CanCer-666: Bladder Cancer

Surgery for Bladder Cancer

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<b>What is surgery?</b></h3>
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Surgery is used to diagnose, stage and treat cancer, and to manage certain cancer-related symptoms. Whether a patient is a candidate for surgery or not depends on factors such as the type, size, location, grade and stage of the tumor, as well as general health factors such as age, physical fitness and other coexisting medical conditions the patient may have.<br />
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For many patients, surgery will be combined with other cancer treatments, such as chemotherapy, radiation therapy or hormone therapy. These nonsurgical treatments may be administered before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy) to help prevent cancer growth, spread or recurrence.<br />
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Surgery for Bladder Cancer</h3>
Surgery is typically the first treatment option for early-stage bladder cancers because tumors have likely not spread to other areas of the body. We may perform <b>surgery for bladder cancers</b> that have recurred or metastasized. For some patients, a bladder-preserving approach may be the best option. For others, removal of the entire bladder may reduce the risk of a subsequent cancer. Your doctor will discuss all of your treatment options, so that you can make the best decision for your care. Our surgical oncology experts are experienced in a variety of procedures and we proactively manage the side effects of bladder cancer surgery.<br />
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The type of surgery done for bladder cancer will depend on its stage.<br />
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<b><span style="color: #6aa84f;">Transurethral surgery</span></b><br />
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For early-stage or superficial (non-muscle invasive) bladder cancers, a transurethral resection (TUR), also known as a transurethral resection of the bladder tumor (TURBT), is the most common treatment. Most patients have superficial cancer when they are first diagnosed, so this is usually the first treatment they receive. This surgery is done using an instrument passed up the urethra, so it does not require cutting into the abdomen. You will get either general anesthesia (where you are asleep) or regional anesthesia (where the lower part of your body is numbed).<br />
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For this operation, a type of rigid cystoscope called a resectoscope is placed into the bladder through the urethra. The resectoscope has a wire loop at its end to remove any abnormal tissues or tumors. The removed tissue is sent to a lab to be looked at by a pathologist. After the tumor is removed, more steps may be taken to try to ensure that it has been destroyed completely. Any remaining cancer may be treated by fulguration (burning the base of the tumor) while looking at it with the cystoscope. Cancer can also be destroyed using a high-energy laser through the cystoscope.<br />
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The side effects of transurethral bladder surgery are generally mild and do not usually last long. You might have some bleeding and pain when you urinate after surgery. You can usually return home the same day or the next day and can resume your usual activities in less than 2 weeks.<br />
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Unfortunately, even with successful treatment, <a href="http://cancer-666.blogspot.com/search/label/Bladder%20Cancer" rel="nofollow" target="_blank">bladder cancer</a> often recurs (comes back) in other parts of the bladder. If transurethral resection needs to be repeated many times, the bladder can become scarred and lose its capacity to hold much urine. Some people may have side effects such as frequent urination, or even incontinence (loss of control of urination). In patients with a long history of recurrent, non-invasive low-grade tumors, the surgeon may sometimes just use fulguration to burn small tumors that are seen during cystoscopy (rather than removing them). This can often be done using local anesthesia (numbing medicine) in the doctor’s office. It is safe but can be mildly uncomfortable.<br />
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<span style="color: #6aa84f;"><b>Cystectomy</b></span><br />
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This <i>bladder cancer surgical procedure</i> may be used to remove either the entire bladder or portions of it. Sometimes, the bladder may be accessed through an incision in the abdomen. It may also be possible to do laparoscopic surgery. With this approach, several small incisions are made using long, thin instruments, one with a video camera on the end that enables the surgeon to see inside the pelvis. Laparoscopic surgery, also called keyhole surgery, may reduce pain and shorten recovery time. However, because this type of surgery for bladder cancer is newer, there is less evidence of its long-term benefit in treating bladder cancer.<br />
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There are two types of cystectomies:<br />
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<b>• Partial cystectomy:</b> If cancer has invaded the muscle layer of the bladder wall, but is not large and is confined to one region of the bladder, then it may be possible to treat the cancer by removing only part of the bladder. With this procedure, the portion of the bladder where there is cancer is removed, and the hole in the bladder wall is then closed.<br />
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<b>• Radical cystectomy with extended lymph node dissection:</b> If the cancer is larger or is in more than one part of the bladder, a radical cystectomy with extended lymph node dissection will be needed. This operation removes the entire bladder and nearby lymph nodes. In men, the prostate is also removed. In women, the ovaries, fallopian tubes (tubes that connect the ovaries and uterus), the uterus (womb), and a small portion of the vagina are often removed along with the bladder.<br />
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General anesthesia (where you are in a deep sleep) is used for either type of cystectomy.<br />
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Typically, these procedures are done through a cut (incision) in the abdomen. You will need to stay in the hospital for about a week after the surgery. You can usually go back to your normal activities in 4 to 6 weeks.<br />
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In some cases, the surgeon may operate through several smaller incisions using special long, thin instruments, one of which has a tiny video camera on the end to see inside the pelvis. This is known as laparoscopic, or “keyhole” surgery. The surgeon may either hold the instruments directly or may sit at a control panel in the operating room and maneuver robotic arms to do the surgery. Laparoscopic surgery may result in less pain and quicker recovery because of the smaller incisions. But it has not been around as long as the standard type of surgery and it’s not yet clear if it is equally as effective.<br />
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It is important that any type of cystectomy be done by a surgeon with experience in treating bladder cancer. If the surgery is not done well, the cancer is more likely to come back.<br />
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Reconstructive surgery after radical cystectomy</h3>
If your whole bladder is removed, you will need another way to store and remove urine. Several types of reconstructive surgery can be done depending on your medical situation and personal preferences.<br />
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<b>• Continent diversion: </b>Another way for urine to drain is called a continent diversion. A valve is created in a pouch made from the piece of intestine attached to the ureters. The valve allows urine to be stored in the pouch. You then empty the pouch several times each day by placing a drainage tube (catheter) into the stoma through the valve. Some people prefer this method because there is no bag on the outside.<br />
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<b>• Incontinent diversion:</b> One option may be to remove a short piece of your intestine and connect it to the ureters. This creates a passageway, known as an ileal conduit, for urine to pass from the kidneys to the outside of the body. Urine flows from the kidneys through the ureters into the ileal conduit. One end of the conduit is connected to the skin on the front of the abdomen by an opening called a stoma (also known as a urostomy).<br />
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After this procedure, a small bag is placed over the stoma to collect the urine, which comes out continuously in small amounts. The bag then needs to be emptied once it is full. This approach is sometimes called an incontinent diversion, because you no longer control the flow of urine out of the body.<br />
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<b>• Neobladder: </b>A newer method routes the urine back into the urethra, restoring urination. One way to do this is to create a neobladder – basically a new bladder made of a piece of intestine. As with the incontinent and continent diversion, the ureters are connected to the neobladder. The difference is that the neobladder is also sewn to the urethra. This lets the patient urinate normally. Over several months, most people regain the ability to urinate normally during the day, although many people might still have some incontinence at night.<br />
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If the cancer has spread or can’t be removed with surgery, a diversion may be made without removing the bladder. In this case, the purpose of the surgery is to prevent or relieve blockage of urine flow, rather than try to cure the cancer.<br />
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<u>Bladder cancer surgeries</u></div>
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Surgery for Bladder Cancer

What is surgery? Surgery is used to diagnose, stage and treat cancer, and to manage certain cancer-related symptoms. Whether a patient...

Treatment for Bladder Cancer

ancorez Bladder Cancer 7:08 PM

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How is bladder cancer treated?</h3>
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Your <b>treatment options for bladder cancer</b> depend on a number of factors, including the type and stage of the cancer, your overall health, and your treatment preferences. Discuss your options with your doctor to determine what treatments are best for you.</div>
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In cancer care, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team.</div>
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Descriptions of the most common treatment options for bladder cancer are listed below. Treatment options and recommendations depend on several factors, including the type, stage, and grade of bladder cancer, possible side effects, and the patient’s preferences and overall health.</div>
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Early-stage bladder cancer can often be treated locally (treatments that just involve the bladder) without removing the whole bladder. Later-stage bladder cancer is often treated with systemic chemotherapy. In later-stage bladder cancer, it may or may not be necessary to remove the bladder during surgery. Radiation therapy may also be used instead of removing the bladder.</div>
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General bladder cancer treatment information</h3>
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Once your cancer has been diagnosed and <a href="http://cancer-666.blogspot.com/2014/04/bladder-cancer-stage-and-grade.html" target="_blank">staged</a>, there is a lot to think about before you and your doctor choose a treatment plan. You may feel that you must make a decision quickly, but it is important to give yourself time to absorb the information you have just learned. Ask your cancer care team questions.</div>
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You will want to weigh the benefits of each<i> treatment option</i> against the possible risks and side effects. The best treatment for you will depend on the type and stage of your bladder cancer as well as your general health, age, and personal preferences.</div>
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If time permits, you might want to get a second opinion about your best treatment option. This can be especially helpful if you have several treatment choices. A second opinion can provide more information and help you feel more confident about the treatment plan you choose.</div>
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Main types of treatment for bladder cancer</h3>
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<span style="color: #6aa84f;"><b>Chemotherapy</b></span></div>
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Chemotherapy is the use of drugs to kill cancer cells, usually by stopping the cancer cells’ ability to grow and divide. A chemotherapy regimen typically consists of a specific number of cycles given over a set period of time. A patient may receive one drug at a time or combinations of different drugs at the same time.</div>
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For bladder cancer, doctors may decide to use one of two types of chemotherapy: intravesical (local) or systemic (whole body) treatment. In general, patients with non-muscle-invasive bladder cancer are more likely to be treated with intravesical chemotherapy after TURBT to reduce the risk of recurrence in the bladder. Patients with muscle-invasive cancer located only in the bladder often receive chemotherapy before (neoadjuvant therapy) or after (adjuvant therapy) cystectomy to reduce the risk of the cancer spreading to other parts of the body. Patients should talk with their doctor about chemotherapy before surgery.</div>
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The types of chemotherapy most often used for bladder cancer are described in more detail below:</div>
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<b>• Chemotherapy for localized muscle-invasive bladder cancer.</b> Researchers are studying new combinations of chemotherapy that are more effective in managing bladder cancer. Treatments may include:</div>
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<li>Combinations of different drugs</li>
<li>Currently used drugs tested in different doses</li>
<li>Drugs or drug combinations given before or after surgery</li>
<li>Drugs or drug combinations given with radiation therapy. If radiation therapy is combined with chemotherapy, it may make chemotherapy more effective in an effect called radiosensitizing.</li>
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Recently, an important clinical trial has shown that the use of intravenous chemotherapy (the MVAC regimen, mentioned above) before radical cystectomy helps patients with invasive bladder cancer live longer. Based on this research, this approach is considered a standard treatment. This type of initial chemotherapy, called neoadjuvant chemotherapy, may shrink the tumor in the bladder and may also kill small areas of cancer that have spread beyond the bladder. It is important to note that chemotherapy with one drug does not seem to help patients with locally advanced bladder cancer live longer, and some patients may not be healthy enough to receive chemotherapy. Therefore, it is recommended that all patients with muscle-invasive bladder cancer talk with their medical oncologist about their treatment options, including the risks and benefits of chemotherapy. </div>
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<b>• Intravesical therapy.</b> Intravesical chemotherapy is usually given by a urologist. In this type of therapy, drugs are placed into the bladder through a catheter inserted into the bladder through the urethra. Local treatment kills only non-muscle-invasive tumor cells. It cannot reach tumor cells in the bladder wall or tumor cells that have spread to other organs. The most common drug that is given as intravesical treatment is an immunotherapy drug called BCG. However, other types of drugs are also used. The most common is mitomycin C (Mitozytrex, Mutamycin). The drugs thiotepa (multiple brand names), doxorubicin (Adriamycin), and gemcitabine (Gemzar) have also been used.</div>
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<b>• Systemic chemotherapy.</b> Systemic chemotherapy is usually given by a medical oncologist, a doctor who specializes in treating cancer with medication. Systemic chemotherapy is delivered through the bloodstream to reach cancer cells throughout the body. It is generally given intravenously (IV; given by injection in a vein).</div>
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For bladder cancer, there are several drugs available, and many of the systemic chemotherapy regimens continue to be tested in clinical trials to help determine which drugs, or which drug combinations, work best to treat bladder cancer. Usually a combination of drugs works better than one drug alone. Researchers are also studying when it is best to use chemotherapy, either before or after surgery.</div>
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A combination of drugs, called MVAC, has been used as the standard treatment for bladder cancer for many years. MVAC has helped delay bladder cancer recurrence, and extend life and cure patients, but it has severe side effects. MVAC uses four drugs: methotrexate (multiple brand names), vinblastine (Velban, Velsar), doxorubicin, and cisplatin (Platinol). The combination of gemcitabine plus cisplatin is also used and works similarly to the MVAC combination but with somewhat fewer side effects. Other drugs are being studied in clinical trials to determine if there is a combination of drugs that will work better and have fewer side effects.</div>
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Side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, loss of appetite, and diarrhea. These side effects usually go away once treatment is finished.</div>
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<b><span style="color: #6aa84f;">Immunotherapy</span></b></div>
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Immunotherapy (also called biologic therapy) is designed to boost the body’s natural defenses to fight the cancer. It uses materials made either by the body or in a laboratory to bolster, target, or restore immune system function. The standard immunotherapy drug for bladder cancer is a weakened bacterium called bacillus Calmette-Guerin (BCG), which is similar to a form of the germ that causes tuberculosis. BCG is placed directly into the bladder through a catheter (called intravesical therapy; see below). BCG attaches to the inside lining of the bladder and attracts the patient's immune cells to the bladder to fight the tumor.</div>
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BCG is used mostly for patients with non-muscle-invasive, high-grade bladder cancer to reduce the risk of the cancer recurring or progressing. A first course of BCG is given weekly for six weeks. Six weeks later, the doctor performs a cystoscopy and sometimes a bladder biopsy (see <a href="http://cancer-666.blogspot.com/2014/04/diagnosis-of-bladder-cancer.html" target="_blank">Diagnosis of Bladder Cancer</a>) to determine if the BCG has eliminated all of the cancer. Patients with no remaining evidence of cancer undergo maintenance therapy, which may be given as three one-week treatment cycles every six months for three years. Before BCG treatment, patients will need to have another TURBT to make sure that the cancer has not spread to the muscle. BCG treatment may help patients avoid a cystectomy. Patients receiving BCG require long-term monitoring with cystoscopy and urine cytology to be sure the cancer does not return. </div>
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BCG can cause flu-like symptoms, chills, mild fever, fatigue, a burning sensation in the bladder, and bleeding from the bladder. Interferon (Roferon-A, Intron A, Alferon) is another immunotherapy drug that can be given as intravesical therapy. It is sometimes combined with BCG if BCG alone does not help treat the cancer.</div>
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<span style="color: #6aa84f;"><b>Intravesical therapy</b></span></div>
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With intravesical therapy, the doctor puts a liquid drug directly into the bladder (through a catheter) rather than giving it by mouth or injecting it into a vein. This could be either immunotherapy, which causes the body’s own immune system to attack the cancer cells, or chemotherapy.</div>
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Medicines given this way mainly affect the cells lining the inside of the bladder, with little to no effect on cells elsewhere. This means that any cancer cells outside of the bladder lining, including those that have grown deeply into the bladder wall, are not treated. Drugs put into the bladder also can’t reach cancer cells in the kidneys, ureters, and urethra, or those that have spread to other organs.</div>
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For this reason, intravesical therapy is used only for non-invasive (stage 0) or minimally invasive (stage I) bladder cancers.</div>
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<span style="color: #6aa84f;"><b>Radiation therapy</b></span></div>
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Radiation therapy is the use of high-energy x-rays or other particles to kill cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most common type of radiation treatment is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. When radiation therapy is given using implants, it is called internal radiation therapy or brachytherapy. A radiation therapy regimen (schedule) usually consists of a specific number of treatments given over a set period of time.</div>
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Radiation therapy is usually not used as a treatment alone for bladder cancer but is given in combination with chemotherapy. However, some patients who cannot receive chemotherapy might receive radiation therapy alone. The combination of radiation therapy and chemotherapy may be used to treat cancer that is located only in the bladder for the following reasons:</div>
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<li>To destroy any remaining tumor after TURBT while sparing the bladder</li>
<li>To relieve symptoms caused by a tumor, such as pain, bleeding, or blockage</li>
<li>To treat a metastasis located in one area, such as the brain or bone</li>
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Side effects from radiation therapy may include fatigue, mild skin reactions, and loose bowel movements. For bladder cancer, side effects most commonly occur in the pelvic or abdominal area and may include bladder irritation with the need to pass urine frequently during the treatment period, and bleeding from the bladder or rectum. Most side effects go away soon after treatment is finished.</div>
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<span style="color: #6aa84f;"><b>Surgery</b></span></div>
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<b>• Bladder preservation or substitution.</b> Living without the bladder can affect a patient’s quality of life. Finding ways to keep all, or part, of the bladder is important whenever possible, especially if removing the bladder will not lengthen a person’s life.</div>
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<li>For some patients, certain treatment plans involving chemotherapy and radiation therapy) may be used instead of removing the bladder.</li>
<li>As explained above, sometimes surgeons can use part of the intestine to create a substitute for the bladder by making a neobladder or continent urinary reservoir. With these procedures, the patient does not need a urinary bag and can have a better quality of life. However, the patient may need to insert a catheter if urine does not empty through the neobladder. Also, patients with a neobladder will no longer have the urge to urinate and will need to learn to urinate on a consistent schedule.</li>
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<b>• Cystectomy.</b> This procedure is often used for deeply invasive cancer or a noninvasive cancer that has recurred. A radical cystectomy is the removal of the whole bladder and possibly nearby tissue and organs. For men, the prostate and urethra also may be removed. For women, the uterus, fallopian tubes, ovaries, and part of the vagina also may be removed. Lymph nodes in the pelvis are also removed for both men and women; this is called a pelvic lymph node dissection. Recent research suggests that doing a thorough pelvic lymph node dissection may be beneficial. In some situations, only part of the bladder may be removed, called a partial or segmental cystectomy. Research shows that chemotherapy before or after a radical cystectomy may increase survival for men with muscle-invasive bladder cancer.</div>
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In a laparoscopic or robotic cystectomy, the surgeon makes several small incisions instead of the one larger incision used in traditional surgery. The surgeon uses telescoping equipment with or without robotic assistance to remove the bladder. The surgeon must make an incision to remove the bladder and surrounding tissue. This surgery may take longer, but it is less painful afterward and patients may recover more quickly. Several studies are in progress to determine whether laparoscopic or robotic cystectomy is as safe as the standard surgery and whether it is able to cure bladder cancer as successfully as standard surgery.</div>
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<b>• TURBT with fulguration.</b> This procedure is often used for early-stage cancer. It is a treatment for non-muscle-invasive cancer and is used to find out the stage, which helps doctors plan treatment. It may also be used to rule out muscle-invasive cancer before using intravesical chemotherapy. During TURBT, the surgeon inserts a cystoscope through the urethra into the bladder and removes the cancer using a tool with a small wire loop or using a laser or fulguration (high-energy electricity). This procedure is done with an anesthetic so it is not painful.</div>
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<b>• Urinary diversion.</b> If the bladder is removed, the doctor will make a new way to pass urine out of the body by using a section of the small intestine to divert urine to a stoma or ostomy (an opening) to the outside of the body. The patient wears a bag attached to the stoma to collect and drain urine.</div>
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Increasingly, surgeons can use part of the small or large intestine to make a urinary reservoir, which is a storage pouch that sits inside the body. For some patients, the surgeon is able to connect the pouch to the urethra, creating what is called a neobladder, so the patient can pass urine out of the body normally. For other patients, the pouch is connected to the skin on the abdomen by a small stoma creating a type of continent urinary reservoir, meaning that the urine will stay in the reservoir until the patient drains the pouch and no urinary pad is needed. The pouch is drained by inserting a catheter (a thin tube) through the small stoma and then removing the catheter and covering the stoma with a bandage.</div>
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<i>The side effects of bladder cancer surgery</i> depend on the procedure. Patients should talk with their doctor in detail to understand exactly what side effects may occur, including urinary and sexual side effects, and how they can be managed. In general, the side effects may include:</div>
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<li>Mild bleeding and discomfort after surgery.</li>
<li>Infections or urine leaks after cystectomy or a urinary diversion, and if a neobladder is created, a patient may sometimes be unable to urinate or completely empty the bladder.</li>
<li>Men may be unable to have an erection (called impotence) after cystectomy. Sometimes, a nerve-sparing cystectomy can be performed. When this is done successfully, men may be able to have a normal erection.</li>
<li>Damage to the nerves in the pelvis and loss of sexual feeling and orgasm for both men and women. Often, these problems can be fixed. Patients should talk with their doctor about any side effects they are experiencing.</li>
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<u>Treatment for Bladder Cancer</u></div>
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Learn more about <a href="http://cancer-666.blogspot.com/search/label/Bladder%20Cancer" target="_blank">Bladder Cancer</a></div>
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Treatment for Bladder Cancer

How is bladder cancer treated? Your treatment options for bladder cancer depend on a number of factors, including the type and stag...

Causes and Types of Bladder Cancer

ancorez Bladder Cancer 4:00 AM

<div dir="ltr" style="text-align: left;" trbidi="on"><h3 style="text-align: justify;"><span style="color: #6aa84f;">Causes of bladder cancer</span></h3><div style="text-align: justify;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjb7dzHVaL4rQx-CKG7xC41g9nHtSX28nn6WmGbPMIVzp3GB4bLPL9Wd-nsNaftA7QnUbbauWxUA3iewavb3ao6Lab-dn_KUVJkzqv0x9LKL7AgdhDjG1qVe3ajKoiLOaqfyYNN4XaZgv8/s1600/Causes+and+Types+of+Bladder+Cancer.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="320" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjb7dzHVaL4rQx-CKG7xC41g9nHtSX28nn6WmGbPMIVzp3GB4bLPL9Wd-nsNaftA7QnUbbauWxUA3iewavb3ao6Lab-dn_KUVJkzqv0x9LKL7AgdhDjG1qVe3ajKoiLOaqfyYNN4XaZgv8/s1600/Causes+and+Types+of+Bladder+Cancer.jpg" width="213" /></a></div><div style="text-align: justify;">It's not always clear <b>what causes bladder cancer</b>. Bladder cancer has been linked to smoking, a parasitic infection, radiation and chemical exposure.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Bladder cancer develops when cells in the bladder begin to grow abnormally. Rather than grow and divide in an orderly way, these cells develop mutations that cause them to grow out of control and not die. These abnormal cells form a tumor.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">We do not know exactly what causes most bladder cancers. But researchers have found some risk factors (see the section “<a href="http://cancer-666.blogspot.com/2014/05/bladder-cancer-risk-factors.html" target="_blank">What are the risk factors for bladder cancer?</a>") and are starting to understand how they cause cells in the bladder to become cancerous.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Certain changes in the DNA inside normal bladder cells can make them grow abnormally and form cancers. DNA is the chemical in each of our cells that makes up our genes – the instructions for how our cells function. We usually look like our parents because they are the source of our DNA, but DNA affects more than just how we look.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Some genes control when cells grow, divide into new cells, and die. Genes that help cells grow, divide, and stay alive are called oncogenes. Genes that slow down cell division or cause cells to die at the right time are called tumor suppressor genes. Cancers can be caused by DNA changes that turn on oncogenes or turn off tumor suppressor genes. Several different gene changes are usually needed for a cell to become cancerous.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Some people inherit DNA changes (mutations) from their parents that increase their risk for developing certain cancers. But bladder cancer does not often run in families, and inherited gene mutations are not thought to be a major cause of this disease.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">DNA changes related to bladder cancer usually develop during a person’s life rather than having been inherited before birth. Some of these acquired DNA mutations result from exposure to cancer-causing chemicals or radiation. For example, chemicals in tobacco smoke can be absorbed into the blood, filtered by the kidneys, and end up the urine, where they can affect bladder cells. Other chemicals may reach the bladder in a similar way. But in some cases, gene changes may just be random events that sometimes happen inside a cell, without having an outside cause.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">The gene changes that lead to bladder cancer are not the same in all cases. Acquired changes in certain genes, such as the TP53 or RB1 tumor suppressor genes and the FGFR and RAS oncogenes, are thought to be important in the development of some bladder cancers. Changes in these and similar genes may also make some bladder cancers more likely to grow and invade the bladder wall than others. Research in this field is aimed at developing tests that can find bladder cancers at an early stage by finding their DNA changes.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><i>Bladder cancers are not usually caused</i> by inherited mutations in oncogenes or tumor suppressor genes, but some people seem to inherit a reduced ability to detoxify (break down) and get rid of certain types of cancer-causing chemicals. These people are more sensitive to the cancer-causing effects of tobacco smoke and certain industrial chemicals. Researchers are developing tests to identify such people, but these tests are not routinely done. It is not certain how these test results would be used since doctors recommend that all people avoid tobacco smoke and hazardous industrial chemicals.</div><hr style="margin-left: 0px; margin-right: 0px;" /><div style="text-align: justify;"><br />
</div><h3 style="text-align: justify;"><span style="color: #6aa84f;">Types of bladder cancer</span></h3><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><u>Different types of cells in your bladder</u> can become cancerous. The type of bladder cell where cancer begins determines the type of bladder cancer. Your bladder cancer type determines which treatments may work best for you. Types of bladder cancer include:</div><ul style="text-align: justify;"><li><b>Adenocarcinoma.</b> Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is rare in the United States.</li>
<li><b>Squamous cell carcinoma.</b> Squamous cells appear in your bladder in response to infection and irritation. Over time they can become cancerous. Squamous cell bladder cancer is rare in the United States. It's more common in parts of the world where a certain parasitic infection (schistosomiasis) is a prevalent cause of bladder infections.</li>
<li><b>Transitional cell carcinoma.</b> Transitional cell carcinoma occurs in the cells that line the inside of your bladder. Transitional cells expand when your bladder is full and contract when your bladder is empty. These same cells line the inside of your ureters and your urethra, and tumors can form in those places as well. Transitional cell carcinoma is the most common type of bladder cancer in the United States.</li>
</ul><div style="text-align: justify;">Some <a href="http://cancer-666.blogspot.com/search/label/Bladder%20Cancer" target="_blank">bladder cancers</a> include more than one type of cell.</div></div>

Causes and Types of Bladder Cancer

Causes of bladder cancer It's not always clear what causes bladder cancer . Bladder cancer has been linked to smoking, a parasitic infe...

Bladder Cancer Risk Factors

ancorez Bladder Cancer 2:40 PM

<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHaaoKC3Jj43qYfKa4TczeOZtNjh69UKENWzc8nQzFSj0939HtsbnlkE80C6Qe0s_S8qwjg7K_B480927yng9P5Xy9b6HxZ9DzSJY1BzMi8YzR9KjaYWy1oyyUUjALTbdmW-J8AjVVJPs/s1600/Bladder+Cancer+Risk+Factors.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjHaaoKC3Jj43qYfKa4TczeOZtNjh69UKENWzc8nQzFSj0939HtsbnlkE80C6Qe0s_S8qwjg7K_B480927yng9P5Xy9b6HxZ9DzSJY1BzMi8YzR9KjaYWy1oyyUUjALTbdmW-J8AjVVJPs/s1600/Bladder+Cancer+Risk+Factors.jpg" width="178" /></a>A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of cancer, most do not directly cause cancer. Some people with several risk factors never develop cancer, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.<br />
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The following factors may raise a person’s risk of developing bladder cancer:<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Age</span></b></span><br />
The risk of bladder cancer increases with age. About 9 out of 10 people with bladder cancer are older than 55.<br />
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</b></span></span> <span style="color: #6aa84f;"><span style="font-family: "Trebuchet MS",sans-serif;"><b>Arsenic</b></span></span><br />
Arsenic in drinking water has been linked with an increased risk of bladder cancer in some parts of the world. The chance of being exposed to arsenic depends on where you live and whether you get your water from a well or from a public water system that meets the standards for arsenic content. For most Americans, drinking water is not a major source of arsenic.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Bladder birth defects</span></b></span><br />
Before birth, there is a connection between the belly button and the bladder. This connection, called the urachus, normally goes away before birth. If part of this connection remains after birth, it could become cancerous. Cancers that start in the urachus are usually adenocarcinomas, which are made up of malignant gland cells. About one-third of the adenocarcinomas of the bladder start here. However, this is still rare, accounting for less than a half of 1% of all bladder cancers.<br />
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Another rare birth defect called exstrophy greatly increases a person’s risk of developing bladder cancer. In bladder exstrophy, both the bladder and the abdominal wall in front of the bladder fail to close completely during development and are fused together. This leaves the inner lining of the bladder exposed outside the body. Surgery soon after birth can close the bladder and abdominal wall (and repair other related defects), but people who have this still have a higher risk for urinary infections and bladder cancer.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Diet</span></b></span><br />
<b>• Certain medicines or herbal supplements</b><br />
According to the US Food and Drug Administration (FDA), use of the diabetes medicine pioglitazone (Actos) for more than one year may be linked with an increased risk of bladder cancer.<br />
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Dietary supplements containing aristolochic acid (mainly in herbs from the Aristolochia family) have been linked with an increased risk of urothelial cancers, including bladder cancer. <br />
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<b>• Low fluid consumption</b><br />
Not drinking enough fluids may increase the risk of bladder cancer. People who drink a lot of fluids each day have a lower rate of bladder cancer. This is thought to be because they empty their bladders often. By doing this, they keep chemicals from lingering in their bodies.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Family history and genetic conditions</span></b></span><br />
People who have family members with bladder cancer have an increased risk of getting it themselves. In some cases, these family members may all be exposed to the same cancer- causing chemical. They may also share changes in some genes (like GST and NAT) that cause their bodies to be slow to break down certain toxins, which can make them more likely to develop bladder cancer.<br />
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A small number of people inherit a gene syndrome that increases their risk for bladder cancer. For example:<br />
<ul><li>A mutation of the retinoblastoma (RB1) gene can cause cancer of the eye in infants, and also increases the risk of bladder cancer.</li>
<li>Cowden disease, caused by mutations in a gene called PTEN, is linked mainly to cancers of the breast and thyroid. People with this disease also have a higher risk of bladder cancer.</li>
<li>Lynch syndrome (also known as hereditary non-polyposis colorectal cancer, or HNPCC) is linked mainly to colon and endometrial cancer. People with this syndrome also have an increased risk of bladder cancer, as well as cancer of the ureters.</li>
</ul><hr style="margin-left: 0px; margin-right: 0px;" /><br />
<span style="font-family: "Trebuchet MS",sans-serif;"><span style="color: #6aa84f;"><b>Gender</b></span></span><br />
Bladder cancer is much more common in men than in women.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Immune system</span></b></span><br />
<b>• Organ transplant</b><br />
Bladder cancer risk is around threefold higher among renal transplant recipients, compared with the general public, a meta-analysis showed.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Infections</span></b></span><br />
<b>• Chronic bladder irritation and infections</b><br />
Urinary infections, kidney and bladder stones, bladder catheters left in place a long time, and other causes of chronic bladder irritation have been linked with bladder cancer (especially squamous cell carcinoma of the bladder), but it is not clear if they actually cause bladder cancer.<br />
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<b>• Human papillomavirus (HPV)</b><br />
One study showed a doubling in risk of bladder cancer in patients with condylomata acuminata (genital warts). Genital warts are caused by infection with the human papillomavirus (HPV), and a meta-analysis showed a three-fold increased risk associated with HPV infection.<br />
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<b>• Schistosomiasis</b><br />
Schistosomiasis (also known as bilharziasis), an infection with a parasitic worm called Schistosoma hematobium that can get into the bladder, is also a risk factor for bladder cancer. In countries where this parasite is common (mainly in Africa and the Middle East), squamous cell cancers of the bladder are seen much more often. This is an extremely rare cause of bladder cancer in the United States.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Ionising radiation</span></b></span><br />
A very small proportion of bladder cancer cases are associated with therapeutic irradiation in the pelvic region, for example for testicular cancer or cervical cancer. Men with a history of prostate cancer, both those treated with and without radiotherapy, have an increased risk of bladder cancer. The risk of bladder cancer has been shown to be increased two-fold in women treated for cervical cancer without radiotherapy, which may be due to shared risk factors such as smoking. A risk increase was also seen in women treated with radiotherapy- the risk was almost six-fold for women treated for cervical cancer 40 or more years previously.<br />
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A study published in December 2011 has estimated that 2.6% of bladder cancer cases in men and 2.3% in women in the UK in 2010 were linked to radiation exposure, with most of these cases linked to exposure to diagnostic radiation.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Medical conditions and treatments</span></b></span><br />
<b>• Chemotherapy and radiation therapy</b><br />
Long-term use of the chemotherapy drug cyclophosphamide (Cytoxan) can irritate the bladder and increase the risk of bladder cancer. People taking this drug are often told to drink plenty of fluids to help protect the bladder from irritation and decrease the risk of bladder cancer.<br />
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People who are treated with radiation to the pelvis are more likely to develop bladder cancer.<br />
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<b>• Disability</b><br />
Paraplegics have a greatly increased risk of squamous cell carcinomas of the bladder, due to their disposition to chronic urinary tract infection. Kidney and urinary stones may also slightly increase risk.</div><br />
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<div style="text-align: justify;"><b>• Gastric ulcers</b><br />
There is limited evidence that a history of gastric ulcer increases risk.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Occupational exposures</span></b></span><br />
It has been estimated that, in the UK, around 7% of bladder cancer cases in men and 2% in women are linked to occupational exposures. This proportion may be higher in countries with less-regulated industrial processes.<br />
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<b>• Aromatic amines</b><br />
In 1895 Rehn reported cases of bladder cancer in a German aniline dye factory. This led to occupational studies in other countries but it was not until the 1950s that the risk from aromatic amines, particularly benzidine and a-and ß-naphthylamine, was established by Case.<br />
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Aromatic amines were widely used in the manufacture of dyes and pigments for textiles, paints, plastics, paper and hair dyes, in drugs, pesticides and as antioxidants in the rubber industry. Production of ß-naphthylamine ceased in the UK in 1952 (its use was withdrawn from the rubber and cable industry prior to this in 1949) and in 1953 bladder cancer became, and still is, a prescribed industrial disease.<br />
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<b>• Diesel engine exhaust</b><br />
In June 2012, IARC classified diesel exhaust as associated with an increased risk of bladder cancer. This was based on limited evidence mainly from studies of highly-exposed workers.<br />
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<b>• Polycyclic aromatic hydrocarbons (PAH)</b><br />
Exposure to polycyclic aromatic hydrocarbons (PAH), which are by-products of combustion processes and therefore present in a range of industries, has also been investigated. It is calculated that about 4% of bladder cancer cases in European men are due to exposure to PAH. A recent meta-analysis showed a risk increase of about 30% for bladder cancer in painters and the International Agency for Research on Cancer classifies occupation as a painter as a cause of bladder cancer.<br />
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<span style="font-family: "Trebuchet MS",sans-serif;"><span style="color: #6aa84f;"><b>Personal history of bladder or other urothelial cancer</b></span></span><br />
Urothelial carcinomas can form in many areas in the bladder as well as in the lining of the kidney, the ureters, and urethra. Having a cancer in the lining of any part of the urinary tract puts you at higher risk of having another tumor. The tumor can form in the same area as before, or in another part of the urothelium (lining). This is true even when the first tumor is removed completely. For this reason, people who have had bladder cancer need close, routine medical follow-up. <br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Race and ethnicity</span></b></span><br />
Whites are about twice as likely to develop bladder cancer as African Americans. Hispanics, Asian Americans, and American Indians have slightly lower rates of bladder cancer. The reasons for these differences are not well understood.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Reproductive factors</span></b></span><br />
Women who have given birth at least once have a 27-31% lower risk of bladder cancer compared with those who have never given birth, meta-analyses have shown. The link is stronger in never-smokers than ever-smokers. Women who had early menopause (younger than 43-49) have a 49% increased bladder cancer risk compared with those who had menopause later, though being post-menopausal is not in itself associated with risk. Late age at menarche (older than 15) was associated with 43% decreased bladder cancer risk in a large US cohort study. Links with hormone replacement therapy (HRT) use remain unclear, while use of oral contraceptives is not associated with risk increase.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Tobacco</span></b></span><br />
<b>• Smoking</b><br />
Smoking is the most important risk factor for bladder cancer. Smokers are at least 3 times as likely to get bladder cancer as nonsmokers. Smoking causes about half of the bladder cancers in both men and women.<br />
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When smokers inhale, some of the carcinogens (cancer-causing chemicals) in tobacco smoke are absorbed from the lungs and get into the blood. From the blood, they are filtered by the kidneys and concentrated in the urine. These chemicals in urine can damage the cells that line the inside of the bladder, which increases the chance of cancer developing.<br />
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<b>• Environmental tobacco smoke</b><br />
In a recent European study, exposure to environmental tobacco smoke (ETS) during childhood increased the risk of bladder cancer by almost 40%. However, the body of evidence does not support a link between ETS exposure in adults and bladder cancer risk. A record linkage study of bladder cancer incidence in the offspring of men and women diagnosed with lung cancer found a significant increase in risk of bladder cancer in those whose mothers had lung cancer, but no increased risk for paternal lung cancer. The authors interpreted this as evidence that exposure to tobacco carcinogens in utero or while breastfeeding may lead to bladder cancer in later life.<br />
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Smoking cessation after diagnosis may favourably alter the course of the disease but the evidence is incomplete. It has also been suggested that high fruit consumption may reduce the effect of smoking on developing bladder cancer.<br />
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The precise mechanism by which cigarette smoking induces bladder cancer is unclear. Studies show that risk varies by type of tobacco, with a higher risk for black ‘air-cured’ than blond ‘flue-cured’ tobacco. Smokers of black tobacco have higher reported levels of aromatic amines in their urine than smokers of blond tobacco. These aromatic amines are known urothelial carcinogens and the ability to detoxify them is compromised in people who are ‘slow acetylators’ and it is suggested that these people are at higher risk than ‘fast acetylators’ (see Molecular biology and genetics section).<br />
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Tobacco tars have been shown to induce bladder papillomas and carcinomas in mice. It is thought that prolonged exposure of the bladder to such urinary carcinogens during the excretory process may lead to the development of bladder cancer.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Workplace exposures</span></b></span><br />
Certain industrial chemicals have been linked with bladder cancer. Chemicals called aromatic amines, such as benzidine and beta-naphthylamine, which are sometimes used in the dye industry, can cause bladder cancer.<br />
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Workers in other industries that use certain organic chemicals also may be at risk for bladder cancer if exposure is not limited by good workplace safety practices. The industries carrying highest risks include the makers of rubber, leather, textiles, and paint products as well as printing companies. Other workers with an increased risk of developing bladder cancer include painters, machinists, printers, hairdressers (likely because of heavy exposure to hair dyes), and truck drivers (likely because of exposure to diesel fumes).<br />
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Cigarette smoking and workplace exposures can act together to cause bladder cancer. Smokers who work with the cancer-causing chemicals noted above have an especially high risk of developing bladder cancer.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: "Trebuchet MS",sans-serif;">Factors shown to decrease or have no effect on bladder cancer risk</span></b></span><br />
Bladder cancer risk is not increased in people who dye their hair, a meta-analysis showed. People with systemic lupus erythematosus are not associated with bladder cancer, compared with people in the general population, a meta-analysis showed.</div></div>

Bladder Cancer Risk Factors

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the development of ca...

Signs and Symptoms of Bladder Cancer

ancorez Bladder Cancer 3:38 PM

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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXNlGcvqH7bSjB7lWzYKby6QFg1E-QipQ2dV2z-KTRmMHrm38VwsFLY4EibyQSB00liQx6muJwTBKyRy_33_iOqjD_ttKMRNHji1K30rIrMACs3QQuNUwXcvyr8a49jdTX3B43tSEGmlY/s1600/Signs+and+symptoms+of+bladder+cancer.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="200" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjXNlGcvqH7bSjB7lWzYKby6QFg1E-QipQ2dV2z-KTRmMHrm38VwsFLY4EibyQSB00liQx6muJwTBKyRy_33_iOqjD_ttKMRNHji1K30rIrMACs3QQuNUwXcvyr8a49jdTX3B43tSEGmlY/s1600/Signs+and+symptoms+of+bladder+cancer.jpg" width="200" /></a></div>
People with <b>bladder cancer</b> may experience the following symptoms or signs. Sometimes, people with bladder cancer do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not cancer. Bladder cancer usually does not cause symptoms that specifically indicate cancer. Most often, bladder cancer is diagnosed when a person tells his or her doctor about blood in the urine, also called hematuria. Gross hematuria means that enough blood is present in the urine to be visible to the patient. It is also possible there are small amounts of blood in the urine unable to be seen; this is called microscopic hematuria, and it can only be detected with a urine test.<br />
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<span style="color: #6aa84f;"><b>The most common symptoms of bladder cancer include: </b></span><br />
<ul>
<li>Blood in the urine<br />
In most cases, blood in the urine (called hematuria) is the first warning sign of bladder cancer. Sometimes, there is enough blood to change the color of the urine. Depending on the amount of blood, the urine may be orange, pink, or, less often, darker red. Sometimes, the color of the urine is normal but small amounts of blood are found when a urine test (urinalysis) is done because of other symptoms or as part of a general medical checkup.<br />
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Blood may be present one day and absent the next, with the urine remaining clear for weeks or months. If a person has bladder cancer, blood eventually reappears. Usually, the early stages of bladder cancer cause bleeding but little or no pain or other symptoms.<br />
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Blood in the urine does not always mean you have bladder cancer. More often it is caused by other things like an infection, benign (non-cancerous) tumors, stones in the kidney or bladder, or other benign kidney diseases. But it is important to have it checked by a doctor so the cause can be found.</li>
</ul>
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<li>Pain or burning during urination (dysuria).</li>
<li>Urinating small amounts frequently.</li>
<li>Frequent urinary tract infections (UTIs).</li>
</ul>
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<span style="color: #6aa84f;"><b>Symptoms that may indicate more advanced bladder cancer include:</b></span><br />
<ul>
<li>Pain in the lower back around the kidneys (flank pain).</li>
<li>Swelling in the lower legs.</li>
<li>A growth in the pelvis near the bladder (pelvic mass).</li>
</ul>
<hr />
<b><span style="color: #6aa84f;">Other symptoms that may develop when bladder cancer has spread include:</span></b><br />
<ul>
<li>Weight loss.</li>
<li>Bone pain or pain in the rectal, anal, or pelvic area.</li>
<li>Anemia.</li>
</ul>
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Sometimes when the first <i>symptoms of bladder cancer</i> appear, the cancer has already spread to another part of the body. In this situation, the symptoms depend on where the cancer has spread. For example, cancer that has spread to the lungs may cause a cough or shortness of breath, spread to the liver may cause abdominal pain or jaundice (yellowing of the skin and whites of the eyes), and spread to the bone may cause bone pain or a bone break.<br />
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Your doctor will ask you questions about the symptoms you are experiencing to help find out the cause of the problem, called a diagnosis. This may include how long you’ve been experiencing the symptom(s) and how often.<br />
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If cancer is diagnosed, relieving <u>symptoms and side effects</u> remains an important part of cancer care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.</div>
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Signs and Symptoms of Bladder Cancer

People with bladder cancer may experience the following symptoms or signs. Sometimes, people with bladder cancer do not show any of the...

Bladder Cancer Stage and Grade

ancorez Bladder Cancer 2:45 PM

<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><span style="font-size: large;"><b><span style="font-family: Times,"Times New Roman",serif;">What staging is?</span></b></span><br />
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Staging is a way of describing where the cancer is located, if or where it has invaded or spread, and whether it is affecting the functions of other organs in the body. Doctors use diagnostic tests to determine the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient's prognosis (chance of recovery). There are different stage descriptions for different types of cancer.<br />
<div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUXXqx793Wp-LZfhEHHGH0jxXFukUNDIAdcohKaO2KBWOZhLxAli8c560PihCIHzlheI8y2nQEHHGhSEpuyXLavTtAuzvB2zrOuPs2bIv618Nge8td3sLZSeoOIqceYxjduGCqccjn_hY/s1600/Bladder+Cancer+Stage+and+Grade.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="181" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjUXXqx793Wp-LZfhEHHGH0jxXFukUNDIAdcohKaO2KBWOZhLxAli8c560PihCIHzlheI8y2nQEHHGhSEpuyXLavTtAuzvB2zrOuPs2bIv618Nge8td3sLZSeoOIqceYxjduGCqccjn_hY/s1600/Bladder+Cancer+Stage+and+Grade.jpg" width="200" /></a></div><br />
For<b> bladder cancer</b>, the stage is determined based on the results of the sample removed during a TURBT and whether the cancer has spread to other parts of the body, which is determined by imaging tests, a physical examination, and laboratory tests.<br />
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One tool doctors use to describe the stage is the TNM system. This system judges three factors: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person. There are five stages of bladder cancer: stage 0 (zero) and stages I through IV (one through four). The stage provides a common way of describing the cancer, so doctors can work together to plan the best treatments.<br />
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TNM is an abbreviation for tumor (T), node (N), and metastasis (M). Doctors look at these three factors to determine the stage of cancer:<br />
<ul><li>How large is the primary tumor and how deeply has it invaded the tissue? <b>(Tumor, T)</b></li>
<li>Has the tumor spread to the lymph nodes? <b>(Node, N)</b></li>
<li>Has the cancer metastasized to other parts of the body?<b> (Metastasis, M)</b></li>
</ul><span style="color: #6aa84f;"><b><span style="font-family: Times,"Times New Roman",serif;">The T stages of bladder cancer</span></b></span><br />
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The T part of TNM tells you how far into the bladder the cancer cells have grown. Doctors find the T stage by a combination of looking at the grade of the cancer cells after a biopsy, examination of the bladder under anaesthetic, and a CT scan or MRI scan.<br />
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<b>TX:</b> Main tumor cannot be assessed due to lack of information<br />
<br />
<b>T0:</b> No evidence of a primary tumor<br />
<br />
<b>Ta:</b> Non-invasive papillary carcinoma<br />
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<b>Tis:</b> Non-invasive flat carcinoma (flat carcinoma in situ, or CIS)<br />
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<b>T1</b>: The tumor has grown from the layer of cells lining the bladder into the connective tissue below. It has not grown into the muscle layer of the bladder.<br />
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<b>T2:</b> The tumor has grown into the muscle layer.<br />
<ul><li><b>T2a:</b> The tumor has grown only into the inner half of the muscle layer.</li>
<li><b>T2b:</b> The tumor has grown into the outer half of the muscle layer.</li>
</ul><b>T3:</b> The tumor has grown through the muscle layer of the bladder and into the fatty tissue layer that surrounds it.<br />
<ul><li><b>T3a:</b> The spread to fatty tissue can only be seen by using a microscope.</li>
<li><b>T3b:</b> The spread to fatty tissue is large enough to be seen on imaging tests or to be seen or felt by the surgeon.</li>
</ul><b>T4:</b> The tumor has spread beyond the fatty tissue and into nearby organs or structures. It may be growing into any of the following: the stroma (main tissue) of the prostate, the seminal vesicles, uterus, vagina, pelvic wall, or abdominal wall.<br />
<ul><li><b>T4a:</b> The tumor has spread to the stroma of the prostate (in men), or to the uterus and/or vagina (in women).</li>
<li><b>T4b:</b> The tumor has spread to the pelvic wall or the abdominal wall.</li>
</ul><i>Bladder cancer</i> can sometimes affect many areas of the bladder at the same time. If more than one tumor is found, the letter m is added to the appropriate T category.<br />
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<span style="color: #6aa84f;"><b><span style="font-family: Times,"Times New Roman",serif;">The N stages of bladder cancer</span></b></span><br />
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The N category describes spread only to the lymph nodes near the bladder (in the true pelvis) and those along the blood vessel called the common iliac artery. These lymph nodes are called regional lymph nodes. Any other lymph nodes are considered distant lymph nodes. Spread to distant nodes is considered metastasis (described in the M category). Surgery is usually needed to find cancer spread to lymph nodes, since it is not often seen on imaging tests.<br />
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<b>NX:</b> Regional lymph nodes cannot be assessed due to lack of information.<br />
<b>N0:</b> No cancer in any lymph nodes<br />
<b>N1:</b> There is cancer in one lymph node in the pelvis (the lower part of your tummy, between your hip bones)<br />
<b>N2:</b> There is cancer in more than one lymph node in the pelvis<br />
<b>N3:</b> There is cancer in one or more lymph nodes in the groin<br />
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<span style="font-family: Times,"Times New Roman",serif;"><span style="color: #6aa84f;"><b>The M stages of bladder cancer</b></span></span><br />
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<b>M0:</b> There are no signs of distant spread.<br />
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<b>M1</b>: The cancer has spread to distant parts of the body. (The most common sites are distant lymph nodes, the bones, the lungs, and the liver).</div><hr /><div style="text-align: justify;"><b><span style="font-size: large;"><span style="font-family: Times,"Times New Roman",serif;">Bladder Cancer Stage Grouping</span></span></b><br />
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Once the T, N, and M categories have been determined, this information is combined to find the overall cancer stage. Bladder cancer stages are defined using 0 and the Roman numerals I to IV (1 to 4). Stage 0 is the earliest stage, while stage IV is the most advanced.<br />
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<span style="color: #6aa84f;"><b>Stage 0a (Ta, N0, M0)</b></span><br />
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This is an early cancer that is only found on the surface of the inner lining of the bladder. Cancer cells are grouped together and can often be easily removed. The cancer has not invaded the muscle or connective tissue of the bladder wall. This type of bladder cancer is also called noninvasive papillary urothelial carcinoma (Ta, N0, M0).<br />
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<span style="color: #6aa84f;"><b>Stage 0is (Tis, N0, M0)</b></span><br />
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The cancer is a flat, non-invasive carcinoma (Tis), also known as flat carcinoma in situ (CIS). The cancer is growing in the inner lining layer of the bladder only. It has neither grown inward toward the hollow part of the bladder nor has it invaded the connective tissue or muscle of the bladder wall. It has not spread to lymph nodes (N0) or distant sites (M0).<br />
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<b><span style="color: #6aa84f;">Stage I (T1, N0, M0)</span></b><br />
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The cancer has grown through the inner lining of the bladder to the lamina propria. It has not spread to the thick layer of muscle in the bladder wall or to lymph nodes or other organs (T1, N0, M0).<br />
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<span style="color: #6aa84f;"><b>Stage II (T2a or T2b, N0, M0)</b></span><br />
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The cancer has grown into the thick muscle layer of the bladder wall, but it has not passed completely through the muscle to reach the layer of fatty tissue that surrounds the bladder (T2). The cancer has not spread to lymph nodes (N0) or to distant sites (M0).<br />
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<span style="color: #6aa84f;"><b>Stage III (T3a, T3b, or T4a, N0, M0)</b></span><br />
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The cancer has spread throughout the muscle wall to the fatty layer of tissue surrounding the bladder. It may also have spread to the prostate in a man or the uterus and vagina in a woman. It has not spread to the lymph nodes or other organs (T3a, T3b, or T4a, N0, M0).<br />
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<span style="color: #6aa84f;"><b>Stage IV</b></span><br />
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One of the following applies:<br />
<ul><li><b>T4b, N0, M0</b>: The cancer has grown through the bladder wall and into the pelvic or abdominal wall (T4b). The cancer has not spread to lymph nodes (N0) or to distant sites (M0). Or,</li>
<li><b>Any T, N1 to N3, M0:</b> The cancer has spread to nearby lymph nodes (N1-N3) but not to distant sites (M0). Or,</li>
<li><b>Any T, any N, M1:</b> The cancer has spread to distant lymph nodes or to sites such as the bones, liver, or lungs (M1).</li>
</ul><hr /><br />
<b><span style="font-size: large;"><span style="font-family: Times,"Times New Roman",serif;">What grade is?</span></span></b><br />
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Your doctor may talk to you about <u>the grade of your cancer</u>. This means how well developed the cells look under the microscope.<br />
<ul><li>Low grade cancers have cells that look very like normal cells – they are called low grade or well differentiated and tend to grow slowly and to stay in the lining of the bladder</li>
<li>Medium grade cancers have cells that look more abnormal – they are called moderately differentiated and are more likely to spread into the muscle of the bladder (progress) or to come back after treatment</li>
<li>High grade cancers have cells that look very abnormal – they are called high grade or poorly differentiated, are quickly growing, more likely to come back after treatment and more likely to spread into the bladder muscle (progress)</li>
</ul>If you have early bladder cancer, grade is one thing that your doctor may take into account when deciding your treatment. If the cells are high grade, you are more likely to need further treatment to stop the cancer coming back after your specialist has removed it. Carcinoma in situ tumours of the bladder are high grade.                   <br />
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In 2004 the World Health Organisation developed a new grading system for early bladder cancer, which is increasingly being used. This system divides bladder cancers into the following groups<br />
<ul><li>Urothelial papilloma – non cancerous (benign) tumour</li>
<li>Papillary urothelial neoplasm of low malignant potential (PUNLMP) – very slow growing and unlikely to spread</li>
<li>Low grade papillary urothelial carcinoma – slow growing and unlikely to spread</li>
<li>High grade papillary urothelial carcinoma – more quickly growing and more likely to spread</li>
</ul></div></div>

Bladder Cancer Stage and Grade

What staging is? Staging is a way of describing where the cancer is located, if or where it has invaded or spread, and whether it is affec...

Diagnosis of Bladder Cancer

ancorez Bladder Cancer 3:28 PM

<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><b>Bladder cancer</b> is often found because of signs or symptoms a person is having, or it might be found because of lab tests a person is getting for another reason. If bladder cancer is suspected, exams and tests will be needed to confirm the diagnosis. If cancer is found, further tests will be done to help determine the extent (stage) of the cancer. Tests and procedures used to diagnose bladder cancer may include:<br />
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<span style="color: #38761d;"><b><span style="font-family: Times,"Times New Roman",serif;">• Biopsy</span></b></span><br />
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A biopsy is the removal of a small sample of body tissue to see if it is cancer. The tissue that is removed is sent to the lab, where it is looked at by a pathologist, a doctor who specializes in diagnosing diseases with lab tests. If bladder cancer is suspected, a biopsy is needed to confirm the diagnosis.<br />
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-<b> Biopsies to look for cancer spread</b><br />
If imaging tests (see the next section) suggest the cancer might have spread outside of the bladder, a biopsy is the only way to be sure. In some cases, biopsy samples of suspicious areas are obtained during surgery to remove the bladder cancer.<br />
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Another way to get a biopsy sample is to use a thin, hollow needle to take a small piece of tissue from the abnormal area. This is known as a needle biopsy, and by using it the doctor can take samples without an operation. Needle biopsies are sometimes done using a computed tomography scan or ultrasound to help guide the biopsy needle into the abnormal area.<br />
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<b>- Bladder biopsies</b><br />
Bladder biopsy samples are most often obtained during cystoscopy. A biopsy can show whether cancer is present and what type of bladder cancer it is. If bladder cancer is found, two important features are its invasiveness and grade.<br />
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<b>Invasiveness:</b> The biopsy can show how deeply the cancer has invaded (grown into) the bladder wall, which is very important in deciding treatment. If the cancer stays in the inner layer of cells without growing into the deeper layers, it is called non-invasive. If the cancer grows into the deeper layers of the bladder, it is called invasive. Invasive cancers are more likely to spread and are harder to treat.<br />
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You may also see a bladder cancer described as superficial or non-muscle invasive. These terms include both non-invasive tumors as well as any invasive tumors that have not grown into the main muscle layer of the bladder.<br />
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<b>Grade:</b> Bladder cancers are also assigned a grade, based on how they look under the microscope. <br />
<ul><li><i>Low-grade cancers</i> look more like normal bladder tissue. They are also called well-differentiated cancers. Patients with these cancers usually have a good prognosis (outlook).</li>
<li><i>High-grade cancers</i> look less like normal tissue. These cancers may also be called poorly differentiated or undifferentiated. High-grade cancers are more likely to grow into the bladder wall and to spread outside the bladder. These cancers can be harder to treat.</li>
</ul><br />
People with bladder cancer may develop more cancers in other areas of the bladder or in the urinary system. For this reason, during the biopsy the doctor may take tissue samples from several different areas of the bladder lining.<br />
<hr /><br />
<span style="color: #38761d;"><b><span style="font-family: Times,"Times New Roman",serif;">• Cystoscopy</span></b></span><br />
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Cystoscopy uses an instrument known as a cytoscope (a thin tube with a camera and light at the end) to examine the inside of your bladder. The procedure usually takes about five minutes.</div><br />
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<div style="text-align: justify;">During a cystoscopy a local anaesthetic gel is applied to your urethra (the tube through which you urinate) so you don't feel any pain. The gel also helps the cystoscope to pass into the urethra more easily.<br />
<hr /><br />
<span style="color: #38761d;"><b><span style="font-family: Times,"Times New Roman",serif;">• Imaging tests</span></b></span><br />
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Imaging tests allow your doctor to examine the structures of your urinary tract. Tests to highlight the urinary tract sometimes use a dye, which is injected into a vein before the procedure. An intravenous pyelogram is a type of X-ray imaging test that uses a dye to highlight your kidneys, ureters and bladder. A computerized tomography (CT) scan is a type of X-ray test that allows your doctor to better see your urinary tract and the surrounding tissues.<br />
<hr /><br />
<span style="color: #38761d;"><b><span style="font-family: Times,"Times New Roman",serif;">• Lab tests</span></b></span><br />
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<b>Urine culture</b><br />
If you are having urinary symptoms, this test may be done to see if an infection (rather than cancer) is the cause. Infections and <i>bladder cancers</i> can cause similar symptoms. For a urine culture, a sample of urine is put into a dish in the lab to allow any bacteria that are present to grow. It can take time for the bacteria to grow, so it may take a few days to get the results of this test.<br />
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<b>Urine cytology</b><br />
A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology. Cytology is also done on any bladder washings taken when the cystoscopy was done. Cytology can help find some cancers, but this test is not perfect. Not finding cancer on this test doesn’t always mean you are cancer free.<br />
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<b>Urine tumor marker tests</b><br />
Different urine tests look for specific substances released by bladder cancer cells. These tests may be used along with urine cytology to help determine if a person has bladder cancer. They include the tests for NMP22 and BTA, the Immunocyt test, and the UroVysion test.<br />
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Some doctors find these urine tests useful in looking for bladder cancers, but they may not help in all cases. Most doctors feel that cystoscopy is still the best way to find bladder cancer. Some of these tests are more helpful when looking for possible recurrence of bladder cancer in someone who has already had it, rather than finding it in the first place.<br />
<hr /><br />
<span style="color: #38761d;"><b><span style="font-family: Times,"Times New Roman",serif;">• Medical history and physical exam</span></b></span><br />
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A physical exam provides other information about possible signs of <u>bladder cancer</u> and other health problems. The doctor might examine the rectum and vagina (in women) to feel for a bladder tumor, determine its size, and to see if and how far it has spread.<br />
If the results of the exam are abnormal, your doctor will probably do lab tests such as a urinalysis and might refer you to a urologist (a doctor specializing in diseases of the urinary system and male reproductive system) for further tests and treatment.</div></div>

Diagnosis of Bladder Cancer

Bladder cancer is often found because of signs or symptoms a person is having, or it might be found because of lab tests a person is gettin...

Definition and Description of Bladder Cancer

ancorez Bladder Cancer 10:00 PM

<div dir="ltr" style="text-align: left;" trbidi="on"><div style="text-align: justify;"><h1>Definition of Bladder Cancer</h1></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><b>Bladder Cancer</b> is <a href="http://cancer-666.blogspot.com/">cancer</a> that forms in tissues of the bladder (the organ that stores urine). Most bladder cancers are transitional cell carcinomas (cancer that begins in cells that normally make up the inner lining of the bladder). Other types include squamous cell carcinoma (cancer that begins in thin, flat cells) and adenocarcinoma (cancer that begins in cells that make and release mucus and other fluids). The cells that form squamous cell carcinoma and adenocarcinoma develop in the inner lining of the bladder as a result of chronic irritation and inflammation.</div><div style="text-align: justify;"><br />
</div><div class="separator" style="clear: both; text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSnwd6SD11UG3OX4ZKgLY-1RV5Fif3Mm6wqAEf4b711RW95XTewz0sFAq5pHu0BXY8pF2nKWzI9WHCTpI6zD4mmOIuyUN2qR4stqKTa1wsjHSbkg3-mimZcKcoAUU2ttaDuSEwH2yg5DM/s1600/Description+and+Definition+of+Bladder+Cancer.jpg" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="289" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjSnwd6SD11UG3OX4ZKgLY-1RV5Fif3Mm6wqAEf4b711RW95XTewz0sFAq5pHu0BXY8pF2nKWzI9WHCTpI6zD4mmOIuyUN2qR4stqKTa1wsjHSbkg3-mimZcKcoAUU2ttaDuSEwH2yg5DM/s320/Description+and+Definition+of+Bladder+Cancer.jpg" width="320" /></a></div><div style="text-align: justify;"><i>Bladder Cancer</i> is  a common form of cancer that begins in the lining of the bladder. The most common warning sign is blood in the urine. Symptoms include pain during urination, frequent urination, and feeling the need to urinate without results. A diagnosis of bladder cancer is supported by findings in the medical history, physical examination, examination of the urine, and intravenous pyelogram (IVP). Confirmation of the diagnosis requires a biopsy, usually using a cystoscope. The bladder is lined with cells called transitional cells and squamous cells. A tumor may grow through the lining into the muscular wall of the bladder and extend into nearby organs such as the uterus or vagina (in women) or the prostate gland (in men). When bladder cancer spreads beyond the bladder, the malignant cells are frequently found in nearby lymph nodes and may have spread to other lymph nodes or other places, including the lungs, liver, or bones. Risk factors for bladder cancer include age over 40 years, race (Caucasians are at twice the risk of African-Americans and Hispanic-Americans, with Asian-Americans at least risk), gender (men are two to three times more likely to get bladder cancer), family history of bladder cancer, use of tobacco (which is a major risk factor), occupational exposures (for example, workers in the rubber, chemical, and leather industries, hairdressers, machinists, metal workers, printers, painters, textile workers, and truck drivers), and prior treatment with cyclophosphamide or arsenic exposure. Treatment depends on the growth, size, and location of the tumor. Surgical operations are commonly needed. Chemotherapy, biological therapy, or radiotherapy may also be used.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Bladder cancer is a disease in which the cells lining the urinary bladder lose the ability to regulate their growth and start dividing uncontrollably. This abnormal growth results in a mass of cells that form a tumor.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><h2>Description of Bladder Cancer</h2></div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;"><u>Bladder cancer</u> is the sixth most common cancer in the United States. The American Cancer Society (ACS) estimated that in 2001, approximately 54,300 new cases of bladder cancer would be diagnosed (about 39,200 men and 15,100 women), causing approximately 12,400 deaths. The rates for men of African descent and Hispanic men are similar and are approximately one-half of the rate among white non-Hispanic men. The lowest rate of bladder cancer occurs in the Asian population. Among women, the highest rates also occur in white non-Hispanic females and are approximately twice the rate for Hispanics. Women of African descent have higher rates of bladder cancer than Hispanic women</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">The urinary bladder is a hollow muscular organ that stores urine from the kidneys until it is excreted out of the body. Two tubes called the ureters bring the urine from the kidneys to the bladder. The urethra carries the urine from the bladder to the outside of the body.</div><div style="text-align: justify;"><br />
</div><div style="text-align: justify;">Bladder cancer has a very high rate of recurrence. Even after superficial tumors are completely removed, there is a 75% chance that new tumors will develop in other areas of the bladder. Hence, patients need frequent and thorough follow-up care.</div></div>

Definition and Description of Bladder Cancer

Definition of Bladder Cancer Bladder Cancer is cancer that forms in tissues of the bladder (the organ that stores urine). Most bladder ca...

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