Non-Muscle Invasive Bladder Cancer: A Review of the Current Trend in Africa

Abstract

Bladder cancer is the fourth most common cancer in men and the 11th most common cancer in woman accounting for 6.6% of all cancer cases. Approximately 70-75% bladder cancers are non-muscle invasive bladder cancer (NMIBC). A few African studies have provided considerable rates of NMIBC as compared to western settings 70% to 85%. Critical step in the management of NMIBC is to prevent tumor recurrence which include transurethral resection of the bladder tumor (TURBT) for staging and histological diagnosis. A second TURBT for high grade tumor, T1 tumors and intravesical adjuvant chemotherapy and immunotherapy are essential to reduce recurrence rate. Nevertheless, variant histology, multiple, progressive and recurrent high-grade tumors are best treated with early radical cystectomy. The African literature is scanty on the management of NMIBC. Most of the histological types are squamous cell bladder cancer and may not conform to transurethral resection only but rather radical cystectomy. Most of these patients are not suitable for any form of treatment as they present with advanced disease. However, there is an increasing incidence of urothelial cancer in Africa over the years due to urbanization. It is best that major investment is made in uro-oncological care to address the growing challenge of these subtypes.

The global burden of urinary bladder cancer: an update

“…Worldwide differences in (historical) exposure to risk factors like cigarette smoking, chemical carcinogens in certain occupations and arsenic in drinking water or endemic chronic urinary infections caused by Schistosoma haematobium are largely responsible for the observed variability in occurrence, although a small part of the geographical differences may also be attributable to differences in access to care and availability of diagnostic procedures such as enhanced cystoscopy (e.g. narrow band imaging or blue light cystoscopy) and computed tomography between more and less developed countries [7]. Cigarette smoking is by far the number one risk factor, accounting for up to 50% of all UBC diagnoses, especially urothelial cell cancer (UCC) [8].…”

<p>Review of Testicular Tumor: Diagnostic Approach and Management Outcome in Africa</p>

“…The guideline recommendation of germ cell TC is relatively less expensive than treatment of other forms of urological cancer. 18,19 Secondly, the overall prognosis of germ cell testicular tumor is good after treatment. 1,3,8,9 Diagnosis Staging and Initial Management…”

“…The poor prognosis NSGCT as stratified by the IGCCCG risk classification has a five-year survival of 45% to 50%. 18,19 The standard treatment guideline is 4 cycles of BEP. [1][2][3]8,9 Patients who do not respond to first-line chemotherapy can receive high dose carboplatin + etoposide followed by autologous transplant or ifosfamide + paclitaxel followed by high dose etoposide with stem cell support as second-line therapy.…”

Urinary glycoproteomic profiling of non-muscle invasive and muscle invasive bladder carcinoma patients reveals distinct N-glycosylation pattern of CD44, MGAM, and GINM1

“…Patients are predominantly diagnosed with non-muscle invasive bladder cancer carcinoma (NMIBC) is the prevalent type (70-75%) and is defined as a superficial neoplasia. These tumors are restricted to the mucosal or sub mucosal layer with high risk of recurrence [1]. About, 10-20% of NMIBC will progress into muscle invasive bladder carcinoma (MIBC) which has a high risk of metastasis and is characterized by poor prognosis [2].…”