The awareness of patients with non - muscle invasive bladder cancer regarding the importance of smoking cessation and their access to smoking cessation programs

ABSTRACT Objectives Smoking is the most important risk factor for bladder cancer and smoking cessation is associated with reduced risk of tumor recurrence and progression. The aim of this study is to assess the awareness of non-muscle invasive bladder cancer (NMIBC) patients regarding the importance of smoking cessation, determine their access to smoking cessation programs and the effects of smoking cessation on recurrence rates of NMIBC. Materials and Methods NMIBC patients who were followed with cystoscopy were included in the study. Their demographic properties were recorded, along with their smoking habits, awareness regarding the effects of smoking on bladder cancer and previous attempts for smoking cessation. Moreover, the patients were asked whether they applied for a smoking cessation program. Recurrence of bladder cancer during the follow-up period was also noted. Results A total of 187 patients were included in the study. The mean age was 64.68±12.05 (range: 15-90) and the male to female ratio was 167/20. At the time of diagnosis, 114 patients (61.0%) were active smokers, 35 patients (18.7%) were ex-smokers and 38 patients (20.3%) had never smoked before. After the diagnosis, 83.3% of the actively smoking patients were advised to quit smoking and 57.9% of them quit smoking. At the time of the study, 46.52% of the NMIBC patients were aware of the link between smoking and bladder cancer, whereas only 4.1% of the smoking patients were referred to smoking cessation programs. After a mean follow-up of 32.28±11.42 months, 84 patients (44.91%) had recurrence; however, current smoking status or awareness of the causative role of smoking on NMIBC did not affect the recurrence. Conclusion In our study group, the majority of the NMIBC patients were not aware of the association between smoking and bladder cancer. Although most of the physicians advised patients to quit smoking, a significant amount of the patients were still active smokers during follow-up. Only a small proportion of patients were referred to smoking cessation programs. Urologists should take a more active role in the battle against smoking and refer those patients to smoking cessation programs. Larger study populations with longer follow-up periods are needed to better demonstrate the beneficial effects of smoking cessation on recurrence rates.

Potential chemoprotective effects of green propolis, L-lysine and celecoxib on bone marrow cells and peripheral blood lymphocytes of Wistar rats subjected to bladder chemical carcinogenesis

PURPOSE: To evaluate the genotoxicity of propolis and L-lysine, as well as their effects on the possible cellular damage in erythroblasts (bone marrow) and leukocytes (peripheral blood) caused by the carcinogen BBN (n - butyl - n {4 - hydroxybutyl} nitrosamine) in rats subjected to bladder carcinogenesis and treated with green propolis and L-lysine. METHODS: One hundred and twenty five rats were distributed into the following groups: I, IIA, IIB, III, K, L M N, X, XI, XII and XIII. Groups I to X received BBN in drinking water for 14 weeks (wks). Group I was treated with intragastric (ig) propolis at 150 mg/kg body weight, for 44 wks, beginning 30 days before start of BBN. Groups IIA and III were treated with propolis (150 mg/kg), for 40 wks, subcutaneous (sc) and ig, respectively, beginning simultaneously with BBN. On the 32nd wk, the animals of groups L, M and N were treated ig with L-lysine (300 mg/kg), celecoxib (30 mg/kg) and propolis (300 mg/kg), respectively, up to the 40th wk. The groups that received only BBN (IIB and K) were treated with water, sc and orally, respectively, for 40 wks. Groups XI, XII and XIII received respectively propolis (150 mg/kg), L-lysine (150 mg/kg) and water ig for 40 wks. After 40 wks, the surviving animals were anesthetized and subjected to femoral bone marrow aspiration and blood collection from the aorta, for CA and MNT, respectively, for investigation of genotoxicity. RESULTS: Groups IIB and K, which received only BBN and water, showed the greatest DNA damage in peripheral leukocytes (CA) and largest number of micronuclei in bone marrow erythrocytes (MNT) in relation to all other groups that received BBN and lysine and/or propolis (p<0.001). CONCLUSIONS: Both propolis and L-lysine are effective in protecting against genotoxicity, as well not being genotoxic themselves toward the cells evaluated, at the doses and times administered and according to the two tests utilized. .

Chemoprevention with green propolis green propolis extracted in L-lysine versus carcinogenesis promotion with L-lysine in N-Butyl-N-[4-hydroxybutyl] nitrosamine (BBN) induced rat bladder cancer / Quimioprevenção com própolis verde extraído em L-Lisina versus promoção da carcinogênese como L-Lisina em ratos induzidos ao câncer de bexiga pelo N-Butyl-N-[4-hydroxybutyl] nitrosamine (BBN)

PURPOSE: To determine the effects of green propolis extracted in L-lysine (WSDP) and of L- lysine for 40 weeks on induced rat bladder carcinogenesis. METHODS: The animals (groups I, II, III, IV, V and VI) received BBN during 14 weeks. Group I was treated with propolis 30 days prior received BBN, and then these animals were treated daily with propolis; Groups II and III was treated with subcutaneous and oral propolis (respectively) concurrently with BBN. The animals of Group IV were treated L-lysine; Group V received water subcutaneous; and Group VI received only to BBN. Among the animals not submitted to carcinogenesis induction, Group VII received propolis, Group VIII received L-lysine and Group IX received water. RESULTS: The carcinoma incidence in Group I was lower than that of control (Group VI). The carcinoma multiplicity in Group IV was greater than in Group VI. All animals treated with L-lysine developed carcinomas, and they were also more invasive in Group IV than in controls. On the other hand, Group VIII showed no bladder lesions. CONCLUSION: The WSDP is chemopreventive against rat bladder carcinogenesis, if administered 30 days prior to BBN , and that L-lysine causes promotion of bladder carcinogenesis.

OBJETIVO: Determinar os efeitos da própolis verde extraída em L - Lisina (WSDP) e da L-Lisina por 40 semanas em ratos induzidos a carcinogênese de bexiga. MÉTODOS: Os animais (grupos I, II, III, IV, V e VI) receberam BBN por 14 semanas. O grupo I foi tratado com própolis 30 dias antes de receber BBN e em seguida estes animais foram tratados diariamente com própolis; Os grupos II e III foram tratados com própolis subcutânea e oral (respectivamente) e concorretemente com BBN. Os animais do grupo IV foram tratados com L- Lisina; o grupo V recebeu água subcutânea; o grupo VI recebeu apenas BBN. Entre os animais não submetidos a indução de carcinogênese, Grupo VII, receberam própolis, Grupo VIII, receberam L-Lisina e Grupo IX receberam água. RESULTADOS: A incidência de carcinoma no grupo I foi menor que no grupo controle (grupo IV) A multiplicidade de carcinoma no grupo IV foi maior que no grupo VI. Todos os animais tratados com L - Lisina desenvolveram carcinomas e estes foram mais invasivos no grupo IV que no grupo controle. Por outro lado o grupo VIII não apresentou lesões. CONCLUSÃO: WSDP é quimiopreventiva contra a carcinogese de bexiga se administrada 30 dias antes do início do BBN, e a L - Lisina causa promoção da carcinogênese de bexiga.

Patrón alimentario y desarrollo de tumores de vías urinarias en Córdoba / Dietary patterns and development of urinary tract tumors in Cordoba

Introducción y objetivo: En Argentina, el cáncer de vejiga ocupa el séptimo lugar entre las causas de muerte por cáncer en varones e investigaciones recientes muestran que los Tumores de Vías Urinarias (TVU) constituyen el cuarto tipo de neoplasia más frecuente en la provincia de Córdoba. Numerosos estudios han encontrado que los factores dietarios se relacionan con el riesgo de desarrollar TVU. Estos trabajos se han focalizado, en general, en alimentos aislados y en algunos nutrientes y han analizado el riesgo mediante metodologías tradicionales. De esta manera, solo se han logrado inferencias parciales. Un nuevo enfoque, basado en el análisis de los patrones alimentarios en asociación al riesgo, puede contribuir a una mejor comprensión de la carcinogénesis de vías urinarias. En consecuencia, el objetivo de este estudio de casos y controles, realizado en Córdoba entre 2004 y 2008, fue establecer la relación entre el desarrollo de TVU y el consumo de alimentos que configuran el patrón cultural de esta población. Materiales y Métodos: Se entrevistaron 168 pacientes con TVU, de la variedad transicional, istopatológicamente confirmados, y 334 controles sanos provenientes de los mismos hospitales y clínicas. Todos ellos fueron encuestados y se recabaron datos acerca de su alimentación habitual y su exposición a otros posibles factores de riesgo. Para explorar los patrones alimentarios se utilizó análisis de correspondencia múltiple y para establecer el riesgo se calcularon odds ratios - ajustados por edad, sexo, estado nutricional, estrato social, exposición ocupacional a sustancias con posible efecto mutagénico, hábito de fumar y actividad física – e intervalos de confianza del 95% con regresión logística múltiple. Resultados: Se identificaron dos patrones alimentarios principales: el denominado patrón occidental se asoció con los casos de TVU, en tanto que el patrón prudente, con los controles...

Introduction: Bladder cancer is the 7th most frequent cause of death for males in Argentina and recent studies showed that urinary tract tumors (UTT) are the 4th most common among men in the province of Córdoba. A growing number of studies have shown that usual diet isassociated with the risk of developing UTT. These researches have focused mainly on single foods and nutrients, followed by traditional methods of analysis. Hence, only partialexplanations have been proposed. Thus, establishing food patterns could lead to further understanding of epigenetic factors on bladder tumor risks. The purpose of this case-control study, conducted in Cordoba between 2004 and 2008 was to describe the role of food patterns and to investigate any correlation with the risk of developing UTT. Materials and Methods: 168 patients with histologically confirmed transitional UTT and 334 healthycontrols from the same hospitals were studied. All subjects were interviewed about their food habits and their exposure to a number of known or suspected risk factors for UTT. Multiplecorrespondence analysis was used to explore food patterns and data analysis was performed by calculating Odds Ratios and their 95% confidence intervals by using Multiple LogisticRegression...

A Clinicopathological Study of Urinary Bladder Neoplasms in Patients at Three Centers in Khartoum; Sudan

OBJECTIVES:To present the histopathological pattern of urinary bladder neoplasms using the WHO/ISUP classification system and relate it to the outcome.METHODS:This study was conducted in the period from January 2004 through December 2005 at three centres in Khartoum; Sudan. One hundred and six patients with urinary bladder neoplasms were included in the study.RESULTS:The commonest affected age group was 60-80 years with male to female ratio 4.6:1. Urothelial neoplasms were found in 72 (67.9); Squamous cell carcinoma (SCC) in 26 (24.5); urothelial neoplasms with Squamous differentiation in 3 (2.8); and other types in 5 (4.7) of the patients.There were 43.4of the urothelial neoplasms graded as papillary carcinoma of high grade; 52.6papillary carcinoma of low grade;1.3papillary neoplasm of low malignant potential;1.3papilloma; and 1.3was graded as flat neoplasm.Of the SCCs; twelve (42.9) were poorly differentiated SCCs;nine (32.1) moderately differentiated; and seven (25) cases were well differentiated SCCs. Follow-up information was available in 32 patients.At last followup; fifteen (46.9) patients were dead of the disease; twelve (35.5) were alive with no evidence of disease; four (12.5) were alive with disease; and one (3.1) was alive and terminally ill Conclusion:Histological grade (P: 0.006); and muscle invasion (P: 0.002) were significantly associated with survival.A subset of the cases could not be assessed for muscle invasion due to inadequate sampling; we thus recommend proper trans-urethral bladder biopsy (TUBP) sampling

Assessment of factors that contribute to bladder cancer

The study aimed to assess the factors contributes of patient with bladder cancer and to find out the relationship between the factors of bladder cancer with certain variable. A descriptive study to assessment of factors that contribute to bladder cancer that was carried out Al-Karama teaching hospital, Al-Kendy teaching hospital, Specialty Surgery teaching hospital and Al-Yarmok teaching hospital for the period of November 2003 to August 2004. A purposive [non-probability] sample of [100] patients with bladder cancer. An assessment from was constructed for the purpose of the study. It comprised of two parts, which were dealing with the demographic information sheet, and factors contribute. Test- retest reliability was employed through computation of Pearson correlation coefficient. Content validity of assessment form was determined through a panel of experts and pilot study. Data were collected through the application of the questionnaire and interview technique. The assessment was conducted during the period [10th] March 2004 to [5th] August 2004. Data were analyzed through descriptive statistical approach. The study concluded that the age over [50] years, majority of them was male, married, they had low level education, and most of them were smoking and drinking tea. The study recommended that to stop smoking and establishing specialized center of bladder cancer in Iraq

Experiencia conjunta del uso de dosis bajas de BCG cepa danesa en el tratamiento y la profilaxis del cáncer superficial de vejiga / Joined experience with the use of low doses of Danish strain of BCG in the treatment and prophilaxis of bladder superficial cancer

Se presenta el resultado de ocho años de experiencia con la utilización del bacilo de Calmette-Guérin (BCG) de la cepa danesa, a 35 mg por dosis, de los servicios de urología de las instituciones Centro Médico Nacional "20 de Noviembre" del ISSSTE y Hospital Central Sur de Alta Especialidad de PEMEX. Se ha comprobado en el pasado decenio la eficacia del BCG para el tratamiento del cáncer de células transicionales en etapas superficiales; el resultado puede ser el mejor de los obtenidos con los agentes antitumorales utilizados, pero los pacientes han tenido que pagar un precio muy alto a causa de las reacciones adversas que se presentan con la instilación intravesical de bacilos vivos; incluso se han informado casos fatales en la bibliografía. Se trataron 112 pacientes con BCG, durante un periodo de ocho años, con dos esquemas de tratamiento: 100 se trataron con 35 mg por dosis durante seis semanas, dos pacientes con esquema prolongado de tratamiento a dos años, y diez pacientes se sometieron a resección como único tratamiento. A continuación se compararon los resultados. De los 100 pacientes tratados con esquema corto, se obtuvo una reacción adecuada en 83 por ciento, con una proporción de recidivas de 17 por ciento. Ocurrieron reacciones adversas en 34 por ciento de los casos. Hubo un caso de sepsis del sistema nervioso central. Los dos pacientes tratados con esquema largo se encuentran libres de la enfermedad. Entre los pacientes tratados con resección nada más hubo 60 por ciento de recidivas y 20 por ciento de progreso tumoral

Prophylactic maltose tetrapalmitate and bacillus calmette-guerin immunotherapy of recurrent superficial bladder tumors: final report

We divided randomly into 3 groups 60 patients with recurrent superficial transitional cell carcinoma of the bladder : group 1- 20 controls who underwent transurethral resection only, group 2-20 patients who underwent transurethral resection and Bacillus Calmette-Guerin therapy, and group 3-20 patients treated by transurethral resection and Maltose TetraPalmitate. Mean follow up was 44.85 months for the controls, 52.15 months for group 2 and 59.20 months for group 3. The mean recurrence rate per 100 patient-months was 15.31 +/- 11.55 in the controls, 12.11 +/- 7.66 in group 2 and 7.71 +/- 5.36 in group 3, and the recurrence index per month was 0.153, 0.121 and 0.071, respectively. The recurrence rate and recurrence index per month were significantly decreased in the MTP treated group compared to the controls [p = 0.017] but not significantly reduced in BCG treated group. There was no significant difference between the Bacillus Calmette-Guerin and Maltose TetraPalmitate groups. Invasive carcinoma developed in 65 percent of the controls, 45 percent of group 2 and 35 percent of group 3. Invasive carcinoma required cystectomy +/- chemotherapy or definitive radiotherapy. Bacillus Calmette-Guerin caused irritation of the bladder mucosa, while Maltose TetraPalmitate did not have any side effects