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Published on: December 27, 2024
Association of spina bifida with cancer
Angela M Arlen1, Anne G Dudley2,3, Kathleen Kieran4,5
1Department of Urology, Yale University School of Medicine, New Haven, CT, USA.
Insights
Spina bifida survivors face lifelong challenges, including neurogenic bladder and increased cancer risk. Multidisciplinary care is crucial for managing complications and improving long-term outcomes for these patients.
Area of Science:
- Pediatric neurology
- Urology
- Public health
Background:
- Spinal dysraphism incidence is declining, but survival rates are increasing.
- Spina bifida remains a significant cause of chronic disability and increased adult mortality.
- Neurogenic bladder is a common complication in spina bifida patients.
Purpose of the Study:
- To highlight the evolving challenges in managing spina bifida patients into adulthood.
- To emphasize the importance of awareness regarding neoplastic risks in neurogenic bladders.
- To underscore the necessity of a multidisciplinary approach for optimal patient care.
Main Methods:
- Review of current literature on spinal dysraphism management.
- Analysis of long-term outcomes and complications in spina bifida survivors.
- Discussion of risks associated with neurogenic bladder and surgical interventions.
Main Results:
- Increased survival of spina bifida patients into adulthood presents new management challenges.
- Neurogenic bladder is prevalent, with potential links to urinary tract cancer risk.
- Routine cancer screening and awareness are vital for patients with neurogenic bladders.
Conclusions:
- Optimal care for myelomeningocele requires a comprehensive, multidisciplinary team.
- Proactive management of sequelae is essential for function, quality of life, and survival.
- Awareness of cancer risks in neurogenic bladders is critical for patients and healthcare providers.
Abstract:
While the worldwide incidence of newborns with spinal dysraphism is decreasing, the majority of children now survive and reach adulthood, creating new challenges in patient management and long-term care. Despite medical and surgical advances with a subsequent decline in mortality, spina bifida continues to be a major cause of chronic disability and affected individuals face increased mortality in adulthood. The majority of spina bifida patients have neurogenic bladder. Reconstructive and diverting procedures may increase the neoplastic risk in the urinary tract over time, however bladder dysfunction itself may be a risk factor, therefore patients, caregivers, and physicians must be aware of the baseline risk of cancer in patients with neurogenic bladder, in addition to routine cancer screening. Optimal treatment of myelomeningocele requires a multidisciplinary care team to prevent and manage potential sequelae that may affect function, quality of life, and survival.
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