Bladder Cancer And Lung Cancer

Survival For All Stages Of Bladder Cancer

FDA Approvals in Bladder Cancer and NSCLC, and 2019 ELCC Highlights

Generally, for people diagnosed with bladder cancer in England:

around 75 out of every 100 survive their cancer for 1 year or more after diagnosis
almost 55 out of every 100 survive their cancer for 5 years or more after they are diagnosed
around 45 out of every 100 survive their cancer for 10 years or more after diagnosis

Cancer survival by stage at diagnosis for England, 2019Office for National Statistics

These statistics are for net survival. Net survival estimates the number of people who survive their cancer rather than calculating the number of people diagnosed with cancer who are still alive. In other words, it is the survival of cancer patients after taking into account that some people would have died from other causes if they had not had cancer.

How Is Bladder Cancer Treated

Treatment for bladder cancer depends on

The stage of cancer.
If cancer has spread beyond the lining of the bladder.
The extent of cancer spread.

Treatment options based on tumor grade

High-grade bladder cancer: High-grade cancers that are life-threatening and spread quickly need to be treated with chemotherapy, radiation or surgery.
Low-grade cancers: Less aggressive cancers have a low chance of becoming high grade and do not require aggressive treatments, such as radiation or bladder removal.

Treatment options may vary depending on the tumor stage.

Changes In Bladder Habits Or Symptoms Of Irritation

Bladder cancer can sometimes cause changes in urination, such as:

Having to urinate more often than usual
Pain or burning during urination
Feeling as if you need to go right away, even when your bladder isn’t full
Having trouble urinating or having a weak urine stream
Having to get up to urinate many times during the night

These symptoms are more likely to be caused by a urinary tract infection , bladder stones, an overactive bladder, or an enlarged prostate . Still, its important to have them checked by a doctor so that the cause can be found and treated, if needed.

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Metastatic Lung Cancer Started Someplace Else

Primary tumors can spread from almost anywhere in the body to your lungs. But some types of cancer are more likely to grow in your lungs. These include:

Cancer treatments youâve already had
How you want to treat your cancer

Cancer that has spread to your lungs is also probably in your bloodstream. It could be in places that donât show up on imaging scans. Thatâs why doctors mostly use chemotherapy to treat metastatic lung cancer. It destroys cancerous cells everywhere in your body.

Surgery Is less common. Doctors use it if the tumors are only in a small part of the lung . It can also help when the primary cancer is colorectal cancer, bone cancer, or soft tissue sarcoma.

Other treatment options include:

Hormonal therapy. This slows the growth of certain types of cancer cells and eases your symptoms.
Targeted therapy. It uses medications that attach to proteins on cancer cells to stop or slow their growth.
Immunotherapy. This uses your bodyâs immune system to destroy cancer cells.
Ablation therapy. It destroys cancer cells or tumors with lasers or electrical currents.
Radiation. High energy X-rays are used to destroy tumors.
Thoracentesis. This uses a needle to remove fluid in the space between your lungs and chest wall.
Oxygen therapy. It helps you breathe.
Stents. They open up narrowed airways.

What Causes Bladder Cancer And Am I At Risk

Bladder Cancer Symptoms Pictures: Warning Signs, Treatments, Survival Rates

Each year, about 83,730 new cases of bladder cancer will be diagnosed in the United States. It affects more men than women and the average age at diagnosis is 73.

Cigarette smoking is the biggest risk factor for bladder cancer. About half of all bladder cancers are caused by cigarette smoking. Other risk factors for developing bladder cancer include: family history, occupational exposure to chemicals , previous cancer treatment with cyclophosphamide, ifosfamide, or pelvic radiation, the medication pioglitazone, exposure to arsenic , aristolochic , bladder infections caused by schistosoma haematobium, not drinking enough fluids, a genetic condition called Lynch Syndrome, a mutation of the retinoblastoma gene or the PTEN gene. and neurogenic bladder and the overuse of indwelling catheters.

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What Screening Tests Are Used For Bladder Cancer

It is not standard to screen for bladder cancer. Bladder cancer screening may be used in people who are considered high risk. If you have a history of bladder cancer, a history of a birth defect of the bladder, or have been exposed to certain chemicals at work, you may be considered high-risk. You should ask your provider if screening tests are right for you.

Testing the urine for blood, abnormal cells, and tumor markers can help find some bladder cancers early but the results vary. Not all bladder cancers are found, and some people may have changes in their urine but do not have bladder cancer. These tests can be used in those who already have signs of bladder cancer or if the cancer has returned. However, more research is needed to determine how useful testing the urine is as a screening test.

Hi my Dad was diagnosed with bladder cancer last October. He is 77. He had an operation to remove it and was then packed with chemo. Whilst doing the scan they found lung cancer. The cancer was too close to his heart and he has been told it is inoperable and incurable. This was NYE. He has had an intensive course of radio and chemo and it shrank very slightly. Now my Dad is a private man and probably my parents don’t ask the right questions ie grades outcome. He has gone in for a bladder check and the bladder cancer has come back. My dad has hereditary diabetes so his moods are all over the place and he is angry and depressed. And at the moment no good news is coming. He has lost weight and not eating and the treatment has really knocked him. I have three useless brothers and so it’s all down to me to try and remain positive. What i would like to know is life expectancy as I would like to be a bit more prepared. I thought in a rainbow world this was being won! My dad will not let me go to any appointments and I can’t ask too many questions and I have to respect that. Thanks for reading this.

Hello angelldelight,

I hope you will hear from others here who have faced a similar situation before and that they will be along to share their thoughts with you on this.

Best wishes,

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Case : Isolated Mediastinal Lymphadenopathy

A 68-year-old male, formerly a heavy smoker, was evaluated in the pulmonary clinic for an abnormal chest radiograph . He had been diagnosed with high-grade invasive UBC with focal squamous differentiation 2 years before this evaluation and had been treated with serial transurethral resections as he had refused cystectomy. At the clinic visit, he reported recent weight loss and swelling on the left side of the neck. Physical examination was significant for left posterior cervical lymphadenopathy, scattered wheezes on lung auscultation, and lower extremity pitting edema. Routine laboratory evaluation was unremarkable. CR showed a widened right paratracheal stripe . Computed tomography of the chest without intravenous contrast demonstrated multicompartment mediastinal lymphadenopathy, including the right lower paratracheal and subcarinal lymph node stations . There were no parenchymal lesions. The patient underwent bronchoscopy with core transbronchial needle aspiration of the 4R lymph node, which revealed metastatic carcinoma histologically compatible with urothelial origin with squamous differentiation similar to that seen on the patient’s prior bladder biopsies. Fine-needle aspiration of the enlarged left posterior cervical lymph node yielded similar morphology. The patient refused to undergo chemotherapy and was subsequently lost to follow-up.

Figure 2:

Can Bladder Cancer Be Cured

FDA Approvals in Bladder Cancer, NSCLC, AML, HCC, and a Breakthrough Designation in NSCLC

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.

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What Are The Treatment Options For Bladder Cancer

There are four types of treatment for patients with bladder cancer. These include:

Surgery

Sometimes, combinations of these treatments will be used.

Surgical options

Surgery is a common treatment option for bladder cancer. The type of surgery chosen will depend on the stage of the cancer.

Transurethral resection of the bladder is used most often for early stage disease . It is done under general or spinal anesthesia. In this procedure, a special telescope called a resectoscope is inserted through the urethra into the bladder. The tumor is then trimmed away with the resectoscope, using a wire loop, and the raw surface of the bladder is then fulgurated .
Partial cystectomy is the removal of a section of the bladder. At times, it is used for a single tumor that invades the bladder wall in only one region of the bladder. This type of surgery retains most of the bladder. Chemotherapy or radiation therapy is often used in combination. Only a minority of patients will qualify for this bladder-sparing procedure.
Radical cystectomy is complete removal of the bladder. It is used for more extensive cancers and those that have spread beyond the bladder .

This surgery is often done using a robot, which removes the bladder and any other surrounding organs. In men, this is the prostate and seminal vesicles. In women, the ovaries, uterus and a portion of the vagina may be removed along with the bladder.

Chemotherapy

Methotrexate

Intravesical therapy

Radiation therapy

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.

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How Is Bladder Cancer Staged

Cancer staging describes how much the cancer has grown and invaded the area, explaining the extent of the disease. Bladder cancer is often found at an early stage, as hematuria starts early in the course of the disease. Sometimes bladder cancer can advance to invasive disease before causing symptoms. To best understand staging, you need to know how cancer spreads and advances in stage.

Cancers can spread and disrupt how normal organs work. Bladder cancers often begin very superficially, involving only the lining of the bladder. Bladder cancers can invade the bladder wall, involving the muscular layers of the wall. As bladder cancer grows it can invade the entire way through the wall and into the fat surrounding the bladder or even into other organs . This local extension is the most common way bladder cancer spreads.

When cancer spreads to another area in the body, that area is called metastasis. Cancer can also spread through the lymph system and the bloodstream. Bladder cancer often spreads locally or to lymph nodes before spreading distantly, though this is not always the case. The lungs and bones are the most common areas for metastases to develop. When bladder cancer spreads to another area, it is still bladder cancer. For instance, if it spreads to the lung, it is not called lung cancer, but bladder cancer that has metastasized to the lung. If we look at the affected lung tissue under a microscope, it will look like bladder cancer cells.

Side Effects Of Treatment For Bladder Cancer

All cancer treatments can have side effects. Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it. Call Cancer Council or email to speak with a caring cancer nurse for support.

Resources For More Information

Bladder Cancer Advocacy Network

Offers education and support services, advances research, and raises awareness about bladder cancer. Has an extensive online resource library for bladder cancer patients.

American Bladder Cancer Society

The site is intended to offer help, hope, and support to anyone affected by bladder cancer. Bladder cancer information, resources, and a support forum are offered.

Distant Bladder Cancer Metastasis

Once cancerous cells have reached the lymphatic system, they can make their way to almost any part of the body. However, the most common sites for distant bladder cancer metastases include the:

Lungs
Bones
Liver

Metastatic bladder cancer can also spread to other organs in the urinary and reproductive tracts, such as the prostate, uterus and vagina.

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Local Bladder Cancer Metastasis

When bladder cancer spreads, it first invades the bladder wall, which is made up of four distinct layers. It can take some time for cancer to penetrate all of these layers, but once it has, it can then spread into the surrounding fatty tissues and lymph nodes. Once bladder cancer has reached the lymph nodes, it can travel to distant parts of the body through the lymphatic system. Separately, it can also continue to grow into surrounding areas such as the abdominal wall .

Treating Stage I Bladder Cancer

FDA Approvals in NSCLC, Bladder Cancer, and Breast Cancer, and Death in CAR T-cell Therapy Trial

Stage I bladder cancers have grown into the connective tissue layer of the bladder wall , but have not reached the muscle layer.

Transurethral resection with fulguration is usually the first treatment for these cancers. But its done to help determine the extent of the cancer rather than to try to cure it. If no other treatment is given, many people will later get a new bladder cancer, which often will be more advanced. This is more likely to happen if the first cancer is high-grade .

Even if the cancer is found to be low grade , a second TURBT is often recommended several weeks later. If the doctor then feels that all of the cancer has been removed, intravesical BCG or intravesical chemo is usually given. If all of the cancer wasnt removed, options are intravesical BCG or cystectomy .

If the cancer is high grade, if many tumors are present, or if the tumor is very large when its first found, radical cystectomy may be recommended.

For people who arent healthy enough for a cystectomy, radiation therapy might be an option, but the chances for cure are not as good.

Lung Cancer Drug Could Improve Survival Rates For Bladder Cancer Patients Undergoing Chemotherapy

by University of Sheffield

Scientists from the University of Sheffield have discovered a drug already used to treat lung cancer could help to improve survival rates for bladder cancer patients.

Researchers found that adding nintedaniba targeted cancer growth inhibitor currently used to treat non-small cell lung cancerto chemotherapy, could significantly improve overall survival rate for bladder cancer patients at one, two and five years.

A total of 120 patients from 15 hospitals in the UK were recruited for the NEOBLADE phase two randomized control trial, led by Professor Syed A Hussain from the University of Sheffield’s Department of Oncology and Metabolism.

The primary outcome of the study was to establish if adding the drug nintedanibwhich blocks different proteins from sending signals to cancer cells to growcould improve the pathological complete response of patients undergoing chemotherapy for muscle-invasive bladder cancer.

Although the study, published today in The Lancet Oncology, did not find significant improvement for this primary outcome, results showed adding nintedanib did improve overall survival ratesomething which now requires further investigation in larger trials.

“These results could be related to changes in the microenvironment of cancer cells translating into survival benefit.

Explore further

Copy Number Clonality And Evolutionary Analyses

We determined total, allele-specific, and integer DNA copy number genome wide using the FACETS algorithm in all tumors independent of sequencing platform . Briefly, FACETS simultaneously segments total and allele-specific DNA copy number from the coverage and genotypes of polymorphic SNPs genome wide. Allele-specific segmentation is based on the log odds ratio of allele fractions at SNPs identified as heterozygous in the normal sample. A fit is applied to the resulting segments, identifying in each sample the log ratio corresponding to diploidy, purity, and average ploidy. Major and minor integer copy number is then assigned to each segment by maximum likelihood. Allelic imbalance is determined from a change in the zygosity of heterozygous SNPs. We then defined the presence of genome doubling in samples for which the majority of the genome contains multiple copies from the same parent/allele. Gene-level copy number was assigned from spanning segments of integer copy number data in each tumor. Homozygous deletion was determined from regions of total copy number of zero. Amplifications were those regions of total integer copy number greater than 5 or 6 in diploid and GD cases, respectively. Partial deletions were called whereas partial amplifications were not. This same FACETS-based analytical pipeline was run on all retrospective and prospective cohorts to allow for direct comparison of gene-level copy number calls.

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