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Symptoms & Treatment of Bladder Cancer

Actos bladder cancer patient with nurseIn 2011, the Federal Drug Administration issued a warning that taking the diabetes drug Actos for more than one year may increase the risk of bladder cancer.

Actos, a brand name for pioglitazone, is prescribed to control blood sugar in patients with Type 2 diabetes. As a thiazolidinedione-type drug, or one of the “glitazones”, it acts by increasing insulin sensitivity – it is not an insulin supplement; rather, it allows the body to make better use of the insulin that it naturally produces.

While diabetes patients need to control blood sugar levels in order to avoid diabetic complications like neuropathy and heart disease, overwhelming evidence suggests that the risks of Actos outweigh the benefits. According to one study, patients who take Actos for more than two years are twice as likely to develop bladder cancer. Another study shows links the use of Actos for any length of time with an 83% increased risk of bladder cancer.  The risk of bladder cancer for Actos users is so great that both France and Germany have banned the drug.

Symptoms of bladder cancer

Anyone who has taken Actos should be aware of the signs and symptoms of bladder cancer.

It is important to see a doctor as soon as possible if any of the following are experienced:

  • Blood in urine – this may appear to the naked eye as dark or cola-colored urine or may only visible under a microscope
  • Frequent or painful urination
  • Back pain
  • Pelvic pain

Types of bladder cancer

Cancer develops when cells begin growing excessively and threaten to invade other areas of the body. Cancers that start in epithelial cells are termed carcinomas.

There are three main types of carcinomas known as bladder cancer:

  • Transitional cell carcinoma – the most common type of bladder cancer. Transitional cells are the cells that line the bladder, ureters, and urethra. They allow the bladder to expand when full and contract when empty.
  • Squamous cell carcinoma – a rare form of bladder cancer. Squamous cells arrive in the bladder to fight infections. This type of cancer is more common in other parts of the world where certain parasites are found.
  • Adenocarcinoma – another rare form of bladder cancer. It begins in glands in the bladder that secrete mucous.

Treatment of bladder cancer

The treatment of bladder cancer depends on its stage, or level of advancement. In general, stages and methods of treatment include:

  • Stage 0 – has not invaded the bladder wall. Often treated with a type of surgery known as transurethral resection.
  • Stage I – cancer cells have grown into the connective tissues of the bladder but not into the muscle. Typically first treated with transurethral resection and, if it is believed that all of the tumor has been removed, followed by intravesical therapy. Intravesical therapy is a treatment with liquid drugs. They are administered so that they only affect cancer cells in the bladder lining so this treatment is reserved for cancers that have not spread past the immediately surrounding tissues.
  • Stage II – cancer has spread into the muscle layer of the bladder wall. Transurethral resection is the common first treatment but it is performed as an investigation rather than as a cure. Treatment at this stage often involves chemotherapy and partial or complete removal of the bladder (a “cystectomy”) and lymph nodes.
  • Stage IV – cancer has spread to lymph nodes or other distant parts of the body. At this stage, it is uncommon to be able to completely remove the tumors with surgery so more often chemotherapy and/or radiation treatment is used to slow the spread.

Legal recourse available to Actos patients

Anyone who is taking or has taken Actos to control blood sugar should be aware of the signs of bladder cancer. If any of the symptoms are present, it is critical to speak to a doctor as soon as possible.

There may also be compensation available for Actos users who develop bladder cancer. Thousands of plaintiffs across the country have sued Takada Pharmaceuticals USA Inc., the drug manufacturer, on claims that it hid the risk of bladder cancer from consumers and medical professionals.

Actos lawsuits also name as a defendant Eli Lilly and Company, which has marketed and sold Actos in the United States by for over a decade. Statutes of limitations limit the time that patients injured by Actos have to file a lawsuit so anyone who does or may have a claim should consult with a lawyer to discuss their rights as soon as possible.

  1. U.S. Food & Drug Administration, FDA Drug Safety Communication: Update to ongoing safety review of Actos (pioglitazone) and increased risk of bladder cancer,
  2. Mayo Clinic, Bladder cancer: Symptoms,
  3. Mayo Clinic, Bladder cancer: Causes,
  4. American Cancer Society, Treatment of Bladder Cancer by Stage,