We generally feel bored with our normal routine life, but this gets a big jolt when one is suddenly hit by a life-changing event called cancer. This brings loads of unwanted pain, discomfort, agitation and helplessness not only to the cancer patients but their caregivers and loved ones. The worldwide number of cancer cases is increasing rapidly.
In 2018, 18.1 million new cases of cancer and 9.6 million deaths are reported. It is estimated by several studies that, globally 1 in every 5 men and 1 in every 6 women will develop cancer during their lifetime. Cancers in the bladder are the most common malignancy in the urinary tract. Bladder cancer is one of the most prevalent cancer, ranked 10th in incidence in the world. In India, it is ranked 17th in occurrence and 19th in death rate cases. Its incidence varies across the Indian population. Despite this alarming situation, awareness about this disease and its early symptoms is not much among the general population.
Bladder cancer overview
Bladder cancer develops when abnormal cancerous cells grow uncontrollably in the lining of the bladder, the organ that stores urine. These cancerous cells begin to affect the normal function of the bladder and can spread to surrounding organs.
Early symptoms of Bladder cancer
Alarming signs of bladder cancer generally include blood or blood clot in urine, painful or frequent urination, bedtime multiple times urination, not being able to urinate despite feeling the urge to urinate and one-sided lower back pain. These symptoms can be seen suddenly or over time.
Risk factors for bladder cancer
There are several risk factors for bladder cancer, some are modifiable and some are not.
Consumption of tobacco or smoking
This is a very crucial risk factor for bladder cancer. 50% of bladder cases in India are smoking-related cases. Black tobacco is considered more carcinogenic. 4-aminobiphenyl is the most important dangerous carcinogen in cigarette smoke.
Harmful chemicals produced in the dye industry or workplaces where dye is used are a potential risk factor for bladder cancer. Reports say that the risk of bladder cancer can be seen more in manufacturers of rubber, leather, textiles, steel, metal, and paint products and the printing companies, painters, machinists, printers, hairdressers, and construction workers and truck drivers, in the rubber industry and dye production.
Arsenic in water
Bladder cancer risk increases if the arsenic level in water exceeds 300–500 µg/L.
Less water or fluid intake
Drinking less water concentrates the urine and increases the bladder contact time and simultaneously lowers the removal of excess toxins through urination and hence increasing bladder cancer risk.
Age and gender
Bladder cancer risk increases in 65+ elderly individuals and it is more common in men compared to women.
Chronic Bladder infection
Bladder diseases like Urinary infections, bladder and kidney stones, longer placement of bladder catheter, and chronic bladder irritation increase the risk of bladder cancer.
Family history and genetics
Bladder cancer chances increase in individuals with strong bladder cancer family history.
Dietary factors and bladder cancer risk
Studies show evidence that diet also affects bladder cancer occurrence. Bladder cancer is expensive to treat diseases because of the requirement for long courses of treatment and frequent follow-up examinations. Identifying modifiable dietary risk factors associated with this disease will help in offering timely preventive options.
Having macronutrient or macronutrient containing food and the risk of bladder cancer
It has been documented in many studies that a diet high in meat or fat is associated with a higher risk of bladder cancer. Another study has shown that a 3% increase in the consumption of energy intake from animal protein was associated with a 15% higher risk of developing bladder cancer while a 2% increase in energy from the plant protein intake was associated with a 23% lower risk of developing bladder. A high intake of processed meat and processed red meat also enhances the bladder cancer risk. On the other hand, adequate intake of complex carbohydrates from fruits and vegetables and olive oil lowers the risk.
Intake of fruit and vegetables or micronutrients and risk of bladder cancer
Intake of green, yellow and a variety of vegetables reduces bladder cancer risk. Consumption of berries and cruciferous vegetables containing alpha-carotene, beta-carotene, lycopene, lutein/zeaxanthin, beta-cryptoxanthin, vitamins A, E, and C, and folate lowers bladder cancer risk. Alpha-linolenic acid-containing foods like flaxseeds, pumpkin seeds, walnut, canola oil and soybean may reduce bladder cancer risk to a large extent.
The circulating concentration of micronutrients and risk of bladder cancer
High levels of vitamin A, total carotenoids, α-carotene, β carotene, lutein and zeaxanthin are mostly associated with lower bladder cancer risk. Mostly alpha-tocopherol and retinol offer a protective effect on bladder cancer risk. A low level of blood vitamin D levels increases bladder cancer risk and supplementation of Vitamin D reduces the same. It is interesting to note that bladder cancer can be a preventable disease through the right timely nutritional intervention in heavy chain smokers.
Micronutrient supplementation and bladder cancer risk
Supplementation of vitamin E and C sometimes lowers the risk of bladder cancer. Though gaining the same from fresh dietary sources is better than including supplements routine.
Other food items and bladder cancer risk
Green tea shows a protective effect against bladder cancer risk. An increase in tea consumption, in general, may reduce the bladder cancer risk.
We can convince by available scientific supportive data that a healthy balanced diet may have a good effective impact on reducing the risk of development and progression of bladder cancer. This will also lower the risk of developing other diseases. An adequate intake of nutrients like vitamins, especially vitamins A, B, C, D and E, may lower the overall risk of developing cancer.
Also, bladder cancer risk can be reduced by following healthy lifestyle habits, eating a diet rich in fruits and vegetables, reducing processed meat-eating, controlling arsenic content in drinking water, and protecting industrial workers and other workers where there is more exposure to dyes. A good extravagance awareness needed to be created about the early signs and symptoms of bladder cancer. Simultaneously screening camps should be organized for the high-risk groups to offer better outcomes in terms of preventive management of bladder cancer.
- Indian Journal of Medical Sciences • Volume 73 • Issue 2 • May-August 2021 |
Investig Clin Urol 2016;57 Suppl 1:S14-25