Bladder Cancer: The Hormonal Dependence Enigma And A New Hormonal Player

The letter to the editor discusses the potential hormonal dependence of bladder cancer, which has traditionally been considered hormone-independent. The authors highlight several pieces of evidence suggesting that sex hormones may play a role in the etiology or progression of bladder cancer. They note that men have a higher incidence of bladder cancer than women, even when accounting for common risk factors. Changes in bladder tissue during pregnancy and menopause, the expression of hormone receptors in bladder tissues, and the effects of hormones on bladder cancer development in animal models and human cell lines are all cited as indications of hormonal influence. The authors also report the case of a 65-year-old woman who developed urothelial carcinoma following adjuvant hormonal therapy with an aromatase inhibitor for breast cancer. They propose that the androgenic environment created by the aromatase inhibitor, in the absence of counterbalancing hormones, may contribute to bladder cancer development. The letter concludes that more research is needed to determine the exact role of sex hormones in bladder cancer and suggests that aromatase inhibitors could be a significant factor in the development of bladder cancer in postmenopausal women.