Does smoking cause bladder cancer? Well, that depends on why you’re asking

The easy, obvious answer is, yes, of course smoking causes bladder cancer. Consider these two statistics: smokers are three times more likely to get bladder cancer than nonsmokers and 50 percent of all bladder cancers are likely caused by smoking. (See this report from the National Institutes of Health.)

That’s the easy, obvious answer.

The more complicated answer is that smoking increases your risk for cancers of many kinds, with lung and bladder cancer leading the way. The bladder holds urine, which filters toxins from the body, and the repeated contact between the toxins from cigarettes and the bladder is a dangerous combination.

But, risk is not a personal thing. Risk is a statistical, big picture sort of thing. Statistics tell us about populations, trends, significant (statistically speaking) relationships. Statistics do not tell us about ourselves as individuals.

We don’t know, for instance, how many cigarettes it takes to increase your risk, but most doctors think in terms of pack-years: two packs a day for 10 years equals 20 pack years. Twenty pack years definitely puts you in the high risk category. Again, this is a statistical conclusion.

But, we all know people who have been heavy smokers for their entire lives who have never gotten cancer. My grandfather was a three-pack-a-day smoker for his adult life and he died in his 80s, free from cancer.

Even more importantly, however, we all know people who have died of bladder cancer who never smoked at all. They never lived with a smoker or hung out with smokers. They were healthy, fit, thin, runners, young.

Slide1So, the more complicated answer is that we don’t know what causes cancer. We know some things increase our risk, but cancer is a wily character. It can take hold of an otherwise healthy and hearty 20-year-old and kill them.

Here is the heart of the issue for me. We very much want to know that we’re safe and that we’re in control. If we emphasize the role that cigarettes play in bladder cancer, then we can safely place blame. You smoked and, therefore, you got cancer.

But inside your head you might be saying, “I don’t smoke, and therefore, I won’t get cancer.” And, that is why many people want to know if smoking causes bladder cancer. They want to feel safe. They want to feel that cancer follows a cause and effect model of behavior that can be controlled and regulated.

Don’t get me wrong. It’s stupid to smoke. Your health will improve almost immediately if you stop now. Please stop smoking now. I can’t tell you how much better I feel after 3 1/2 years without cigarettes.

You should also maintain a healthy weight, eat better and exercise…a lot. You’ll feel better now and, statistically speaking, live a better quality of life. Quite possibly, you’ll live a longer one.

But don’t think that you’re safe from cancer. Don’t think declaring “smoking causes cancer” means you’re safe because you never smoked.

And, ask yourself why you’re asking the question. Do you want to sift and sort so that you can put folks with cancer in a box labeled “guilty”?

If so, then you’re bound for heartache, because children get cancer. Young adults get cancer. Mothers with young children get cancer. Middle aged men get cancer. People you love and people like yourself get cancer.

This is why we need more research about treatments and more research about causes. This is why I’ll be walking in Chicago’s Amp Up! fundraiser this Saturday. Please join us. And, if you can, donate $5 to the Cancer is Not a Gift Team. I’m $35 short of my fundraising goal.

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Filed under: Bladder Cancer, Smoking

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