Bladder cancer, a smoking cancer that is progressing in France

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Written by Doug Hampton

the essential
Bladder cancer mainly affects men and smokers. Taken in time, it has a good prognosis, but remains diagnosed late. On the occasion of bladder cancer month, urologist Benjamin Pradère informs about this disease which is progressing.

It is a little known cancer, and yet The urological cancer after that of the prostate. Bladder cancer affects nearly 20,000 new patients each year in France and is progressing steadily. “Catched in time, it is a cancer with a good prognosis, with more than 80% five-year survival; but diagnosed late it becomes much more morbid – 50% survival that’s why we have to talk about it! insists Benjamin Pradère, urologist at the Croix-du-Sud clinic, and member of the cancerology committee of the French Association of Urology (AFU).
Indeed, there is no organized screening for bladder cancer. The main warning sign is hematuria, ie the presence of blood in the urine. “Seeing blood in your urine (red urine or traces of blood) even once should absolutely prompt you to consult”, insists the doctor. A secondary warning sign is frequent urination and recurrent urinary tract infections. »
Signs not to be overlooked, especially since the other particularity of this cancer is that it is painless at first. The diagnosis then goes through a cystoscopy, an examination of the urethra, under local anesthesia to confirm the presence of a tumor.

5 to 7 times more risk in smokers

Another little-known characteristic of this cancer is that it particularly affects smokers. “50% of smokers are at risk of developing bladder cancer, and overall, they are 5 to 7 times more likely to develop bladder cancer than non-smokers”, describes the specialist.
This is the case of Patrice *, 69 years old currently treated by immunotherapy. “Today, I am a repentant smoker, but I smoked until the age of 40… he says. At no time did I think that there could be a link between cigarettes and this disease which is talked about relatively little, compared to other cancers of smokers… ”
Exposure to certain chemicals is also considered a risk factor. The clinical profile of patients? “70% are 65 or older and this disease affects four times more men than women; even if the latter die more often because they are more prone to urinary tract infections, which increases the risk of late diagnosis. »

The hope of new molecules

If doctors insist on the importance of early management, it is because there are two types of localized bladder cancers, apart from metastatic cancers. “80% are non-invasive, limited to the first layer of the bladder wall and have a good prognosis, but if left untreated they can progress to invasive cancer. »
After endoscopic resection of the tumor, local treatment with chemotherapy or immunotherapy is performed. “Immunotherapy with BCG (of the same name as the vaccine against tuberculosis) is the most recent, instilled into the bladder, it makes it possible to avoid recurrences and cystectomy (removal of the bladder). »
This is the protocol followed by Patrice. “My high-grade tumor was non-invasive. After two operations, I did six sessions of immunotherapy by injection into the bladder, I’m waiting for the next check-up, and I hope to keep my bladder, it’s very reassuring. »
In Toulouse, the Croix-du-Sud clinic but also the CHU and the Oncopole offer these new care protocols. With the hope for these molecules of the future, first reimbursements in 2025.
*name has been changed.

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