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Bladder cancer in patients with multiple sclerosis treated with cyclophosphamide
D De Ridder1, H van Poppel, L Demonty
1Department of Urology, Catholic University Leuven, UZ Gasthuisberg, Belgium.
The Journal of Urology
|May 23, 1998
Summary
This study investigated bladder cancer risk in multiple sclerosis patients using indwelling catheters and cyclophosphamide. Results suggest a synergistic role of these factors in cancer development, necessitating regular screening.
Area of Science:
- Urology
- Oncology
- Neurology
Background:
- Multiple sclerosis (MS) management involves treatments that may increase secondary health risks.
- Indwelling catheters and cyclophosphamide are used in MS care but their association with bladder cancer is not fully understood.
Purpose of the Study:
- To define the risk of bladder cancer in multiple sclerosis patients.
- To investigate the roles of indwelling catheters and cyclophosphamide in bladder cancer development.
Main Methods:
- Retrospective review of 2,351 multiple sclerosis patients' records.
- Analysis of bladder cancer incidence in chronically catheterized patients and those treated with cyclophosphamide.
Main Results:
- Bladder cancer was diagnosed in 0.29% of all patients.
- Incidence was 0.7% in chronically catheterized patients and 5.7% in a subgroup treated with cyclophosphamide and catheterized.
- Hematuria was the most common presenting symptom.
Conclusions:
- Cyclophosphamide and chronic catheterization may synergistically increase bladder cancer risk in MS patients.
- Regular cystoscopy is recommended for early detection of bladder tumors.
- Nitric oxide metabolism might play a role in the carcinogenesis of secondary bladder cancer.