Smoking: The path to bladder and kidney cancer

It’s well known that each puff can cost your life. A precaution that is often emphasised when overcoming urinary problems is avoiding smoking. Cigarettes involve distinct kinds of harmful chemicals in it, with each puff having the ability to damage every cell of the body. Smoking is known to be the leading cause of bladder and kidney cancers, say experts.

Dr Andrew Steinberg, Urologist, Montreal Quebec, Canada says that smoking is often considered to have ill-effects on just the heart and lungs. “However, we should not ignore its impact on the urinary system, consisting of bladder and kidney. Smoking is a big risk factor for bladder cancer,” he said. 

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Effect on bladder walls

Dr Srikanth V, urologist, Urocare Clinic, Bengaluru, explained, “Smoking can increase the risk of interstitial cystitis (abnormality in the mucosal layers of the bladder wall) as smoking damages the mucosal layer of the bladder, leading to symptoms such as frequent urination with urgency to urinate, and pain in the bladder area.”

“Tobacco present in cigarettes consists of around 200 chemicals, amongst which ‘nicotine’ is an addictive molecule. On chronic exposure (long-time duration) to this chemical, the individual can become susceptible to bladder cancer and kidney cancer,” says Dr Varun Kumar S, Radiation Oncologist, Bengaluru.

Science behind the harm

“Endothelium is the inner layer of the blood vessels. Smoking can damage this layer. The endothelial damage leads to blockages in vessels, which in turn leads to organ damage including kidneys. In kidneys, filtration reduces over a period of time due to smoking, which means the required nutrients are not efficiently reabsorbed by the kidneys and flushed out through urine,” says Dr Moideen Nafseer, consultant urologist and director, Mangala kidney foundation, Mangaluru.

“Cancer causing agents, known as carcinogens, can cause a sudden change or alteration in the cell. This change is termed as mutation. The kidneys filter all carcinogens from the cigarettes and put them in the urine. This exposes the kidneys to those carcinogens and causes kidney cancer. Once the urine travels down the ureters to the bladder, the carcinogens have “contact time” (time duration while the carcinogens are exposed to an organ) with the bladder, which causes a series of mutations in the cell linings of the bladder that are in contact with the urine. The cells undergo multiple mutations over time, which then turns into bladder cancer,” said Dr Ariel Moradzadeh, Urologist, Marina del Rey, U.S.

Symptoms of bladder cancer and kidney cancer

Bladder cancer

Urge to urinate increases, frequent urination and passage of blood at the end of urination, and amorphous blood clots (round shaped blood clots) in urine.

Kidney cancer

Passage of blood throughout urination (total hematuria) and thread like blood clots in urine.

Early Symptoms indicating cancer

• Hematuria – blood in urine
• Weight loss
• Pain in abdominal region

Tests to identify kidney damage

• Ultrasound scan – kidneys are scanned 
• Serum creatinine test – blood sample collected for the test
• Urine protein assessment – urine sample collected for the test
• Urine routine – to observe the cells in hematuria
• Biopsy- examination of cells
• Cystoscopy – invasive method to examine bladder and urethra
• PET CT – Positron emission tomography-computed tomography is a type of scanning technique used for diagnosis

Takeaways

• The stress that the urinary system goes through due to smoking is difficult for the body to handle. The carcinogens affect the cells and mutations lead to cancers.  
• Avoid smoking, practice Kegel exercises to strengthen pelvic muscles, practice distributed consumption of water throughout the day, avoid bladder irritants such as citrus fruits, coffee, tea and so on and continue medications (bladder relaxants) prescribed by the doctors.