Fight Bladder Cancer by Treating OSA

If you have been diagnosed with bladder cancer, and you have trouble sleeping — and maybe you have had this trouble with sleep for a while — you may want to look into a hidden case of obstructive sleep apnea (OSA). Bladder cancer does not cause OSA, nor does having OSA directly cause bladder cancer.

However, both bladder cancer and OSA are common enough to suggest there is a reasonable chance for a crossover between both illnesses.

The statistics do not lie

The American Cancer Society estimates nearly 84,000 new cases of bladder cancer will be diagnosed in the US in 2021.¹ Meanwhile, research published in 2019 suggests that as many as 24 million people in the US live with moderate to severe OSA, with another 54 million living with mild OSA.² The odds favor the unpleasant reality: that OSA may be a problematic, but treatable, co-condition in someone with bladder cancer.

The link between cancer and sleep health

Researchers confirmed associations between OSA and cancer mortality ten years ago: the more severe the OSA, the higher the risk of death from cancer.³

Certain kinds of sleep disorders, when left untreated, may become risk factors for developing certain kinds of cancer.⁴ This is due to the nature of sleep as a whole-body process. Sleep, or lack of it, can literally affect the very function of our cells.

Meanwhile, cancer itself, and its treatments, may also affect sleep. This can be an immediate concern, as well as a long-lasting one. Many cancer survivors are left with lingering sleep disorders as a consequence of their illness.⁴

Obstructive sleep apnea and bladder cancer

OSA describes a breathing disorder during sleep in which the upper airway collapses, leading to long pauses in breathing that can alter the blood's oxygen levels.

Hypoxia

These long pauses, or apneas, create a condition known as hypoxia. It is this problem of hypoxia that intersects with the problem of living with and treating bladder cancer. If OSA goes untreated, how will that impact a case of bladder cancer?

Hypoxia’s influence

Hypoxia leads to inflammation and can change the way immune cells function, leading to cellular distress, and the creation of a cancer-conducive environment.⁵

Tissue hypoxia, lowered oxygen levels in the tissue, set the stage for conditions that allow cancer cells to multiply, grow, and spread.⁶ Additionally, a potential dampening effect on therapy can also occur. Tumor cells thrive in hypoxic microenvironments, making them more resistant to cancer treatments.⁷

Identifying and treating OSA

Often, people go years feeling tired all day long without realizing that they have OSA. Some common symptoms of OSA besides daytime sleepiness include:

• Witnessed struggles with breathing during sleep, eg. gasping, choking, coughing
• Very loud and frequent snoring
• Treatment-resistant high blood pressure
• Insulin resistance
• Frequent awakenings
• Awakening with a pounding heart and/or heavy sweating
• “Snorting” oneself awake
• Frequent nocturnal urination, defined as going to the bathroom two or more times a night⁸

Fight bladder cancer by treating OSA

If you have any of these symptoms a discussion with your doctor may be in order. Sleep disorder testing for OSA may be as simple as a small sleep apnea test you conduct in the privacy of your own home. This test can identify most cases of sleep apnea in people who qualify for the test.

Most people can usually receive this test, but an in-lab test may be ordered. This comprehensive diagnostic procedure serves as an even more accurate test.

PAP for the win

If you are diagnosed with OSA, chances are good you will be given a PAP (positive airway pressure) machine for therapy. It is considered the "gold standard" treatment for OSA because it has been shown over decades of research to be the most effective at preventing apneas.

Most likely you will start with continuous PAP, otherwise known as CPAP, but some people will be treated with automated PAP (APAP) or bilevel PAP (bi-PAP).

Generally speaking, PAP works as a mechanical device that gently splints open the upper airway by delivering a warm, moist stream of pressurized air through a soft mask worn over the nose.

Preventative vs. reactive treatment

PAP prevents the apneas which lead to hypoxia. By doing this, your immune system and tissues will maintain adequate oxygen levels, making the environment less friendly to tumors while supporting your bladder cancer treatments.

On a personal note

Treating OSA also reduces systemic inflammation, an immune system response that allows for the growth and progression of tumors.

A person with both bladder cancer and OSA, who treats their OSA, will find they are less tired during the day and able to get longer periods of restful sleep at night, which is critical for treatment success.