Severe bladder cancer course in smokers



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Bladder cancer is more severe in smokers

Smoking is not the only risk factor for bladder cancer, but a significant one. US scientists have identified a large number of biomarkers that can be used to determine the course of bladder cancer. They also found an extremely negative influence of smoking on the course of the disease. Smokers are "significantly more likely to develop aggressive and fatal bladder cancer," said Richard J. Cote of the University of Miami and colleagues in Cancer.

As part of their study, the US doctors also searched for biological characteristics that can be used to determine the course of a bladder cancer. They identified a panel of new biomarkers that doctors could use to “predict which particular cases are at greatest risk of fatal outcome.” They also identified the effects of tobacco use on the development of bladder cancer. It was already known that smoking is one of the main causes of bladder cancer. So far, however, the effect of tobacco use on treatment has remained controversial. Now the US scientists confirm "the fatal connection of bladder cancer with tobacco consumption also in relation to the severity of the disease or the course of the disease".

Fatal bladder cancer more common in smokers The research team led by Richard J. Cote from the University of Miami and Anirban Mitra from the Keck School of Medicine at the University of Southern California evaluated the data on the course of bladder cancer in 212 patients as part of his current study Relationships with the tobacco consumption of the test persons were checked. The data were from 1987 to 1996 and were originally collected as part of the "Los Angeles County Cancer Surveillance Program". The scientists found that study participants "who smoked intensely were more likely to develop a deadly form of bladder cancer than those who did not or little smoked", reports the journal "Cancer" (doi: 10.1002 / cncr.27763). In addition, the age of the patients, the stage of the disease that had already been reached at the time of diagnosis, the accompanying therapies and surgical aspects had a significant influence on the course of the disease. The relationship was most striking when smoking.

Nine biomarkers for the course of bladder cancer discovered In the course of their investigation, the scientists also identified biological characteristics that make it possible to predict the course of the disease in bladder cancer regardless of tobacco consumption and the other risk factors. If bladder cancer takes on a fatal form, certain proteins have been changed. "We 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. A very poor prognosis exists for patients with changes in six to nine markers. For them, bladder cancer often leads to death. As the number of detectable changes in biomarkers increased, the severity of the course of the disease increased continuously. This supports the thesis that cancer is not caused by an individual trigger but by the interaction of several changes in the organism. Bladder cancer patients in whom six or nine of the biomarkers found have changed could, according to the researchers, benefit in future from more aggressive treatment of the cancer.

Results clinically highly relevant The scientists conclude that the current "results of the study are extremely clinically 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, "personalized patient management for this disease is urgently needed." However, based on the current classification of the patients or the clinical classification, the course of the disease cannot be predicted and the treatment cannot be adjusted. The assessment based on the biomarkers could mean significant progress here. (fp)

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