bladder cancerMetabolic syndrome – a set of conditions associated with higher diabetes risk – is being linked to more severe forms of bladder cancer. A new study conducted at a research hospital in Istanbul, Turkey analyzed the stage and grade of tumors in bladder surgery patients with and without metabolic syndrome.

Closely related to the development of diabetes, metabolic syndrome is characterized by five metabolic risk factors. These include a large waistline, high triglyceride level, low HDL cholesterol, high blood pressure and high fasting blood sugar. People with at least 3 of these risk factors are said to have metabolic syndrome and are at higher risk for eventually developing diabetes.

In the new Turkish study, 535 bladder cancer patients underwent transurethral resection of a bladder tumor between October 2005 and March 2011. All patients in the study had primary urothelial cell carcinoma (also called transitional cell carcinoma), the most common type of bladder cancer in diabetics. Eighty-six percent of the study subjects were men and almost 14 percent were women.

The researchers found that having metabolic syndrome or diabetes increased the likelihood that a patient’s bladder cancer would have spread farther (higher stage) and be of a faster-growing variety (higher grade). Summarizing these results in the Asian Pacific Journal of Cancer Prevention, lead author Dr. Emin Ozbek concludes, “The patients with metabolic syndrome were found to have statistically significant higher T stage and grade of bladder cancer.” He and his team recommend further studies to confirm the results.

Researchers used the TNM system to stage the bladder cancer cases. Bladder cancer was classified as higher stage if the cancer was higher than T1. The 2004 World Health Organization grading system, which classifies cancer cells based on how different they are from normal cells, was used to assign to a grade to tumors.

While little is known about the connection between metabolic syndrome and bladder cancer, a number of studies indicate an increased risk of bladder cancer among people with diabetes. The risk is even higher in diabetes patients who have taken a blood sugar regulator called Actos. Several recent studies have suggested that the longer a person is on Actos, the higher his or her bladder cancer risk.


Ozbek, E et al, “Association between the Metabolic Syndrome and High Tumor Grade and Stage of Primary Urothelial Cell Carcinoma of the Bladder”, 2014, Asian Pacific Journal of Cancer Prevention, pp. 1447-1451.

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