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Thursday, April 17, 2014
Bladder Tumor: Inherited Versus Environmental
As a part of a kidney stone removal, a very small polyp was found and determined to be carcinoma (grade I -II). It was cauterized and I understand nothing more needs done except periodic monitoring. Are there any statistics or thoughts as to whether this type of cancer is more likely to be genetic or environmental (in general across the population). Secondly, what does Grade I-II mean (briefly). Thanks!
Bladder cancer is the fifth most common cancer among Americans and tends to be a disease of the older population, with a peak incidence in the 70's. It is three times more likely to occur in males than in females, and slightly more common in whites than in blacks.
Environmental factors are very important in the development of bladder cancer. It is a significant occupational hazard among workers in the organic chemical, dye, rubber, and paint industries. Cigarette smoking is strongly associated with bladder cancer, although it may take 15-20 years of smoking. People who abuse the pain-killer phenacetin have an increased risk as well. Chronic bladder irritation can help promote bladder cancer. Irritation can be caused by chronic urinary tract infections and schistosomiasis (blood parasites found in other countries).
We don't know very much about factors which may prevent bladder cancer from occurring. There is a suggestion that milk and vitamin A may decrease its occurrence.
Familial bladder cancer is rare but is more likely if individuals are diagnosed under age 45. Familial bladder cancer may also be associated with a family history of colon cancer or endometrial (uterine) cancer. This combination of colon, endometrial, and urinary cancers is called "Lynch syndrome."
The two types of staging for bladder cancer involve an assessment of the degree to which the cancer has involved the bladder wall. The Marshall-Jewett system is based on examination under anesthesia and a microscopic evaluation of the biopsy tissue. The more accurate system, however, is the TNM system which considers the size of the tumor, presence of involved lymph nodes, and any evidence of further cancer spread. Neither system classifies bladder cancer in a "grade I or II" method. As such, more information would be necessary to completely answer your question.
Judith A Westman, MD
Associate Professor, Clinical Internal Medicine, Pediatrics and Medical Biochemistry
College of Medicine
The Ohio State University