Chimie médicale

Prevention and Early Detection of Urologic Cancers: A Mini-Review

Abstract

Aoun Fouad and Alexandre Peltier

Urological cancers are among the commonest cancers in western countries. Progress in the domain of prevention and early detection of cancer is well known by researchers but studies have shown that advices for patients are sparse, inconsistent and even contradictory. The possible beneficial effects for prevention and early detection of urologic cancers are addressed in this mini-review. Emphasis will be placed on the role of alcohol and tobacco use, natural compounds, dietary supplements, early detection and pharmacological therapy on the risk of each urologic cancer. Most evidence suggests that alcoholic beverages contain a variety of carcinogenic contaminants that are introduced during fermentation and production. Many chemicals are present in tobacco smoke, including at least 69 known carcinogens. Smokeless tobacco, chewing tobacco and dipping snuff contains at least 28 carcinogens. Calorie restricted diet is associated with improvement of urologic cancer outcomes. Obesity is an established risk factor for kidney and prostate cancer. There is an association between obesity and cancer-specific mortality in bladder cancer. There is limited evidence indicating no association between physical activity and testicular or bladder cancers but a growing body of research suggests a modest risk reduction for kidney cancer and advanced prostate cancer. It seems to be no effect of lycopen and carbohydrates with prostate cancer chemoprevention. In addition, there is little evidence to support daily use of multivitamins to protect against urologic cancers. The tremendous potential benefits of catechins in tea, pomegranate, luteolin and flavanoid, needs further studies to confirm their role in urologic cancers chemoprevention. For medical agents, statins and 5 alpha reductases inhibitors are good candidates for future studies. Screening is not recommended for all urologic cancers except for prostate cancer where controversies remain. In contrast, opportunistic screening leads to early detection and decrease specific cancer mortality for almost all urologic cancers.