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01-08-2010 | Original Article

Arsenic exposure predicts bladder cancer survival in a US population

Authors: Ryan C. Kwong, Margaret R. Karagas, Karl T. Kelsey, Rebecca A. Mason, Sam A. Tanyos, Alan R. Schned, Carmen J. Marsit, Angeline S. Andrew

Published in: World Journal of Urology | Issue 4/2010

Abstract

Purpose

Chronic arsenic exposure at levels found in US drinking water has been associated with bladder cancer. While arsenic is a known carcinogen, recent studies suggest that it is useful as a therapeutic agent for leukemia. This study examined the relationship between arsenic exposure and bladder cancer mortality.

Methods

We studied 832 cases of bladder cancer diagnosed in New Hampshire from a population-based case–control study. Individual exposure to arsenic was determined in home drinking water using ICP-MS and in toenail samples by instrumental neutron activation analysis.

Results

Among the high arsenic exposure group, found using toenail arsenic level or arsenic consumption, cases experienced a de-escalated survival hazard ratio (HR) [high (≥75 percent) versus low (<25th percentile) toenail arsenic overall survival HR 0.5 (95% CI 0.4–0.8)], controlled for tumor stage, grade, gender, age and treatment regimen. This association was found largely among invasive tumors, in smokers and was not modified by TP53 status. Bladder cancer cause-specific survival showed a similar trend, but did not reach statistical significance [HR 0.5 (95% CI 0.3–1.1)].

Conclusions

Arsenic exposure may be related to the survival of patients with bladder cancer.

Council NR (1999) Arsenic in drinking water. National Academy Press, Washington

Karagas MR, Tosteson TD, Morris JS et al (2004) Incidence of transitional cell carcinoma of the bladder and arsenic exposure in New Hampshire. Cancer Causes Control 15:465–472CrossRefPubMed

Andrew AS, Burgess JL, Meza MM et al (2006) Arsenic exposure is associated with decreased DNA repair in vitro and in individuals exposed to drinking water arsenic. Environ Health Perspect 114:1193–1198CrossRefPubMed

Kapaj S, Peterson H, Liber K et al (2006) Human health effects from chronic arsenic poisoning–a review. J Environ Sci Health A Tox Hazard Subst Environ Eng 41:2399–2428PubMed

Rossman TG (2003) Mechanism of arsenic carcinogenesis: an integrated approach. Mutat Res 533:37–65PubMed

Hu J, Fang J, Dong Y et al (2005) Arsenic in cancer therapy. Anticancer Drugs 16:119–127CrossRefPubMed

Sun H, Ma L, Hu X (1992) Ai-lin 1 treated 32 cases of acute promyelocytic leukemia. Chi J Integrat Chin West Med 12:170–172

Zhu XH, Shen YL, Jing YK et al (1999) Apoptosis and growth inhibition in malignant lymphocytes after treatment with arsenic trioxide at clinically achievable concentrations. J Natl Cancer Inst 91:772–778CrossRefPubMed

Murgo AJ (2001) Clinical trials of arsenic trioxide in hematologic and solid tumors: overview of the National Cancer Institute Cooperative Research and Development Studies. Oncologist 6(Suppl 2):22–28CrossRefPubMed

10.

Maeda H, Hori S, Ohizumi H et al (2004) Effective treatment of advanced solid tumors by the combination of arsenic trioxide and l-buthionine-sulfoximine. Cell Death Differ 11:737–746CrossRefPubMed

11.

Pu YS, Hour TC, Chen J et al (2002) Arsenic trioxide as a novel anticancer agent against human transitional carcinoma-characterizing its apoptotic pathway. Anticancer drugs 13:293–300CrossRefPubMed

12.

Tsai YS, Tzai TS, Chow NH et al (2003) Prognostic values of p53 and HER-2/neu coexpression in invasive bladder cancer in Taiwan. Urol Int 71:262–270CrossRefPubMed

13.

Kelsey KT, Hirao T, Schned A et al (2004) A population-based study of immunohistochemical detection of p53 alteration in bladder cancer. Br J Cancer 90:1572–1576CrossRefPubMed

14.

Jung I, Messing E (2000) Molecular mechanisms and pathways in bladder cancer development and progression. Cancer Control 7:325–334PubMed

15.

Karagas MR, Tosteson TD, Blum J et al (2000) Measurement of low levels of arsenic exposure: a comparison of water and toenail concentrations. Am J Epidemiol 152:84–90CrossRefPubMed

16.

Kelsey KT, Hirao T, Hirao S et al (2005) TP53 alterations and patterns of carcinogen exposure in a US population-based study of bladder cancer. Int J Cancer 117:370–375CrossRefPubMed

17.

Marsit CJ, Karagas MR, Andrew A et al (2005) Epigenetic inactivation of SFRP genes and TP53 alteration act jointly as markers of invasive bladder cancer. Cancer Res 65:7081–7085CrossRefPubMed

18.

Zhu J, Chen Z, Lallemand-Breitenbach V et al (2002) How acute promyelocytic leukemia revived arsenic. Nat Rev Cancer 2:705–713CrossRefPubMed

19.

Andrew AS, Mason RA, Memoli V et al (2009) Arsenic activates EGFR pathway signaling in the lung. Toxicol Sci 109(2):169–171CrossRef

20.

Herbst RS, Fukuoka M, Baselga J (2004) Gefitinib—a novel targeted approach to treating cancer. Nat Rev Cancer 4:956–965CrossRefPubMed

21.

Chen CH, Chiou HY, Hsueh YM et al (2009) Clinicopathological characteristics and survival outcome of arsenic-related bladder cancer in Taiwan. J Urol 181:547–552 (discussion 553)CrossRefPubMed

22.

Tan LB, Chen KT, Guo HR (2008) Clinical and epidemiological features of patients with genitourinary tract tumour in a Blackfoot disease endemic area of Taiwan. BJU Int 102:48–54CrossRefPubMed

23.

Pu YS, Hour TC, Chen J et al (2002) Cytotoxicity of arsenic trioxide to transitional carcinoma cells. Urology 60:346–350CrossRefPubMed

24.

Chen GQ, Shi XG, Tang W et al (1997) Use of arsenic trioxide (As2O3) in the treatment of acute promyelocytic leukemia (APL): I. As2O3 exerts dose-dependent dual effects on APL cells. Blood 89:3345–3353PubMed

25.

Kitareewan S, Roebuck BD, Demidenko E et al (2007) Lysosomes and trivalent arsenic treatment in acute promyelocytic leukemia. J Natl Cancer Inst 99:41–52CrossRefPubMed

26.

Park WH, Seol JG, Kim ES et al (2000) Arsenic trioxide-mediated growth inhibition in MC/CAR myeloma cells via cell cycle arrest in association with induction of cyclin-dependent kinase inhibitor, p21, and apoptosis. Cancer Res 60:3065–3071PubMed

27.

Liu J, Lu Y, Wu Q et al (2008) Mineral arsenicals in traditional medicines: orpiment, realgar, and arsenolite. J Pharmacol Exp Ther 326:363–368CrossRefPubMed

28.

Soucy NV, Ihnat MA, Kamat CD et al (2003) Arsenic stimulates angiogenesis and tumorigenesis in vivo. Toxicol Sci 76:271–279CrossRefPubMed

29.

Straub AC, Stolz DB, Ross MA et al (2007) Arsenic stimulates sinusoidal endothelial cell capillarization and vessel remodeling in mouse liver. Hepatology 45:205–212CrossRefPubMed

30.

Ostrosky-Wegman P, Gonsebatt ME, Montero R et al (1991) Lymphocyte proliferation kinetics and genotoxic findings in a pilot study on individuals chronically exposed to arsenic in Mexico. Mutat Res 250:477–482PubMed

Title: Arsenic exposure predicts bladder cancer survival in a US population
Authors: Ryan C. Kwong
Margaret R. Karagas
Karl T. Kelsey
Rebecca A. Mason
Sam A. Tanyos
Alan R. Schned
Carmen J. Marsit
Angeline S. Andrew
Publication date: 01-08-2010
Publisher: Springer-Verlag
Published in: World Journal of Urology / Issue 4/2010
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-009-0477-y

At a glance: The STEP trials

Springer Medicine

Arsenic exposure predicts bladder cancer survival in a US population

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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