CANCER OF THE BLADDER

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Abstract
T HERE are three aspects of urothelial tumors of contemporary interest. The first is the initiation of tumors due to the exposure of workmen to an environment containing carcinogenic substances. The second is the problem of multifocal uro-. thelial disease, whether it be due to im- plantation of exfoliated cells, the presence ofcarcinogens in the urine, or other factors. The third is the problem of infiltration which may be iatrogenic due to bad sur- gery, possibly due to a chromosomal abnormality, but which is of bad prog- nostic significance. INITIATION OF INDUSTRIAL ORIGIN involved in the processes of manufacture of aniline in a dye factory developed tumors in their bladder as the result of exposure to aniline. This original observa- tion (but unfortunate concept) of an "aniline dye tumor" crept into clinical use and the idea that aniline was the sole causative factor acted as a screen to delay the search for the real carcinogenic agent. Hueper in 1938 showed that $-naphthyl- amine, the intermediate compound in the preparation of dyes, was carcinogenic to dogs, and at this time suspicion was aroused that tumors occurring in men em- ployed in various industries could be the result of exposure to industrial chemicals. Events during thenext few yearsprevented furtherresearch,but in 1949 the Imperial Chemical Industry voluntarily ceased man- ufacture of /3-naphthylamine in England and withdrew all known stocks of this chemical. During the last two years the manufacture of benzidine and of a-naph- thylamine have also been stopped in England, but not in America.6

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