Today, the relationship between smoking and bladder cancer is more than proven, both in men, in whom this neoplasia is more common, and in women, who are also affected, although to a lesser extent because they tend to smoke less than men.
Dr. Salvador Esquena is head of the Urology Service at the Hospital Universitari General de Catalunya (Barcelona), a hospital center attached to the Quirónsalud group, and explains that bladder cancer is a neoplasm that arises from the cells that line the inside of the bladder. , those that are in contact with urine.
“Classically, bladder cancer is a predominantly male tumor. In fact, of the 23,000 cases annually, about 18,000 are in men; Although the incidence of bladder cancer in women is increasing in recent years due to the incorporation of women's smoking habits in recent decades. The age of presentation of this disease is usually between 50-60 years,” this expert clarifies.
Regarding its prevalence in Spain, he says that it is more present in men due to its relationship with smoking, “men smoke more than women”; At the same time, this urologist highlighted that the Spanish incidence of bladder cancer is “one of the highest in the world” and is also “the fourth most common tumor in men.”
“Without a doubt, smoking is the greatest risk factor for the development of bladder cancer, and the possibility of a smoking patient developing it is three times greater than that of a patient who does not smoke. Smoking causes more than half of bladder cancers in both men and women,” this specialist clarifies.
In this sense, the Spanish Society of Medical Oncology (SEOM) emphasizes that cigarettes contain more than 60 carcinogenic products, substances that are absorbed and eliminated through urine, consequently affecting "to a large extent" the cells of the skin. wall of the urinary tract. In fact, this scientific society points out that “more than 40% of all diagnosed cases of bladder cancer are attributed to tobacco.”
This specialist from the General University Hospital of Catalonia remembers that it is usual to detect this cancer in the early stages of development because patients do usually notice symptoms (bleeding in the urine), so surgeries for its resection are usually sufficient for a cure. of the patient in many cases.
Now, if it is more advanced stages of the disease, Dr. Esquena maintains that the cure may be “more difficult”, then changing the objectives of the treatment to focus on achieving the patient's survival and improving their quality of life, today. possible in most situations or cases thanks to new targeted therapies and immunotherapy.
Regarding its symptoms, the head of the Urology Service at the Hospital Universitari General de Catalunya points out, therefore, that the “key symptom” is bleeding in the urine, sometimes accompanied by clots; although he recognizes that in many cases the disease is usually asymptomatic, so the patient will not have any discomfort. “If bleeding appears in the urine of a smoker, bladder cancer should be suspected,”
When suspecting bladder cancer, this urologist indicates that the initial test to be performed is an ultrasound, where the inside of the bladder and possible neoformations can be seen to confirm the diagnosis; although he points out that they can also perform a CT scan, or a cystoscopy, an endoscopy to see the bladder.
Given the diagnosis, Dr. Esquena emphasizes that there are numerous treatment possibilities, which initially consists of a transurethral resection of the bladder, with which to eliminate the bladder tumor. “With this intervention, the cancer will be studied, and we will know its aggressiveness,” he maintains. “Once this is done, and the result of the pathological anatomy is known, we will know the characteristics of the tumor, and it will be decided if it needs to be complemented with another treatment,” he emphasizes.
In this sense, the patient with bladder cancer has the possibility of having a cystoscopy and a transurethral resection performed, and in these cases being complemented with chemotherapy inside the bladder through several periodic instillations with a urinary catheter. , or you have the possibility of taking oral immunotherapy. Another of the possibilities available today for bladder cancer, as this expert continues, are cystectomies, that is, the removal of the urinary bladder.
