* An Overview of Bladder cancer - causes, symptoms and treatment alternatives

* An Overview of Bladder cancer - causes, symptoms and treatment alternatives

A patient-friendly overview on Bladder cancer, its causes, symptoms and treatment alternatives from chemotherapy to immunotherapy and natural and alternative treatments including BCG, immunotherapy, PDT, metformin, gene therapy and MVAC.

Bladder cancer - A growing cause for concern

Bladder cancer is the seventh most common cancer in the UK with over 10,000 cases diagnosed a year, and the incidence is rising. In America in 2017, there were 79,000 cases. It is the fourth most common cancer in males. This makes a mockery of those cancer charities who insist that the only cause is smoking, which is in decline in males the UK. Cancer charities also suggest that 50 per cent of people developing the disease will die from it, and that figure is expected to fall, apparently, by 35 per cent over the next twenty years. 

What is bladder cancer? 

In the UK about 90 per cent of bladder cancers arise in the cells of the lining of the bladder – the urothelium. These may be invasive into the muscle tissue, or not, and two separate lines of treatment then ensue.  

If they are not yet invasive they are ‘early stage’ and probably will just involve polyps, or mushroom-like growths, which are easy to remove during surgery. This is termed Papilliary Bladder Cancer. Early stage bladder cancer is highly treatable. 

A small number of bladder cancers have flat, moist cells and are called Squamous cell bladder cancers. Alternatively, they may be flat rapidly dividing cells, which can be treated but are more likely to return. This type of cancer is called Transitional cell bladder cancer as it may move on to become invasive. These same cells line the walls of your ureters and urethra and the cancer can spread to these as well. 

Where the cancer is invasive into the muscle tissue, treatment is much more intense as now there is a risk that the cancer may spread around the body.  

The causes of bladder cancer

1. Urinary microbiome inbalance and bladder cancer 

There is now quite extensive research on the gut microbiome. It would now appear that a microbiome also exists in the urinary tract and its composition differs greatly between those people with cancer and those that are healthy. A review in 2017 concluded that organisms producing microRNA may well influence the health of the tract especially as microbes such as Escherichia coli have been found there. Of course, antibiotics and drugs can destabilize the whole tract including the bladder. And they may well influence the success of treatments such as BCG. A small scale 2018 study in Nature names a number of pathogens including Fusobacterium nucleatum as being possible causes of bladder cancer.

In a 2008 review of some 40 studies, a good number supported a link between the Schistosoma haematobium parasite and bladder cancer, particularly squamous cell rather than transitional cell cancer. It is a blood fluke found in Africa and the Middle East.

Certainly in developing countries bladder cancer is known be linked to an infection by a parasitic worm and is called schistosomiasis or bilharzia.  

2. Toxins and bladder cancer 

Toxins leave the body in several ways, but a major pathway is through the urinary tract. Harvard Health has linked bladder cancer to both environmental toxins and smoking.

In men, smokers have three times the risk of non-smokers and this accounts for between 50 and 60 per cent of bladder cancers. In women the figure is lower at 20 to 30 per cent.  50 per cent of all cases of Bladder cancer are found in smokers.

Environmental toxins are ‘processed’ by the kidneys and pass with the urine to the bladder. There have been links recorded in research to arsenic, chemicals used in the manufacture of dyes, textiles, plastics, paints and leather, and for workers in the petroleum, tyre, gasworks, chemical and printing industries.  Bladder cancer has also been linked to the primary solvent used in dry cleaning.  

Interestingly, research studies have shown that smokers who come into contact with environmental toxins have a much higher risk of bladder cancer – the risk factor multiplies up. 

Chemotherapy drugs such as Cyclophosphamide (Cytoxan) and ifosfamide (Ifex) have been linked to higher risk of bladder cancer. 

Several studies have also shown a link with a group of drugs, thiazolidinediones (or TZDs), used in the treatment of diabetes. According to 2012 research from the School of Public Health, University of Alberta pioglitazone was associated with an increased risk of bladder cancer based on a pooled estimate from three cohort studies involving more than 1.7 million individuals. Another study from Perelman School of Medicine at the University of Pennsylvania has confirmed that finding. 

Women exposed to radiotherapy for cervical cancer have a higher risk of subsequently developing bladder cancer. 

MD Anderson Cancer Center has shown that genetics plays a part in bladder cancer risk, recurrence, disease progression, and patient survival (Online CANCER, the journal of the American Cancer Society).

There is a little evidence that artificial sweeteners may be linked to bladder cancer.

People with type-2 diabetes have a 40% increased risk of bladder cancer, compared to people without diabetes.

Although not officially a side-effect there is concern that type-2 diabetes drug metformin intake may increase risk, although a meta-analysis seems to have disproved this; and metformin may even help increase bladder cancer survival. It might be safer to use the herb berberine instead. There is research that it cuts blood sugar in the same way and can cause bladder cancer cell death.

3. Low vitamin D and increased risk of bladder cancer

There are several studies  (for example HERE) linking low blood vitamin D levels with an increased risk of bladder cancer. Approximately 80% of people on diagnosis have levels below 20ng/ml. Boston Medical School are the experts on vitamin D and suggest cancer patients should aim for a level above 70ng/ml, by taking at least 5,000IUs a day, or going in the sun for 4 hours.

Polyps and Bladder cancer

Although rare, polyps can form in the ureters and top of the bladder. They are usually benign and develop from the epithelial membrane causing symptoms similar to a urinary tract infection. The polyps may become cancerous and that cancer may then spread through the bladder and ureter.

There is research that two proteins may cause bladder cancer to become aggressive; one study specifically relates to polyps.

Bladder cancer symptoms 

Blood in the urine is the most frequent symptom and occurs in some 80 per cent of cases. Frequency of urinating and pain when doing so may be indicative, although all symptoms could also be due to other causes such as infection. 

Sometimes a test (urine cytology) is used to detect cancer cells in the urine.

There is as yet, no screening test, nor is there any test that is 100% accurate. People may be routinely tested - if they have had bladder cancer before; if they were born with a bladder defect; or if their work place uses harmful chemicals.

Bladder cancer ’Active Surveillance’

Researchers at UCLA’s Jonsson Comprehensive Cancer Center have found that more intense surveillance and treatment of bladder cancer in the first two years after diagnosis can reduce the number of patients whose cancer returns (Cancer). The researchers found that although 80 per cent of all bladder cancer patients survive 5 years, nearly three quarters of patients with high-grade, non-muscle-invasive bladder cancer suffered a return of the disease within 10 years. In 33 percent of patients, the cancer progressed to a more advanced form requiring removal of the bladder, radiotherapy or chemotherapy; and in a further 41 percent, the cancer recurred without further spread of the disease. 

Complementary programmes such as diet and exercise can be mportant to survival.

"If you would like to know the latest complementary and integrative approaches to this cancer, why not have a personal programme built for you by Chris Woollams. See what people have to say about them HERE"

Bladder cancer treatment

Bladder cancer - act quickly. This is most definitely one of those cancers where early detection yields more treatment options and a greater chance of survival.

Research carried out by a team at Plymouth University has uncovered the signalling process that allows a benign, small polyp to develop into something that spreads and is invasive. Key is a protein, pancreatic secretory trypsin inhibitor (PSTI), which is present in most bladder cancers, (American Journal of Physiology -- Renal Physiology Aug. 1, 2013).  

Bladder cancer surgery - nowadays, much of the surgery is robotic. Sometimes, in the case of invasive cancer, bladder removal is required (radical cystectomy) and increasingly a new bladder (neobladder reconstruction) can be provided, set inside the abdomen. In early stages, where the cancer is non-invasive, patients may be offered a TURBT (transurethral resection of bladder tumour).

Bladder cancer drugs - when you look at the standard list of drugs used, it is easy to see that basic bladder cancer chemotherapy treatment has not moved on much in years. 

Typically, drugs used are:

     * Cisplatin and gemcitabine

     * Carboplatin and gemcitabine

     * MVAC - which uses 4 drugs - methotrexate, vinblastine, adriamycin (doxorubicin) and cisplatin

You can look up your drug by going to the top right hand corner of this page and clicking on the ‘search for your drug here’ button. MD Anderson in Texas showed vitamin C and vitamin K could improve the action of bladder cancer drugs. 

Bladder cancer immunotherapy - at CANCERactive we covered an early trial of an immunotherapy drug for bladder cancer. As if to support the point above, Professor Peter Johnson said that it was full of potential and was the first new bladder cancer drug for 30 years!

In America, 2017 became the year immunotherapy and bladder cancer moved on. 

     * Atezolizumab was approved as a first line drug for people where cisplatin was ineffective.

     * Nivolumab (Opdivo) showed success with metastatic bladder cancer.

     * Three more PD-1 check point inhibitors were approved by the FDA - Pembrolizumab (Keytruda), Imfinzi, and Avelumab, covering first and second-line treatment.

BCG treatment - where the cancer is non-invasive and some surgery has taken place BCG (Bacillus Calmette-Guerin) therapy may be used. Typically this is a virus used to inoculate children against a similar virus that causes tuberculosis. It is live. It is delivered by catheter into the bladder after a TURBT. 

The idea is that the virus causes an immune reaction and the immune system then deals with the remaining bladder cancer cells. This can cause fever-like symptoms.

In rare cases it can pass round the body and has been known to cause lung illnesses such as pneumonia.

Bladder cancer radiotherapy - because of the location, proton beam therapy may be the safer option.

Alternative Bladder Cancer Treatments

Some cancer centres and clinics use other treatments. For example:

 * Using off-label drugs to treat cancer. Certain drugs, originally created for other reasons, have new lives treating cancer - perhaps the diabetes drug, metformin, and the lipophyllic statin, atorvastatin are the most common. But other 'repurposed' drugs are gaining favour. You can find out more about 'building an off-label drug protocol here'.

*  PDT - The University of Wales showed promise with photodynamic therapy (PDT) and bladder cancer - specifically using mitomycin and ALA rather than porphyrin.

Go to: Photodynamic Therapy 

* Virotherapy, or Gene Therapy -  CVA21, a strain of the common cold virus can be used to knock out early stage Bladder cancer according to researchers from Surrey, England. The use of oncolytic viruses is in its infancy. The National Cancer Institute reviews oncolytic viruses and bladder cancer HERE.

* Nanoknife IRE - Inoperable or deep-seated tumours are increasingly being treated using the Nanoknife technology. 

Go To: Nanoknife IRE 

* Natural Compounds - Read about fumaric acid, the benefits of certain vegetables, mushrooms with bladder cancer ...

Go to: Bladder cancer - Latest news, latest research

* Laser Ablation Therapy is another alternative bladder cancer treatment. It is used to reduce the size of tumours, and also to ’mop up’ areas of cancer cells. Early stage bladder cancers can be treated in this way.

Confused? Want to understand the best way forward? Want a more Integrative or more natural approach? Why not discuss your options with Chris Woollams? Read more here ... 

Go to: Read what other cancer patients say about a Personal Prescription 

Building an Integrated Treatment Programme for bladder cancer

CANCERactive is Europe’s Number 1 Integrative Cancer Charity. This website alone has more than 4,000 pages of information on it, either as articles or as news stories. More than 10,000 people visit our websites every day. We know from the feed-back we receive just how much we are valued by people trying to beat cancer. 

We believe you can increase your personal odds of cancer survival by taking simple health-enhancing steps and adding both complementary cancer therapies and alternative cancer therapies into your mix of treatments. 

For example, Hyperbaric Oxygen, curcumin, calorie restriction, melatonin, probiotics and whole body hyperthermia have all been shown in research to make chemotherapy work better. It then kills more cells! The research is covered on this website. Surely it makes a lot of sense to use them in your personal cancer treatment programme?
Go to: How to improve your chemotherapy

We cover how to improve your radiotherapy (and reduce side-effects) too. 
Go to: Improve your Radiotherapy, and reduce side-effects

We have a complete review of Immunotherapy telling you the accurate figures and what to watch out for. We tell you what is working and when two new drugs have been used, rather than one. It’s a new, emerging and alternative cancer therapy, but not fully there yet!

Go to: A complete review of Immunotherapy  

Then we have an article on how to improve the success of your radiotherapy (and reduce the potential side-effects) – all by adding complementary therapies. Our Guidelines on Diet and Exercise can be found through this link:

Go to: CANCERactive Guidelines on Diet and exercise 

Our recommended anti-cancer diet is the colourful Mediterranean Diet (with its focus on the French paradox):  

Go to: The Rainbow Diet

Like Hippocrates, we believe all cancer begins in the gut and that gut problems, yeast, viral and parasite infections are common constituents of cancer.

Go to: All cancer begins in the gut

But if you just want to look at the most comprehensive list of Complementary Therapies you can find it here:

Go to: CANCERactive Complementary and Integrative cancer therapies

And if you want alternative cancer therapies start here:

Go to: CANCERactive Alternative cancer therapies 

Finally, if you want all this put together for you in one simple plan, why not look into having a Personal Prescription?

Go to: Personal Prescriptions with Chris Woollams

We don’t take one penny from any Pharmaceutical company, cancer clinic or supplements company. We have no vested interest. We just want to see you beat cancer. 

"If you are already thinking of supplementing with any of the above products, why not take a look at Our Natural Selection by clicking here."

Other articles that you may find interesting are:

  1. A diet for Chemotherapy
  2. Immunotherapy overview
  3. A to Z Guide to Complementary Therapies

Go to: Return to the CANCERactive drug list

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