cut in half people's risk of bladder cancer, the fourth leading cancer killer among men, a study says. The research, released at a cancer conference Sunday, is the latest blip in the ups and downs of perceptions about this nutrient's powers to ward off disease. Experts once had high hopes for vitamin E as a safeguard against heart attacks, but repeated studies failed to show any protective effect. Whether vitamin E does anything to stop cancer is far from proven, but some think the vitamin may be helpful, perhaps by warding off the damaging effects of oxygen. The study was based on questionnaires about the eating habits of about 1,000 Houston residents. Those whose vitamin E intake was in the top 25 percent had half as much bladder cancer as those in the lowest quarter. Bladder cancer kills about 12,500 Americans annually and is four times more common in men than women.

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New research could lead to better bladder cancer screening-(Yahoo News-19/04/2004)

A Charles Sturt University academic researching the high rates of bladder cancer in the Riverina in southern New South Wales is hoping her work will result in new more sensitive methods of screening. Wagga Wagga-based Helen Moriarty says current screening for organophosphates is inadequate, with farmers receiving negative results when they have clearly been exposed to the carcinogen. The organophosphates are found in agricultural chemicals such as insecticides and fungicides. Ms Moriarty says they are clearly harmful. "We do think that we've found a link with bladder cancer and organophosphates. We think we've found a gateway by which organophosphates might induce DNA damage and that seems to link up with bladder cancer and that's been published in an American journal," she said.

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Bladder Cancer Gene Identified-(ET-25/02/2004)

British researchers said they had identified a gene linked to bladder cancer that could improve the treatment of the disease. "This is a very exciting development. E2F3 is the missing link in our knowledge of the disease," said Professor Colin Cooper of Britain's Institute of Cancer Research. The E2F3 gene is involved in controlling the division of human cells. Cooper and his colleagues found that multiple copies of E2F3 were associated with a proliferation of cells and the development of bladder cancer. When they measured the amount of E2F3 protein in bladder cancer cells in laboratory tests they discovered it corresponded to the grade or seriousness of the tumor.

Grade 1 bladder cancer cells, which are less dangerous, had smaller amounts of the protein, while cells of a higher grade and more aggressive cancer had increased levels. "These findings will boost the development of new treatments to target bladder cancer as well as predicting the aggressiveness of a particular cancer leading to tailor-made, more effective treatments for each individual patient," Cooper, who reported the findings in the journal Oncogene, said in a statement. Bladder cancer is the ninth most common cancer worldwide. The disease kills about 130,000 people worldwide each year and 330,000 new cases are reported annually. Smoking is the single most important cause of bladder cancer, accounting for 65 percent of male cases and 30 percent of female cases, according to the International Agency for Research on Cancer in Lyon, France.

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Drinking a Lot Doesn't Stop Bladder Cancer Return-(Reuters Health-07/11/2003)

Drinking a lot of fluids is thought to prevent bladder cancer, but new research indicates that this doesn't work for people who've been treated for such cancers in the past. In theory, high fluid intake might prevent cancer by diluting any cancer-causing chemicals in the bladder or by washing them away before they could have an effect. The findings, which are reported in The Journal of Urology, are based on a study of 267 patients who were treated for bladder cancer and were then followed to see if the cancer returned. During each follow-up visit, the patients completed a questionnaire regarding fluid intake. All of the patients were followed for at least 2 years. Nearly half of them experienced one or more tumor recurrences during the study, according to the report. There was no evidence of a link between fluid intake and tumor recurrence, regardless of smoking status, note lead author Dr. S. Machele Donat and colleagues, from Memorial Sloan-Kettering Cancer Center in New York.

Moreover, the average fluid intake was comparable to the amounts that seemed to be beneficial in other studies. "These findings indicate that proposed strategies...(involving) fluid intake are unlikely to decrease the frequency of tumor recurrence in patients already diagnosed with bladder cancer," the authors conclude.

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