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.
What Causes Bladder Cancer And Am I At Risk
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.
Colorectal Cancer Liver Metastases
Liver metastasis from colorectal cancer has a maximum survival rate of an average of 6 months to 1.5 years, if left untreated. A two-year survival rate is not common and five-year survival rate is very rare. Factors associated with a significant disadvantage in the unresected group include the extent of liver disease, the presence of extrahepatic disease, the age of the patient, and carcinoembryonic antigen level. Though most patients with colorectal liver metastases have a poor prognosis, some patients can still benefit from radical surgery and possibly even avoid recurrence.
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Where Does Prostate Cancer Spread
The most common place for prostate cancer to spread to is the bones. It can also spread to the lymph nodes, liver and lungs and other organs.
A large tumour in the prostate gland can spread into or press on areas around the prostate, such as the back passage or urethra. The urethra is the tube which carries urine from the bladder to the outside of the body.
What Is The Prognosis For Liver Metastases
Prognosis is a clinical term describes how a disease condition develops, the signs and symptoms of the disease, how soon an affected individual is expected to recover, and how will be the quality of life of the affected individual over a period of time post treatment like ability to carry out activities of daily living the chances of any complications and other health concerns, and the chances of overall survival in cases of rare or incurable disease. In short, prognosis is referred to as the expected length of the disease, course of the disease, chances of any expected or unforeseen adverse events.
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The Effect Of Age At Diagnosis With Pancreatic Cancer Metastasis To Liver
The Kaplan Meier survival curve showed significant difference in overall survival for patients diagnosed at different age groups . The overall survival time was negatively correlated with the age at diagnosis. Among the three groups, the prognosis of patients diagnosed at age less than 52 years old was the best, and of which the median survival time was 1 year. .
Kalpan Meier survival curve showing the effect of age at diagnosis with pancreatic cancer metastasis to liver.
Intrahepatic Chemotherapy And Chemoembolisation
Intrahepatic chemotherapy and chemoembolisation involve giving chemotherapy directly into the liver. This is done through a thin tube, called a catheter, into the main blood supply to the liver.
Giving chemotherapy directly into the liver means a higher concentration of the drug can be delivered to the area of cancer.
In chemoembolisation, the chemotherapy is delivered along with an oily liquid or foam which blocks the blood supply to the cancer. The cancer is deprived of oxygen and nutrients, and the chemotherapy stays in the area for longer. The liver continues to be supplied with blood in the normal way.
These treatments may not be routinely available on the NHS but may be offered as part of a clinical trial.
Palliative And Supportive Care
Palliative and supportive care focuses on symptom control and support. Its an extremely important part of the care and treatment for many people living with secondary breast cancer and can significantly improve quality of life for them and their families.
People often associate palliative care with end-of-life treatment. However, many people value having it at any stage of their illness, alongside their medical treatment, to help prevent and relieve symptoms such as pain or fatigue. It can also help with the emotional, social and spiritual effects of secondary breast cancer.
The palliative and support care teams are based in hospitals, hospices and the community. You can be referred by your treatment team, GP or breast care nurse depending on your situation.
What Is Stage 4 Bladder Cancer
Being diagnosed with bladder cancer can be overwhelming, especially if its stage 4.
Stage 4 bladder cancer is the most advanced stage and carries the worst prognosis. Many cancer treatments will be both difficult and challenging.
However, treatment can reduce or even eliminate your symptoms and help you live a longer, more comfortable life.
Its important to consider the pros and cons of treating stage 4 bladder cancer because treatments come with side effects and risks.
Symptoms of bladder cancer can include:
- blood or blood clots in your urine
- pain or burning during urination
- frequent urination
- needing to urinate at night
- needing to urinate but not being able to
- lower back pain on one side of the body
These symptoms commonly lead to a diagnosis, but they arent unique to stage 4 bladder cancer.
Stage 4 bladder cancer is also called metastatic bladder cancer. This means the cancer has spread outside of the bladder into other parts of the body.
People with metastatic cancer may experience symptoms relating to where the cancer has spread. For example, if a persons bladder cancer has spread to their lungs, they may experience chest pain or increased coughing.
Metastatic bladder cancer is difficult to cure because it has already traveled to other parts of the body. The later youre diagnosed and the farther the cancer has traveled, the less chance that your cancer will be cured.
The 5-year survival rate is the rate of surviving for 5 years after a cancer diagnosis.
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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.
Survival Rates For Bladder Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
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The Effect Of Treatment With Pancreatic Cancer Metastasis To Liver
Regardless of age at diagnosis, surgery alone was the optimal treatment option for patients with pancreatic cancer metastasis to liver, followed by surgery combined with chemotherapy , chemotherapy alone and no treatment . And the median survival time of patients with surgery alone was approximately 3.54 years. .
Kalpan Meier survival curve showing the effect of treatment with pancreatic cancer metastasis to liver.
Forms Of Prognostic Scoring
Another way to predict overall outcomes for cancers is through prognostic Scoring. The prognosis for small-cell lung cancer can be done through Manchester score.
International Prognostic Index is used for prognosis of a condition like Non-Hodgkin lymphoma. There are also certain other conditions where prognostic indicators are used like Drug mediated Liver Dysfunctions and exercise stress test after myocardial infarction. Prognostic indicators are also used to predict the overall outcome of patients with multiple myeloma.
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Types Of Bladder Cancer
Once diagnosed, bladder cancer can be classified by how far it has spread.
If the cancerous cells are contained inside the lining of the bladder, doctors describe it as non-muscle-invasive bladder cancer . This is the most common type of bladder cancer.
When the cancerous cells spread beyond the lining, into the surrounding bladder muscle, it’s referred to as muscle-invasive bladder cancer . This is less common, but has a higher chance of spreading to other parts of the body.
If bladder cancer has spread to other parts of the body, it’s known as advanced or metastatic bladder cancer.
Read more about diagnosing bladder cancer.
Metastatic Bladder Cancer Treatment
Without a professional evaluation, it can be difficult to know if the symptoms youre experiencing are the result of bladder cancer or something else. While its important not to panic most of these issues can be caused by other, less serious conditions its also important to talk with an expert if you notice something out of the ordinary. The earlier that bladder cancer is detected, the more treatment options youre likely to have.
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Second Opinion For Peace Of Mind
Desperate for Hope,
I am very sorry for the situation. I can image the anguish you are having with the occurrence. Your bravery surprises me and I applaud you for the evident efforts you are doing to have the best diagnosis and treatment for your husband. He is very fortunate.I do not want my comments to distract you from your good work, however, I think you should get second opinions from an independent physician/radiologist, which opinion would provide you the deserved peace of mind.
The information you share above allows a newer perception of the diagnosis following your post of Oct 17. Things are moving fast and spinning around.The MRImp will add information for what has been found . Probably this MRI exam will conclude the process of staging and the story so far is not pleasant. Cancer spread into the bladder, if any, up to the ureters tubes are still classified localized but the probable T3 is now/becomes T4 disease. This may be the basis of the radiologist that follows the CAR guilines in radiotherapies.
Max above is also suspicious of the affair. The clinical trial of your link is sponsored by the University Health Network, Toronto, Canada, now recruiting patients. Logically a number of hospitals/clinics and physicians are in charge of supplying patients. I believe your urologist to make part of their list for his proposal to you.
I would appreciate if you can post the images taken in the cystoscopy.
Best of lucks,
Bladder Cancer Clinical Trials
What about Clinical Trials?
You may hear about clinical trials for your bladder cancer. Clinical trials are research studies that test if a new treatment or procedure is safe and effective.
Through clinical trials, doctors find new ways to improve treatments and the quality of life for people with disease. Trials are available for all stages of cancer. The results of a clinical trial can make a major difference to patients and their families. Please visit our clinical trials research webpage to learn more.
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Can I Lower My Risk Of Getting A Second Cancer
There are steps you can take to lower your risk and stay as healthy as possible. For example, prostate cancer survivors should do their best to stay away from all tobacco products and tobacco smoke. Smoking can increase the risk of bladder cancer, as well as increase the risk of many other cancers.
To help maintain good health, prostate cancer survivors should also:
- Get to and stay at a healthy weight
- Keep physically active and limit the time you spend sitting or lying down
- Follow a healthy eating pattern that includes plenty of fruits, vegetables, and whole grains, and limits or avoids red and processed meats, sugary drinks, and highly processed foods
- Not drink alcohol. If you do drink, have no more than 1 drink per day for women or 2 per day for men
These steps may also lower the risk of some other health problems.
See Second Cancers in Adults to learn a lot more about the causes of second cancers.
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.
Bostrom PJ, Soloway MS. Secondary cancer after radiotherapy for prostate cancer: Should we be more aware of the risk? Eur Urol. 2007 52:973-982.
Moon K, Stukenborg GJ, Keim J, Theodorescu D. Cancer incidence after localized therapy for prostate cancer. Cancer. 2006 107:991-998.
Last Revised: June 9, 2020
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How We Care For You
The symptoms of liver metastases are often vague and hard to identify yourself. If you have any concerns, contact your doctor. Memorial Sloan Kettering has a team of specialists who are very experienced in diagnosing and treating the condition.
- Our goal is to provide treatment options that give you the very best possible quality of life and survival rate.
- MSK surgeons work closely with interventional radiologists in using powerful imaging tests such as CT, ultrasound, or MRI to guide treatments directly to where your tumor is located. We can often destroy tumors with minimally invasive techniques, such as ablation and embolization.
- Through genetic testing of tumors, we learn about the molecular blueprint of your particular cancer and customize a treatment plan for you. Another option is to combine surgery with hepatic arterial chemotherapy, which delivers the drug directly to the liver.
We also offer a range of support programs that can help you and your loved ones manage the challenges and stress of life during and after treatment for liver cancer.
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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:
Metastatic bladder cancer can also spread to other organs in the urinary and reproductive tracts, such as the prostate, uterus and vagina.
What Tests Will I Have If My Doctor Suspects Bladder Cancer Or Another Urinary Problem
Your doctor will want to analyze your urine to determine if an infection could be a cause of your symptoms. A microscopic examination of the urine, called cytology, will look for cancer cells.
A cystoscopy is the main procedure to identify and diagnose bladder cancer. In this procedure, a lighted telescope is inserted into your bladder from the urethra to view the inside of the bladder and, when done under anesthesia, take tissue samples , which are later examined under a microscope for signs of cancer. When this procedure is done in the doctors office, local anesthesia gel is placed into the urethra prior to the procedure to minimize the discomfort.
If the diagnosis of bladder cancer is made, then the next step is to remove the tumor for detailed staging and diagnosis.
Transurethral resection is a procedure done under general or spinal anesthesia in the operating room. A telescope is inserted into the bladder and the tumor is removed by scraping it from the bladder wall , using a special cystoscope . This procedure is diagnostic as well as therapeutic.
This often can be done as an outpatient procedure, with patients discharged from hospital the same day. After removal, the tumor is analyzed by a pathologist, who will determine the type of tumor, the tumor grade and the depth of invasion. The purpose of the procedure is to remove the tumor and obtain important staging information .
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What Types Of Testing Should I Expect For Monitoring My Condition
Since metastatic prostate cancer isnt curable, your doctor will most likely set up regular visits to check the cancers location, and to manage any long-term side effects from the cancer or any medication youre taking.
And since treatments for advanced prostate cancer are changing so fast and need to be given in a certain sequence to be the most effective, youll probably have not only a prostate cancer doctor but other specialists taking care of you. Your care team should coordinate closely, say the authors of a major study of such teams published in August 2015 in the journal Annals of Oncology.
Along with regularly testing your prostate-specific antigen levels, your care team may request blood tests that measure such prostate cancer indicators as alkaline phosphatase and lactate dehydrogenase. Magnetic resonance imaging or PET scans of the spine or other bones can also help identify how your cancer responds to treatment.
If youve had radiation, youre at an increased risk for bladder and colorectal cancer and should get screened regularly for these as well.
The tests youll have and how often youll need them should be customized to you. Your care team will consider your overall health, medications that are safe for you to take, other health conditions you might have, and what stage your cancer was when you were diagnosed.