Childhood Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI]

Clinical Presentation and Risk Factors

Urothelial bladder neoplasms are extremely rare in children. The most common presenting symptom of bladder cancer in children is hematuria.[1,2] Bladder tumors can present throughout the pediatric age range. In one small series, the mean age was 11.9 years (range, 4–19 years).[3] In another study, patients were aged between 16 months and 19 years. Most of the bladder tumors occurred in males.[4]

Bladder cancer in adolescents may develop as a result of exposure to alkylating-agent chemotherapy that was given to treat other childhood tumors or leukemia.[5,6,7,8] The association between cyclophosphamide exposure and bladder cancer is one of the only established relationships between a specific anticancer drug and a solid tumor.[9] An excess prevalence of bladder tumors has also been observed in survivors of specific cancer types (e.g., heritable retinoblastoma), supporting the concept that genetic factors contribute to the development of subsequent neoplasms.[10]

References:

1. Saltsman JA, Malek MM, Reuter VE, et al.: Urothelial neoplasms in pediatric and young adult patients: A large single-center series. J Pediatr Surg 53 (2): 306-309, 2018.
2. Rezaee ME, Dunaway CM, Baker ML, et al.: Urothelial cell carcinoma of the bladder in pediatric patients: a systematic review and data analysis of the world literature. J Pediatr Urol 15 (4): 309-314, 2019.
3. Galiya R, Stanislav K, Jawdat J, et al.: Pediatric urothelial bladder neoplasm. J Pediatr Urol 18 (6): 833.e1-833.e4, 2022.
4. Shumaker AD, Harel M, Gitlin J, et al.: Pediatric Bladder Tumors: A Ten-Year Retrospective Analysis. Urology 169: 185-190, 2022.
5. Di Carlo D, Ferrari A, Perruccio K, et al.: Management and follow-up of urothelial neoplasms of the bladder in children: a report from the TREP project. Pediatr Blood Cancer 62 (6): 1000-3, 2015.
6. Ritchey M, Ferrer F, Shearer P, et al.: Late effects on the urinary bladder in patients treated for cancer in childhood: a report from the Children's Oncology Group. Pediatr Blood Cancer 52 (4): 439-46, 2009.
7. Travis LB, Curtis RE, Glimelius B, et al.: Bladder and kidney cancer following cyclophosphamide therapy for non-Hodgkin's lymphoma. J Natl Cancer Inst 87 (7): 524-30, 1995.
8. Kersun LS, Wimmer RS, Hoot AC, et al.: Secondary malignant neoplasms of the bladder after cyclophosphamide treatment for childhood acute lymphocytic leukemia. Pediatr Blood Cancer 42 (3): 289-91, 2004.
9. Johansson SL, Cohen SM: Epidemiology and etiology of bladder cancer. Semin Surg Oncol 13 (5): 291-8, 1997 Sep-Oct.
10. Frobisher C, Gurung PM, Leiper A, et al.: Risk of bladder tumours after childhood cancer: the British Childhood Cancer Survivor Study. BJU Int 106 (7): 1060-9, 2010.