Bladder cancer lesions are thought to be the result of a combination of environmental exposure and genetic susceptibility. Clinically, morphologically and pathologically, bladder tumors can be classified as superficial, low-grade papillary tumors and high-grade carcinoma in situ or invasive malignancies Most bladder tumors (70-80%) are superficial and can be surgically removed that are confined to the mucosal layer. Following resection, recurrence occurs in approximately 50-70% of patients, mostly at 12 months after diagnosis. Approximately 5-20% of patients with recurrence will progress to the muscle-infiltrating stage.
Two hypotheses provide explanations for the frequent recurrence of bladder tumors.
The first, the “soil effect or soil malignancy” hypothesis, suggests that exposure to various toxins increases the susceptibility of the entire uroepithelium, increasing the risk of subsequent development of multiple, unique tumors.
The other “seed” hypothesis suggests metastasis of clonal tumor cells into the adjacent normal bladder mucosa.
Conceptually, both models provide new ideas for adjuvant implementation strategies to prevent tumor formation.
What are the causes of bladder cancer?
Carcinogens in drinking water. Drinking tap water disinfected with chlorine and containing chlorinated by-products can increase the risk of bladder cancer; arsenic contamination in drinking water in Taiwan and Argentina, South America, is also associated with increased risk of bladder cancer.
2, urethral diseases, chronic stimulation of urethral epithelium or human metabolites increase the level of carcinogens in urine, which can make the urethral epithelium proliferate and then become cancerous, for example, squamous bladder cancer is related to schistosome infection in Egypt or bladder stones.
3.Coffee, the risk of bladder cancer is higher in coffee drinkers than non-drinkers, but there is no dose and time trend between the two. The results of epidemiological studies have ruled out a strong correlation between coffee and bladder cancer, but do not rule out a correlation between the two.
4.Drugs, taking large amounts of painkillers containing finasteride can increase the risk of bladder cancer, and the drug has been discontinued. The risk of bladder cancer can be increased several-fold in patients with lymphoma treated with cyclophosphamide, and the tumor is often infiltrative.
Artificial sweeteners, a study in the late 1970s reported that sweeteners could increase the risk of bladder cancer in men by 60%, but subsequent studies have failed to confirm the correlation, so currently the International Agency for Research on Cancer no longer includes sweeteners as carcinogens of human bladder cancer.