Risk Factors for Bladder Tumors in Spinal Cord Injury Patients

Stonehill, William H.; Dmochowski, Roger R.; Patterson, Lynn; Cox, Claire E.

doi:10.1097/00005392-199604000-00029

Cited by 30 publications

(54 citation statements)

References 9 publications

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“…2,16,17 Moreover, long-term indwelling catheter can lead to bladder cancer. 18 Catheters should be removed before the onset of irreversible complications. Some patients do not agree for SCIC or sphincterotomy (men) despite continuous improvements of appliances.…”

Section: Discussionmentioning

confidence: 99%

Neurogenic bladder management and cutaneous non-continent ileal conduit

et al. 2002

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Section: Discussionmentioning

confidence: 99%

Neurogenic bladder management and cutaneous non-continent ileal conduit

et al. 2002

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“…14 The exact mechanisms of carcinogenesis are not understood but are likely related to the repeated chronic irritation caused by a foreign object resulting in metaplasia, then dysplasia, and finally carcinoma. One theory relating chronic cystitis to BC, particularly squamous cell carcinoma, implicates nitric oxide and NNCs, whose levels are raised in chronic cystitis associated with chronic indwelling catheterization.…”

Section: Schistosomiasismentioning

confidence: 99%

Molecular Mechanisms and Pathways in Bladder Cancer Development and Progression

Jung

Messing

2000

Cancer Control

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Background: The basis for bladder cancer development and progression is complex and involves genetic abnormalities. These abnormalities yield phenotypic changes that allow normal transitional cells to becomeity of these new cases, approximately 75%, are limited to the mucosa (stage Ta or Tis) and lamina propria (T1) at presentation, and most of these tumors can be removed by transurethral resection. Recurrence rates are high (30% to 85%), and 10% to 30% of "superficial" tumors (T1 or less) will subsequently progress to muscle invasive disease (stages T2-T4), which has a poorer prognosis. 2 For the remaining 25%, the initial presentation involves muscle invasive disease that will usually relapse with metastases (as well as localized disease persistence) within a median of 2 years if managed only by transurethral resection and intravesical therapy. 3 These data support the heterogeneous nature and malignant potential of transitional cell carcinoma

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“…The following characteristics make particular cancers more suitable than others for screening: 4,5 (a) substantial morbidity and mortality, (b) a high prevalence in a detectable preclinical state, (c) the possibility of e ective and improved treatment because of early detection, and (d) the availability of a good screening test. The screening test must be safe, rapid, inexpen- 8 an occurrence which was noted in this study as well. This suggests that lowstage disease is not readily identi®ed by screening.…”

Section: Discussionmentioning

confidence: 66%

“…The majority of the reported cases of bladder cancer in SCI patients list the tumor stage at the time of diagnosis as T2 or greater, with very few super®cial tumors. 3,8,9 The high stage of the disease at diagnoses would argue for heightened surveillance. But the rapidly progressive nature of the disease, seen in two patients during this study who died within a year of diagnosis and reported by others, 10,11 discounts the utility of practical screening measures.…”

Section: Discussionmentioning

confidence: 99%

Screening cystoscopy in chronically catheterized spinal cord injury patients

Yang

Clowers

1999

Spinal Cord

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Study design: Retrospective review. Objectives: An annual screening cystoscopy protocol was begun at our institution in an attempt to minimize the morbidity and mortality of bladder cancer in the chronically catheterized spinal cord injured (SCI) population. The objectives of this study are: (1) to present the results of 6 years of screening for primary bladder cancer in this population, and (2) examine the suitability of this protocol based upon accepted principles of cancer screening. Setting: Veterans hospital, Seattle, WA, USA. Methods: SCI patients selected for screening cystoscopy were those who had been continuously catheterized for 10 or more years, or were smokers who had been catheterized for 5 or more years. Biopsies and/or urine cytologies were taken at the surgeon's discretion. Results: Fifty-nine patients underwent 156 cystoscopy procedures from January 1992 through December 1997. The vast majority of patients were at risk for autonomic dysre¯exia, so cystoscopy was performed with anesthesia. No bladder cancers were diagnosed by screening cystoscopy. All bladder biopsies and cytology specimens were benign. During the same period of time four SCI patients presented with symptomatic bladder cancers. Two patients did not ®t the criteria for surveillance, one patient was not being followed by the SCI unit and presented to an outside physician, and one patient had a screening cystoscopy 4 months prior to presenting with bladder cancer. Conclusions: Cystoscopy does not ful®l the accepted criteria for screening for primary bladder cancer in SCI patients. The disease does not appear to be amenable to screening, the population to be screened is not easily de®nable, and the costs are excessive compared to the low cancer detection rate.

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Risk Factors for Bladder Tumors in Spinal Cord Injury Patients

Cited by 30 publications

References 9 publications

Neurogenic bladder management and cutaneous non-continent ileal conduit

Neurogenic bladder management and cutaneous non-continent ileal conduit

Molecular Mechanisms and Pathways in Bladder Cancer Development and Progression

Screening cystoscopy in chronically catheterized spinal cord injury patients

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