‘Surprising Link’: Smoking and Bladder Cancer

Many people don’t realize that smoking tobacco is the single most important known risk factor for bladder cancer.

The effects of cigarette smoke toxins entering your body have received a lot of attention, but far too little attention has been given to how those toxins make their way out.

“These carcinogens leave the body through the urinary tract,” says urologist Robert Abouassaly, MD.

“When urine is in contact with the bladder for many hours at a time, the bladder can be exposed to very high concentrations of toxins from cigarette smoke.”

The result is alarmingly high rates of bladder cancer among smokers.

The evidence is striking:

• Smokers are at least three times as likely to get bladder cancer as nonsmokers, according to the American Cancer Society.
• A study by the National Institutes of Health (NIH) found that 50% of all cases of bladder cancer are found in smokers.
• Former smokers are twice as likely to develop the disease as those who never smoked; current smokers are four times more likely.
• A recently published analysis of 89 studies underscores these findings.

“People are often surprised by the link,” Dr. Abouassaly says. “Efforts toward smoking cessation are really critical to try to prevent this disease.”

Women at increasing risk

Even though the prevalence of bladder cancer is higher among men, rates of the disease in women have grown. Dr. Abouassaly attributes this to increases in smoking among women, particularly younger women.

Previous studies indicated that smoking was responsible for 28% of bladder cancer cases in women; however, NIH research found the risk for women has risen to 50%, equal to that of men.

Watch for the signs

Another contributing factor to bladder cancer death is that people wait too long to seek medical attention for their symptoms.

These symptoms include:

• Blood in the urine.
• Recurrent bladder infections.
• Frequent or burning urination.

“When it’s identified at an early stage it’s highly curable, but many times people delay seeing a doctor,” says Dr. Abouassaly. “Unfortunately, in some cases, it’s too late for anything to be done.”

Treatment can require bladder removal

When bladder cancer is detected early, Dr. Abouassaly says he can often remove the tumors with endoscopic surgery, chemotherapy, immunotherapy or other medications delivered through the bladder.

“Once it’s invaded into the bladder, that’s a sign that more significant treatment is needed,” he says. “Usually that’s removal of the bladder with systemic chemotherapy.”

In some cases, reconstructive surgery can create a new bladder out of the small intestine; otherwise, bladder removal can require an ostomy, an opening that routes urine out of the body into an external pouch.

Preventing bladder cancer

“The critical thing in preventing and treating bladder cancer is awareness, risk reduction through smoking cessation and early diagnosis,” Dr. Abouassaly says.

While quitting smoking isn’t easy, experts say it’s the one healthy change that offers the most benefit in your overall health.