UROLOGICAL ONCOLOGY

Prevention of Bladder Cancer: A Review
Leppert JT, Shvarts O, Kawaoka K, Lieberman R, Belldegrun AS, Pantuck AJ
Department of Urology, David Geffen School of Medicine at UCLA, USA
Eur Urol. 2006; 49: 226-34

• Introduction: Bladder cancer represents an ideal tumor model to test and apply cancer prevention strategies. In addition to reviewing the epidemiology of transitional cell carcinoma (TCC), we review the current status and the future directions of bladder cancer prevention.
• Materials and Methods: A literature review of peer-reviewed articles which address bladder cancer prevention was performed.
• Results: Pre-clinical and limited clinical data suggest that bladder cancer is responsive to efforts to delay or prevent its development in at-risk patients, and in reducing the risk of recurrence in patients with established disease. Many epidemiologic studies, however, investigating natural products, such as vitamins and herbal compounds, lack conclusive evidence of their chemopreventive effects.
• Conclusions: While many agents hold promise in the prevention of bladder cancer, none currently can be recommended as proven chemoprevention strategies. Improving the accuracy of patient risk assessment and identification of surrogate endpoint biomarkers are crucial to the testing of these strategies. Efficient study design will ensure rapid and substantial advances in the chemoprevention of bladder cancer.
  
  
• Editorial Comment
  Doctor, what can I do to prevent my risk of bladder cancer?
  These or similar questions might not be so easily answered given the amount of conflicting data on this topic. Reading the review of Leppert and coworkers might give some help. The well-known data e.g. on smoking and occupational exposure are summarized and commented, and many new information on dietary changes (fat, soy bean, vitamins, selenium) and nonsteroidal anti-inflammatories are given. With this paper at hand, a well-founded answer to the above question is possible.

Dr. Andreas Bohle
Professor of Urology
HELIOS Agnes Karll Hospital
Bad Schwartau, Germany