2 drugs that may cause bladder cancer

One of the causes of bladder cancer is drugs. There are two main types of drugs that can cause bladder cancer:

1. Phenacetin: Phenacetin is a derivative of aniline. It can form o-hydroxyaminophenol during metabolism and has carcinogenic effects. Long-term abuse of phenacetin can indeed increase the incidence of urothelial carcinoma. The use of phenacetin analgesics causes phenacetin nephropathy, which has long been known to people. 5% to 10% of phenacetin nephropathy patients can further develop urothelial carcinoma, mainly in the upper urinary tract. Fokken (1997) first reported that phenacetin induces bladder cancer. The occurrence of bladder cancer is related to the amount of phenacetin ingested. For those who ingest 5 to 15 kg in 10 years, that is, >1g per day, the risk of bladder cancer increases by 2 to 4 times, and the incubation period is as long as 15 to 20 years; small doses are occasionally used, and the total dose does not exceed 2g, and there is no obvious risk of carcinogenesis.

2. Cyclophosphamide: Hydroxylation substances are produced during the metabolism of cyclophosphamide. The metabolites are mainly excreted in the urine and act on the urothelium, which can induce the occurrence of urothelial cancer. About 30% of patients who use cyclophosphamide to treat lupus erythematosus and rheumatoid arthritis develop bladder cancer, and the risk of bladder cancer is 9 times higher than those who do not use the drug. The risk and latency of bladder cancer are related to the dosage, duration and method of taking the drug. A group of experiments were conducted on 31 patients who developed bladder cancer after taking cyclophosphamide for a long time. The dosage used was 8 to 285g, with an average of (14±85)g. The average interval from the start of drug use to the occurrence of cancer was (6.5±3.3) years. The longer the medication time, the higher the incidence rate. Most of the cancers did not occur during the medication period, but occurred 10 years after stopping the medication. Cyclophosphamide and acrolein were detected in the patient's urine during the medication period. It was also observed that bladder mucosal epithelial necrosis occurred within 24 hours of medication, followed by epithelial regeneration and proliferation, indicating that the bladder may be carcinogenic due to the hydroxylation of cyclophosphamide metabolites.