MedUni Vienna: Not smoking can prevent or improve bladder cancer

Smoking is the main cause of bladder cancer as has been known for quite a while. New studies, conducted under the direction of Shahrokh Shariat, the new head of the University Department of Urology at the MedUni Vienna at the Vienna General Hospital, prove that even by giving up smoking once diagnosed the chances of survival and the quality of life of those affected improve considerably.

In Europe more than 550,000 people suffer from bladder cancer (urothelial cell carcinomas). This means that this type of cancer is one of the most common. For men, bladder cancer occupies fifth place in the national average, for women eleventh place. The tendency in women is on the increase, one reason is because women smoke more today than they did a few years ago. 60 to 70 percent of those afflicted are smokers or ex-smokers and most of them are over 65. Due to the expensive treatment involved, bladder cancer not only counts as one of the most costly types of cancer, it also massively reduces the quality of life of those affected. Not infrequently, the bladder is damaged by the illness or has to be removed, which makes an artificial bladder necessary. This causes inconvenience in everyday life and also affects the patient’s sex life. Despite modern surgery and chemotherapy nearly half of those affected die from their illness.  

Tumours more aggressive in smokers
In the course of his work as a urologist and within the framework of numerous studies, Shahrokh Shariat, head of the University Department of Urology at the MedUni Vienna and the Urologic Oncology Unit of the Comprehensive Cancer Center of the MedUni Vienna and the Vienna General Hospital, has worked intensively on the influence of smoking and smoking cessation on bladder cancer.

The results of the latest studies are sobering. They clearly show that the tumour is considerably more aggressive in smokers than it is in non-smokers. Smokers are most likely to develop a more advanced stage tumour, have more metastases, respond more poorly to treatment, require higher doses and have a higher rate of recurrence (tumour reappears). And, due to the comorbidities (accompanying illnesses), many treatments cannot be prescribed. Says Shariat: "Smokers and ex-smokers fare worse in every respect than non-smokers." However, studies do also show that giving up smoking, even after the diagnosis of bladder cancer has been received, improves the prognosis. "Smoking negatively affects the immune system and takes away the body’s strength to fight the tumour. Regardless of when one stops smoking, stopping smoking helps to overcome bladder cancer and keep it under control," says the MedUni Vienna experts.

Wide-ranging campaign on giving up smoking urgently needed
As the negative influence of smoking on health is so great, Shariat is promoting the introduction of programmes to help smokers give up and anti-smoking campaigns. He emphasises: "It is our duty to protect children and young people, and adults as well. I am convinced that a general cessation would solve many problems in our health system because people would be less ill, need less medical help and would respond better to treatment. Enormous improvements can be achieved with simple means. Now is our chance - we can't wait any longer."

Service: European Urology
"Impact of Smoking and Smoking Cessation on Outcomes in Bladder Cancer Patients Treated with Radical Cystectomy," Rink M, Zabor EC, Furberg H, Xylinas E, Ehdaie B, Novara G, Babjuk M, Pycha A, Lotan Y, Trinh QD, Chun FK, Lee RK, Karakiewicz PI, Fisch M, Robinson BD, Scherr DS, Shariat SF., Eur Urol. 2013 Sep;64(3):456-64. doi: 10.1016/j.eururo.2012.11.039. Epub 2012 Nov 27.

"Impact of Smoking and Smoking Cessation on Oncologic Outcomes in Primary Non–muscle-invasive Bladder Cancer," Rink M, Furberg H, Zabor EC, Xylinas E, Babjuk M, Pycha A, Lotan Y, Karakiewicz PI, Novara G, Robinson BD, Montorsi F, Chun FK, Scherr DS, Shariat SF, Eur Urol. 2013 Apr;63(4):724-32. doi: 10.1016/j.eururo.2012.08.025. Epub 2012 Aug 21.

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