Abstract
Study design:
Retrospective review.
Objective:
Spinal cord injury is a known risk factor for bladder cancer. The risk of bladder cancer has been reported at 16–28 times higher than the general population. Earlier studies have identified indwelling catheters as risk factors. We examined the characteristics of bladder cancers in a spinal cord injury (SCI) population.
Setting:
Long Beach VA Hospital Spinal Cord Injury Unit, Long Beach, California
Methods:
We reviewed SCI patients seen and diagnosed with bladder tumors between January 1983 and January 2007. Data collected included time since diagnosis, method of diagnosis, form of bladder management, pathologic type, treatment of the tumor, and outcome.
Results:
A total of 32 patients with bladder cancer were identified out of 1319 seen. Tumors found were 46.9% squamous cell carcinoma (SCC), 31.3% transitional cell carcinoma (TCC), 9.4% adenocarcinoma, and 12.5% mixed TCC and SCC. The primary form of bladder management was 44% urethral catheter for a mean of 33.3 years, 48% external catheter for a mean of 37.4 years, and 8% intermittent catheterization for a mean of 24.5 years. Nineteen patients had a known method of cancer detection with 42% found on screening cystoscopy.
Conclusions:
The pathologic makeup of the tumors is similar to that reported earlier. Over 50% of patients diagnosed with bladder cancer in our population did not have an indwelling catheter. This suggests that the neurogenic bladder, not the indwelling catheter, may be the risk factor for bladder cancer. Urologists should consider diligent, long-term screening of all patients with SCI for bladder cancer and not just those with indwelling catheters.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Kaufman JM, Fam B, Jacobs SC, Gabilondo F, Yalla S, Kane JP et al. Bladder cancer and squamous metaplasia in spinal cord injury patients. J Urol 1977; 118: 967–971.
Groah SL, Weitzenkamp DA, Lammertse DP, Whiteneck GG, Lezotte DC, Hamman RF . Excess risk of bladder cancer in spinal cord injury: evidence for an association between indwelling catheter use and bladder cancer. Arch Phys Med Rehabil 2002; 83: 346–351.
Bejany DE, Lockhart JL, Rhamy RK . Malignant vesical tumors following spinal cord injury. J Urol 1987; 138: 1390–1392.
Subramonian K, Cartwright RA, Harnden P, Harrison SCW . Bladder cancer in patients with spinal cord injuries. BJU Int 2004; 93: 739–743.
West DA, Cummings JM, Longo WE, Virgo KS, Johnson FE, Parra RO . Role of chronic catheterization in the development of bladder cancer in patients with spinal cord injury. Urology 1999; 53: 292–297.
Messing EM . Urothelial tumors of the bladder. In: Walsh PC, Retik AB, Vaughn Jr ED, Wein AJ (eds). Campbell-Walsh Urology, 9th edn. Saunders: Philadelphia, 2002. pp 2407–2447.
Shokeir AA . Squamous cell carcinoma of the bladder: pathology, diagnosis and treatment. BJU Int 2004; 93: 216–220.
Spinal Cord Injury and Disorders System of Care Procedures. VHA Handbook 11761. Department of Veterans Affairs, Veterans Health Administration: Washington DC, 2005.
Stonehill WH, Dmochowski RR, Patterson AL, Cox CE . Risk factors for bladder tumors in spinal cord injury patients. J Urol 1996; 155: 1248–1250.
Razdan S, Leboeuf L, Meinbach DS, Weinstein D, Gousee AE . Current practice patterns in the urologic surveillance and management of patients with spinal cord injury. Urology 2003; 61: 893–896.
Kitahara S, Iwatsubo E, Yasuda K, Ushiyama T, Nakai H, Suzuki I et al. Practice patterns of Japanese physicians in urologic surveillance and management of spinal cord injury patients. Spinal Cord 2006; 44: 362–368.
Davies B, Chen JJ, McMurry T, Landsittel D, Lewis N, Brenes G et al. Efficacy of BTA stat, cytology and surviving in bladder cancer surveillance over 5 years in patients with spinal cord injury. Urology 2005; 66: 908–911.
Richie JP, Waisman J, Skinner DG, Dretler SP . Squamous carcinoma of the bladder: treatment by radical cystectomy. J Urol 1976; 115: 670–672.
Larsen LD, Chamberlin DA, Khonsari F, Ahlering TE . Retrospective analysis of urologic complications in male patients with spinal cord injury managed with and without indwelling urinary catheters. Urology 1997; 50: 418–422.
Navon JD, Soliman H, Khonsari F, Ahlering TE . Screening cystoscopy and survival of spinal cord injured patients with squamous cell cancer of the bladder. J Urol 1997; 157: 2109–2111.
Bickel A, Culkin DJ, Wheeler Jr JS . Bladder cancer in spinal cord injury patients. J Urol 1991; 146: 1240–1242.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kalisvaart, J., Katsumi, H., Ronningen, L. et al. Bladder cancer in spinal cord injury patients. Spinal Cord 48, 257–261 (2010). https://doi.org/10.1038/sc.2009.118
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2009.118
Keywords
This article is cited by
-
Primary Care in the Spinal Cord Injury Population: Things to Consider in the Ongoing Discussion
Current Physical Medicine and Rehabilitation Reports (2023)
-
The argument against screening for bladder cancer in neuro-urological patients
World Journal of Urology (2022)
-
Bladder cancer in patients with neurogenic bladder disorder: a comparative study of different etiologies
World Journal of Urology (2022)
-
Bladder cancer detection in patients with neurogenic bladder: are cystoscopy and cytology effective, and are biomarkers pertinent as future diagnostic tools? A scoping review
World Journal of Urology (2022)
-
Bladder cancer in patients with spina bifida: a serious risk
World Journal of Urology (2021)
