Quantitative Evaluation of Heavy Metals and Trace Elements in the Urinary Bladder: Comparison Between Cancerous, Adjacent Non-cancerous and Normal Cadaveric Tissue

Does the Presence of Heavy Metals Influence the Gene Expression and Oxidative Stress in Bladder Cancer?

Heavy metal toxicity is associated with cancer progression. Studies have reported the relation between some metal ions and bladder cancer (BC). Direct influence of such agents in bladder carcinogenesis is still needed. Total 49 BC patients were included in the study. Level of Pb, Cr, Hg and Cd, oxidative stress markers, and gene expression of Bcl-2, Bax, IL-6, AKT, and P38 genes were detected in cancer and non-cancerous tissues obtained from bladder cancer patients. Concentrations of Pb, Cr, and Cd were significantly elevated in cancer tissues than normal, while Hg level was significantly increased in normal tissue than cancer. MDA level was significantly higher and SOD activity was lower in the cancer tissues compared to non-cancerous. The expressions of Bcl-2, IL-6, AKT, and P38 were significantly increased in the cancer tissues than in normal tissues while Bax level was significantly increased in non-cancerous tissue than in cancer tissue. In cancer tissue, there were significant correlations between Cr level with expression of Bax, AKT, and P38 while Cd level was significantly correlate with Bax, IL-6, AKT, and P38expression. The correlation between Cr and Cd with the expression of Bax, IL-6, AKT, and P38 may indicate a carcinogenic role of these metals on progression of bladder cancer.

Serum Trace Element Levels in Cancer Patients Undergoing Chemotherapy: a Before-After Analysis

Trace elements (TEs) play a crucial role in metabolism through their biochemical and catalytic effects, and alterations in their levels have been observed in various malignancies. Given that chemotherapy is a common treatment for cancer, it is important to understand how it may affect the levels of TEs in the body. By investigating changes in TEs levels before and after chemotherapy, this study aims to provide insights into the potential impact of chemotherapy on TEs levels in cancer patients. In the present study, analyses were performed on the serum level of some elements including Zn, Cu, Cd, and Se in 69 patients with leukemia, lymphoma, prostate and breast cancers before and after three courses of chemotherapy. The serum TEs were measured by atomic absorption spectroscopy. The serum Zn levels in patients with leukemia, lymphoma, and breast cancer significantly decreased after chemotherapy (P < 0.05). Significant reductions were also observed in the post-chemotherapy serum level of Cd in patients with prostate (P = 0.020) and breast cancer (P = 0.013). Moreover, the Se serum level significantly decreased after chemotherapy compared to before it in the breast cancer patients (P < 0.001). In contrast, the serum level of Cu was higher before than after chemotherapy in all the patients, but no significant difference was found (P > 0.05). The results show that chemotherapy can alter the level of TEs. The assessment of TEs in cancer patients may provide information about the side effects of chemotherapy as well as the use of appropriate strategies to better manage the clinical conditions of patients.

Association Between Serum Cadmium and Arsenic Levels with Bladder Cancer: A Case-control Study

Background: Bladder cancer is the second most common cancer of the genitourinary system and the eighth cause of cancer death. In addition to known risk factors such as smoking and urinary stones, trace elements are also effective in causing bladder cancer and other cancers. Objectives: This study was conducted to determine the association between bladder cancer and the carcinogens cadmium and arsenic. Methods: This case-control study was conducted on 40 patients with bladder cancer admitted to Shahid Bahonar Hospital and a control group of 40 healthy individuals in Kerman, Iran, in 2018. The serum levels of arsenic and cadmium were measured by atomic absorptiometry. The paired t-test and chi-square tests were employed to assess the difference between cases and controls groups. An unadjusted and 2 multivariable conditional regression models were separately adjusted on sex, family cancer history, residence, occupation, and smoking and were used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) to assess the association between arsenic and cadmium levels and bladder cancer. The statistical software SPSS version 26 and R software version 3.6.3 were used to perform the statistical analyses. Results: The mean cadmium level was 2.99 ± 1.45 and 2.59 ± 0.46 in the case and control groups, respectively, with no statistically significant difference between the groups (P = 0.100). The mean arsenic level was 2.12 ± 1.04 and 1.43 ± 0.73 in the case and control groups, respectively, demonstrating a statistically significant difference between the groups (P = 0.001). Unadjusted and adjusted conditional logistic regression models indicated significant association between arsenic levels and bladder cancer (unadjusted: odds ratio (OR) (95% CI): 0.66 (0.46 - 0.94), P-value = 0.022; adjusted: OR (95% CI): 0.64 (0.44 - 0.92), P-value = 0.018). Conclusions: Overall, cadmium and arsenic levels are higher in patients with bladder cancer, with a statistically significant difference for arsenic. However, these elements are not interrelated and are not related to other factors.

Quantitative and qualitative evaluation of toxic metals and trace elements in the tissues of renal cell carcinoma compared with the adjacent non-cancerous and control kidney tissues

Toxic metals and trace elements (TMTE) are linked to the development of several human cancers. Many reports have documented the association between some TMTE and renal cell carcinoma. In this work, we assessed the presence (qualitative) and evaluated the concentration (quantitative) of 22 TMTE in three groups of kidney tissue samples: renal cell carcinoma (RCC), adjacent non-cancerous, and control kidney tissues from cadavers. A total of 75 paired specimens of RCC and adjacent non-cancerous tissues were harvested immediately after radical nephrectomy and preserved in 10% diluted formalin solution. Twelve specimens, age- and sex-matched from the normal kidney tissue of the cadavers, who died from non-cancerous reasons, were collected and served as control. All tissue specimens were subjected to evaluation of TMTE concentration (22 elements in each specimen) by using the inductively coupled plasma optical emission spectrometry (ICP-OES) technique. The tumor, histopathology, stage, and grade were correlated with the concentration and types of TMTE. The results showed that the histological types of RCC were as follows: clear cell type in 35 (21.5%), chromophobe 22 (13.5%), papillary 7 (4.5%), oncocytoma 5 (3.1%), and unclassified 6 (3.7%). ICP-OES revealed that tumorous (RCC) tissues had a higher concentration of 9 TMTE (Ca, Cd, K, Mg, Mn, Na, Pb, S, and Sr) compared with both the adjacent non-cancerous and control tissue. The adjacent non-cancerous kidney tissues showed the highest concentration of Fe, K, and Na. The control of kidney tissues from cadavers had the highest level of Cu, Zn, Mo, and B compared with the cancerous and adjacent non-cancerous tissues. Female patients had higher concentrations of Zn and Cu in the non-cancerous tissues of their kidneys. Younger patients had a higher concentration of B in the adjacent non-cancerous, and higher Cu in the cancerous tissues. Cadmium concentration was highest in the chromophobe cell type of RCC compared with other subtypes. There was no correlation between the TMTE concentration and the pathological stage of RCC.

Prevention of bladder cancer incidence and recurrence: nutrition and lifestyle

PURPOSE OF REVIEW

We review the influence of nutrition and lifestyle on bladder cancer incidence and recurrence and summarize food items, diets and lifestyle practices that physicians may wish to prioritize for discussion with their patients.

RECENT FINDINGS

Recent study results suggest an association between bladder cancer incidence and several food items including meat, fruit, vegetables, milk products and oil. Micronutrient deficiency is associated with bladder cancer risk; however, it remains unclear if micronutrient supplementation can modify bladder cancer incidence. Furthermore, total fluid intake, alcohol, coffee and tea seem to have no influence on bladder cancer incidence. There is weak evidence that stress, anxiety and lack of sleep may increase the risk of developing bladder cancer, whereas exercise may reduce the risk of dying from it.

SUMMARY

Several dietary items and life styles are associated with bladder cancer incidence and recurrence. However, besides smoking cessation, there is no evidence that a certain diet or lifestyle can decrease bladder cancer incidence.

Diagnostic potential of major and trace elements in the serum of bladder cancer patients

Major and trace elements may play a role in the diagnosis of diseases. In this study, we investigated the concentration of 26 major and trace elements in the serum by inductively coupled plasma (ICP) - optical emission spectrometry (OES) and ICP-sector field-mass spectrometry (sf-MS). We analyzed the serum from a discovery cohort of 6 bladder cancer (BCa) patients and 12 healthy controls as well as from a validation cohort of 21 BCa patients, 29 non-tumor bladder patients (with acute and chronic inflammation) and 18 healthy controls. Patients were recruited after written consent was obtained at one medical center. Serum was prepared from peripheral blood prior to surgical treatment. Differences in the levels of major and trace elements were determined by a nonparametric Mann-Whitney test and Kruskal-Wallis statistics. In the discovery cohort, we measured significantly increased levels of calcium, mercury, potassium, lithium, nickel, phosphorus and strontium and a significantly decreased level of sodium in BCa patients compared with healthy controls. These findings were reassessed in our validation cohort. We measured significantly increased levels of boron, calcium, cadmium, copper, chromium, lead, lithium, potassium, magnesium, nickel, sulfur, strontium, titan, vanadium and zinc and significantly decreased levels of iron and molybdenum. When we studied the concordance for the discovery and validation cohorts, concentrations of five elements were detected as significantly increased in BCa patients compared with healthy controls: calcium, lithium, potassium, nickel, and strontium. Interestingly, the levels of three elements (calcium, potassium and strontium) were also significantly increased in non-tumor bladder patients compared with healthy controls. But no element was significantly altered between non-tumor bladder patients and BCa patients. In summary, we suggest that determination of the elements calcium, lithium, nickel and strontium in the serum could be a new and promising tool for the early diagnosis of BCa.