F Grading The Strength Of Evidence For Major Comparisons And Outcomes
The strength of evidence for each key question will be initially assessed by one researcher for each clinical outcome by using the approach described in the AHRQ Methods Guide.12 To ensure consistency and validity of the evaluation, the grades will be reviewed by the entire team of investigators for:
- Risk of bias
- Consistency
- Directness
- Precision
- Reporting bias
Assessments of reporting bias will be based on whether studies defined and reported primary outcomes, and when available, by comparing published results to results reported in trial registries. The strength of evidence will be assigned an overall grade of high, moderate, low, or insufficient according to a four-level scale by evaluating and weighing the combined results of the above domains:
What Is Metastatic Cancer
Cancer that spreads from where it started to a distant part of the body is called metastatic cancer. For many types of cancer, it is also called stage IV cancer. The process by which cancer cells spread to other parts of the body is called metastasis.
When observed under a microscope and tested in other ways, metastatic cancer cells have features like that of the primary cancer and not like the cells in the place where the metastatic cancer is found. This is how doctors can tell that it is cancer that has spread from another part of the body.
Metastatic cancer has the same name as the primary cancer. For example, breast cancer that spreads to the lung is called metastatic breast cancer, not lung cancer. It is treated as stage IV breast cancer, not as lung cancer.
Sometimes when people are diagnosed with metastatic cancer, doctors cannot tell where it started. This type of cancer is called cancer of unknown primary origin, or CUP. See the Carcinoma of Unknown Primary page for more information.
Is Bladder Cancer Treatable
Many types of therapy are used to treat bladder cancer. In general, the treatment pathway chosen depends on the type and stage of bladder cancer present and a patients overall health and individual preferences. Common treatment options include:
- Surgery: to remove tumor cells and surrounding tissue. The type of surgery used depends on factors such as the size and progression of the tumor.
- Chemotherapy: which refers to the use of drugs to destroy cancer cells. Chemotherapy may be local or systemic .
- Immunotherapy: which uses naturally occurring or man-made substances to improve or bolster the bodys immune system function. Like with chemotherapy, immunotherapy may be delivered locally or systemically.
- Radiation therapy: which uses x-rays or other high-energy waves or particles to kill cancer cells.
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Nature And Burden Of Non
Bladder cancer is the fourth most commonly diagnosed cancer in men and tenth most commonly diagnosed cancer in women in the United States.1 The American Cancer Society estimates there will be 72,570 new cases of bladder cancer in the U.S. in 2013 , and about 15,210 deaths due to bladder cancer .1 The lifetime probability of developing bladder cancer in the U.S. is approximately 3.8 percent in men and 1.2 percent in women, although the incidence of bladder cancer is increasing in women. Bladder cancer occurs primarily in men older than 60 and roughly twice as frequently in white compared to black men,2 though mortality is similar, presumably due to delayed diagnosis in black men.
Bladder cancer remains an important health problem, with no improvement in associated mortality since 1975.3 Economic analyses have shown bladder cancer to be the costliest cancer to treat in the U.S. on a per capita basis, taking into account diagnostic testing, management, and long term follow up.4 The most common risk factor for bladder cancer is smoking, though other risk factors include occupational exposures and family history. The most common symptom of bladder cancer is painless hematuria .
Bladder Cancer And Its Stages
Bladder cancer is a disease that can have varying symptoms and severity according to its stage. The estimated life expectancy of people who are diagnosed with bladder cancer is dependent on their condition and treatment.
The stages of bladder cancer have different levels of effects to the patient. Although living with bladder cancer can be difficult and challenging, do not lose hope as some of the stages of bladder cancer can be treated.
If people with bladder cancer receive treatment early on the first stage of cancer, the symptoms can be neutralized. The stages of bladder cancer usually depend on the formation of cancer in other parts of the body. If the first stage is managed early, the spread of cancer can be stopped.
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Cancer Survival Rates Dont Inform The Whole Story
Survival rates are often based on previous outcomes of large numbers of individuals who had the disease, but they cannot anticipate exactly what will take place in any particular persons case. There are a variety of limitations to keep in mind:
- The numbers below are among the most existing readily available. However to obtain 5-year survival rates, doctors have to look at individuals who were alleviated at least 5 years ago. As treatments are enhancing in time, people who are now being detected with bladder cancer might have a much better outlook than these data reveal.
- These data are based on the stage of the cancer when it was first identified. They do not apply to cancers that later on returned or spread, for example.
- The outlook for people with bladder cancer varies by the stage of the cancer in general, the survival rates are greater for people with earlier phase cancers. But many other aspects can impact an individuals outlook, such as age and general health, and how well the cancer reacts to treatment. The outlook for each person is specific to their conditions.
Your physician can tell you how these numbers may use to you, as she or he recognizes with your certain scenario.
What Is A Bladder
The bladder can be described as a hollow organ, which is located next to the kidneys. The bladder functions by collecting all the urine coming from the kidneys through the ureter. It then stores the urine until it is removed from the body.
Having a bladder cancer causes an uncontrolled growth and development of cells in the bladder. The increasing production of cells is abnormal. Once the cells have grown, they can cause some complications in the person’s body including pain.
Have a question about
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Substantial Improvement In Survival
Dr. Powles and his colleagues enrolled 700 people with locally advanced or metastatic bladder cancer in the international JAVELIN Bladder 100 study, which was funded by Pfizer, the drugs manufacturer.
All trial participants had already received chemotherapywith either cisplatin and gemcitabine or carboplatin and gemcitabine, if their health did not allow them to receive cisplatinand their disease had not worsened during chemotherapy.
Participants were then randomly assigned to receive either maintenance treatment with avelumab plus supportive care or supportive care alone. People in the maintenance group received infusions of avelumab every 2 weeks until their cancer started growing again or they left the study for other reasons. Supportive care for both groups included pain management, nutritional support, and treatment of infections.
People in the supportive care group whose cancer got worse did not receive avelumab as part of the trial. However, they could receive it or any other immunotherapy drug after leaving the study.
Maintenance treatment with avelumab after chemotherapy turned out to have substantial benefits. The median overall survival for people who received maintenance avelumab was more than 21 months, compared with about 14 months for people who received only supportive care until their cancer got worse.
Survival Rates By Stage
The numbers listed below are based upon countless people detected with bladder cancer from 1988 to 2001. These numbers originated from the National Cancer Institutes SEER database.
- The 5-year relative survival rate for people with stage 0 bladder cancer has to do with 98%.
- The 5-year relative survival rate for individuals with stage I bladder cancer has to do with 88%.
- For stage II bladder cancer, the 5-year relative survival rate is about 63%.
- The 5-year relative survival rate for stage III bladder cancer has to do with 46%.
Bladder cancer that has spread to other parts of the body is often hard to alleviate. Phase IV bladder cancer has a relative 5-year survival rate of about 15%. Still, there are typically treatment alternatives readily available for people with this phase of cancer.
Remember, these survival rates are only approximates they cant predict exactly what will happen to any individual person. We comprehend that these data can be complicated and may lead you to have more concerns. Speak with your physician to much better comprehend your certain situation.
Being diagnosed with bladder cancer can be overwhelming and scary, especially if its phase 4.
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Can Bladder Cancer Be Cured
When detected at an early stage, bladder cancer can usually be treated successfully whereas later-stage cancers may present greater challenges for the patient and their healthcare team. As discussed later, people who have had bladder cancer are at risk for recurrence for the best chance of successfully treating recurrent cancer, early detection is again important.
Sexuality And Bladder Cancer
Having bladder cancer and treatment can change the way you feel about yourself, other people, relationships and sex. These changes can be very upsetting and hard to talk about. Doctors and nurses are very understanding and can give you support. You can ask for a referral to a counsellor or therapist who specialises in body image, sex and relationships.
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Prognosis And Survival For Bladder Cancer
If you have bladder cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for bladder cancer.
Signs And Symptoms Of Bladder Cancer
Sometimes bladder cancer doesnt have many symptoms. Signs or symptoms can include:
- blood in your urine
- pain or burning when passing urine
- not being able to pass urine when you need to.
Not everyone with these symptoms has bladder cancer. If you have any of these symptoms or are worried, always see your doctor.
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Prognosis Of Patients With Muscle Invasive Bladder Cancer Who Are Intolerable To Receive Any Anti
Muscle invasive bladder tumor has a high propensity for rapid growth and distant metastasis.
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The aim of this retrospective study was to evaluate the prognosis of patients who had been diagnosed with muscle invasive bladder cancer and did not receive anti-cancer treatment because of their physical characteristics.
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We evaluated 26 patients. Median overall survival was 12 months.
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These results may assist in counseling older patients with MIBC if the disease is left untreated.
Latest Treatment For Bladder Cancer
Intravesical therapy is a newer treatment for people who have bladder cancer. With intravesical therapy, the doctor puts a liquid medication right into your bladder rather than administering it orally or injecting it into your blood. The medication is put in through a catheter thats placed into your bladder through the urethra. The medication stays in your bladder for up to two hours, so it can affect the cells lining the inside of the bladder without having major effects on other parts of your body. Intravesical therapy is commonly used after transurethral resection of bladder tumor . Its often performed within 24 hours of the TURBT procedure. The goal is to kill any cancer cells that may be left in the bladder.
Intravesical chemotherapy is used to treat non-invasive bladder cancer. It is used for these early-stage cancers because medication given this way mostly affects the cells lining the inside of the bladder. It has little to no effect on cells elsewhere. This means any cancer cells outside of the bladder lining are not treated by intravesical chemotherapy.
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When Metastatic Cancer Can No Longer Be Controlled
If you have been told your cancer can no longer be controlled, you and your loved ones may want to discuss end-of-life care. Whether or not you choose to continue treatment to shrink the cancer or control its growth, you can always receive palliative care to control the symptoms of cancer and the side effects of treatment. Information on coping with and planning for end-of-life care is available in the Advanced Cancer section of this site.
Prognosis And Survival Rates For Bladder Cancer
When someone is diagnosed with bladder cancer, their doctor will give them a prognosis. A prognosis is the doctors opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the persons age and general health.
Bladder cancer can usually be effectively treated if it is found before it spreads outside the bladder.
If you have bladder cancer, your doctor will talk to you about your individual situation when working out your prognosis. Every persons experience is different, and there is support available to you.
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What Is A 5
A relative survival rate compares people with the same type and stage of bladder cancer to people in the overall population. For example, if the 5-year relative survival rate for a specific stage of bladder cancer is 90%, it means that people who have that cancer are, on average, about 90% as likely as people who dont have that cancer to live for at least 5 years after being diagnosed.
Bladder Cancer Stages And Survival Rates
Cancer survival rates are also categorized according to the stage of the cancer when it was diagnosed. The stage of cancer generally refers to how far it has progressed, and whether it has spread to other parts of the body. For bladder cancer, the 5-year survival rate for people with:2,3
- Bladder cancer in situ is around 96 percent
- Localized bladder cancer is around 70 percent
- Bladder cancer that has spread to the regional lymph nodes is 35 percent
- Distant or metastasized bladder cancer is 5 percent
If you would like to learn more about bladder cancer statistics, consider speaking with someone on your health care team. They will be able to explain more about how these statistics apply to your cancer. Tell us about your experience in the comments below, or with the community.
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Treatment Of Bladder Cancer By Stage
Most of the time, treatment of bladder cancer is based on the tumors clinical stage when its first diagnosed. This includes how deep its thought to have grown into the bladder wall and whether it has spread beyond the bladder. Other factors, such as the size of the tumor, how fast the cancer cells are growing , and a persons overall health and preferences, also affect treatment options.
What Is Muscle Invasive Bladder Cancer
Muscle invasive bladder cancer is a cancer that spreads into the detrusor muscle of the bladder. The detrusor muscle is the thick muscle deep in the bladder wall. This cancer is more likely to spread to other parts of the body.
In the U.S., bladder cancer is the third most common cancer in men. Each year, there are more than 83,000 new cases diagnosed in men and women. About 25% of bladder cancers are MIBC. Bladder cancer is more common as a person grows older. It is found most often in the age group of 75-84. Caucasians are more likely to get bladder cancer than any other ethnicity. But there are more African-Americans who do not survive the disease.
What is Cancer?
Cancer is when your body cells grow out of control. When this happens, the body cannot work the way it should. Most cancers form a lump called a tumor or a growth. Some cancers grow and spread fast. Others grow more slowly. Not all lumps are cancers. Cancerous lumps are sometimes called malignant tumors.
What is Bladder Cancer?
When cells of the bladder grow abnormally, they can become bladder cancer. A person with bladder cancer will have one or more tumors in his/her bladder.
How Does Bladder Cancer Develop and Spread?
The bladder wall has many layers, made up of different types of cells. Most bladder cancers start in the urothelium or transitional epithelium. This is the inside lining of the bladder. Transitional cell carcinoma is cancer that forms in the cells of the urothelium.
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Living With Advanced Cancer
Advanced cancer usually means cancer that is unlikely to be cured. Some people can live for many months or years with advanced cancer. During this time palliative care services can help.
Most people continue to have treatment for advanced cancer as part of palliative care, as it helps manage the cancer and improve their day-to-day lives. Many people think that palliative care is for people who are dying but palliative care is for any stage of advanced cancer. There are doctors, nurses and other people who specialise in palliative care.
Treatment may include chemotherapy, radiation therapy or another type of treatment. It can help in these ways:
- slow down how fast the cancer is growing
- shrink the cancer
- help you to live more comfortably by managing symptoms, like pain.
Treatment depends on:
- how far it has spread
- your general health