title: [Secondary prevention in patients with superficial urothelial carcinoma].
abstract: BACKGROUND
  Urothelial cancer is the 4th most common cancer in men and the 7th most common malignancy in women in Germany. 95 % of all tumors of the urinary bladder are urothelial carcinomas. At the time of diagnosis approximately 80 % of these carcinomas are not invasive. The affection is often multicentric. Approximately 10-15 % of the tumors develop into muscle-invasive growth. In this prospective study, we analyzed measures patients independently took to reduce their risk of bladder cancer recurrence.
  
  
  METHODS
  During the period January 2012 to December 2013, we surveyed a total of 97 patients with superficial transitional cell carcinoma (pTa). The question was how far the diagnosis of urothelial cancer has changed their lives, eating and drinking habits or whether follow-up consultations had been carried out regularly. Furthermore, we recorded whether they accepted psychological care or had autonomously adopted prophylactic measures, as well as changed their smoking habits, if they had smoked.
  
  
  RESULTS
  Of the 97 patients questioned, there were 79 men and 18 women (56 smokers and 41 nonsmokers). The median age was 71 years (range 36-96 years). For 22 patients (22.7 %), the diagnosis resulted in no changes. In 33 patients the changes were small (44 %), moderate in 20 (26.7 %), in 14 (18.6 %) strong and very strong in 8 (10.7 %). A total of 25 patients (25.8 %) changed their eating habits. In all, 49 patients changed their drinking habits; 48 patients claimed to drink more (> 2.0 L/day). One patient reduced his drinking amount. Regarding smoking, 40 patients (71.4 %) had stopped and 7 (12.5 %) reduced consumption, while 6 patients (10.7 %) had not changed their smoking habits. Overall, 44 patients (45.4 %) changed their physical activity: 11 (25 %) exercised more, 8 (18.1 %) less. Only 3 patients (3.1 %) used psycho-oncological care and 39 (40.2 %) patients used supportive/complementary medicine measures of favorablly influence their disease (mistletoe therapy, vitamin supplements). In addition, 22 patients (22.7 %) sought advice from their physician. However, 45.4 % of all patients did not believe in the success of their measures taken.
  
  
  CONCLUSIONS
  Of all patients diagnosed with urothelial carcinoma, 77.3 % reported a change in their living habits and they were willing to take specific steps, such as giving up smoking, being more physically active, changing drinking and eating habits in order to positively influence their disease. However, almost half of the patients (45.4 %) did not believe in a resounding success of their measures taken.
authors.affiliation: Abteilung Urologie und Kinderurologie, Universitätsklinikum Ulm, Prittwitzstraße 43, 89075, Ulm, Deutschland, thomas.schnoeller@gmail.com.
authors.forename: T J
authors.initials: TJ
authors.lastname: Schnöller
authors.forename: F
authors.initials: F
authors.lastname: Zengerling
authors.forename: C
authors.initials: C
authors.lastname: Hirning
authors.forename: F
authors.initials: F
authors.lastname: Jentzmik
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000529:Complementary Therapies / Q000523:psychology / Q000706:statistics & numerical data; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005858:Germany / Q000453:epidemiology; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention / Q000706:statistics & numerical data*; D012907:Smoking / Q000453:epidemiology; D016540:Smoking Cessation / Q000379:methods / Q000523:psychology; D016896:Treatment Outcome; D014571:Urologic Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology*