Epidemiology

It’s shown in the graphs below that there are extremely high incidence and mortality rates in northeastern United States, in the New England region. Studies are underway to explore the reasoning behind this dramatic increase in bladder cancer and mortality rates in northeastern United States.    The use of well water compared to those who use water from private sources is under investigation.  Well water may contain elevated levels of arsenic, which is one of the health risks for bladder cancer.   The possibilities for this dramatic increase can be due to clean water, lifestyle, or occupation; the study is currently underway.    [17].

Occurrence of Bladder Cancer in White Males in U.S  [17]

Occurrence of Bladder Cancer in White Females in U.S [17]

Re-occurrence

Taking all superficial bladder tumors together, about 50 to 70 out of every 100 (50 to 70%) will come back. But most of these will come back as early, non invasive bladder cancer. About 10 to 30 out of every 100 early bladder cancers (10 to 30%) will come back as cancer that has spread into the deeper layers of the bladder.

Surgery or radiotherapy will cure some of these cancers. But in some people the cancer will come back and need more treatment. Doctors cannot usually tell which cancers are likely to come back and which are likely to be cured. One of the most important factors is how far the cancer has grown into the wall of the bladder. For instance, a stage 3 or 4 cancer is more likely to come back than a stage 2 cancer.  If the cancer has spread into the lymph glands, the risk of it coming back is much higher.

Bladder cancer has the highest recurrence rate of any malignancy. Although most patients with bladder cancer can be treated with organ-sparing therapy, most experience either recurrence or progression, creating a great need for accurate and diligent surveillance

Reduce Chances of Re-occurrence

To try to reduce the chance of the cancer coming back, you are likely to have chemotherapy into your vein, as well as surgery or radiotherapy. In several large clinical trials, chemotherapy before surgery lowered the risk of recurrence for high risk invasive bladder cancers and improved outcomes slightly. Clinical trials in the UK are continuing to look into adding chemotherapy to radiotherapy for bladder cancer.