On September 17, the U.S. Food and Drug Administration announced that long-term use of the diabetes drug Acto, or pioglitazone, was associated with sn elevated risk of bladder cancer in patients with type 2 diabetes mellitus.

The FDA said it has not concluded that the use of the Actos is the cause for the increased risk of bladder cancer.  However, the agency cited animal studies and two 3-year controlled clinical studies of Actos suggested that using Actos can potentially boost the risk of this malignancy in patients with type 2 diabetes mellitus.

The FDA announced that it will post more information on the safety issue of Actos when available. The Agency has advised that doctors should follow the current recommendations to prescribe the drug and diabetes patients should not discontinue taking the drug if they are taking the medicine.

So what is bladder cancer? Bladder cancer is a tumor that forms in tissues of the bladder - the organ that stores urine.

Bladder cancer is expected to be diagnosed in 52,760 men and 17,770;14,680 men and women in the United States will die of the urinary bladder cancer in 2010, according to the National Cancer Institute. 

Bladder cancer is more commonly diagnosed in white men (40.4 per 100,000) and white women (9.8 per 100,000) than in Asian Americans (16 per 100,000 for men and 4 per 100,000 for women) and American Indians (13 per 100,000 for men and 3.2 per 100,000). The rates of death from the cancer are similarly distributed among the races.

Different stages of bladder cancer result in different survival rates.  If the cancer has spread, the 5-year survival rate will be no more than 5.6 percent, while 96.6 percent of in situ bladder cancer cases, which account for 50 percent of all cases, can have a 5-year survival.

The lifetime risk for men and women to develop bladder cancer is 2.39 percent.

It has not been clearly established what causes bladder cancer;;however,  studies have suggested that risk factors include smoking, occupational exposure to chemicals used in the dye, rubber, chemical, metal, textile and leather industries.

Additonally, certain cancer treatments, such as chemotherapy cyclophosphamide, and radiation therapy for the abdomen or pelvis, along with exposure to arsenic, increase bladder cancer risk.

Jimmy Downs and editing by Rachel Stockton