Bone Metastases Pattern In Newly Diagnosed Metastatic Bladder Cancer: A Population
Chao Zhang1*, Lele Liu1*, Fang Tao1*, Xu Guo1,6, Guowei Feng3, Feiran Chen3, Yao Xu1, Lili Li1, Xiuxin Han1, Vladimir P. Baklaushev4, Andrey S. Bryukhovetskiy5, Xin Wang2 , Guowen Wang1
1. Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin’s Clinical Research Center for Cancer, Tianjin, China.2. Department of Epidemiology and Biostatistics, First Affiliated Hospital, Army Medical University, 30 Gaotanyan Street Shapingba District, Chongqing, China.3. Department of Urology, Tianjin Key Laboratory of Breast Cancer Prevention and Therapy, Ministry of Education, National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.4. Federal Research and Clinical Center of Specialized Medical Care and Medical Technologies, Federal Biomedical Agency of the Russian Federation, Moscow, Russian Federation.5. Central Clinical Hospital of the Russian Academy of Science, Moscow, Russian Federation.6. Department of Orthopedics, Cangzhou Central Hospital, Cangzhou, Hebei, China.*These authors contributed equally to this work.
Metastatic Disease Or An Early Stage Bladder Cancer A Difficult Question
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Aydin Ataturk State Hospital, Turkey
Correspondence: Ozge Keskin, MD, Aydin Ataturk State Hospital Medical Oncology Department, Aydin, Turkey,, Tel 9.05E+11, Fax 9.03E+11
Received: February 28, 2017 | Published: April 28, 2017
Citation: Keskin O, Oktay E Metastatic Disease or an Early Stage Bladder Cancer? A Difficult Question. J Cancer Prev Curr Res 8: 00261. DOI: 10.15406/jcpcr.2017.08.00261
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Effect Of Surgeries To The Primary Sites And Metastatic Sites On Survival Outcomes
For all patients included in this study, patients who received RC were associated with better OS and CSS , regardless of the specific metastatic sites . This phenomenon remained true with regard to patients with a single-site metastasis . In patients with multisite metastases, however, the survival outcomes of patients who received RC did not differ from that of patients with no RC , as shown in . The effect of RC on survival outcomes of patients stratified by their metastatic sites was further analyzed and the results revealed that for patients with bone-only , lung-only and distant node-only metastases , RC could significantly improve the OS and CSS outcomes, while patients with liver metastases seemed not to benefit from this surgery in terms of OS and CSS . Multivariate analysis revealed that RC was a strong prognostic indicator in the overall cohort and in patients with single metastatic site .
KaplanMeier curves of overall survival and cancer-specific survival according to whether or not radical cystectomy has been done for the overall cohort , in patients with single metastatic site and in patients with multiple metastatic sites .
KaplanMeier curves of overall survival and cancer-specific survival according to whether or not radical cystectomy has been done for patients with bone-only , liver-only , lung-only and distant node-only metastases.
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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.
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Surgery For Bladder Cancer
Surgery is done for most bladder cancers. The type you have depends on the stage of the cancer.
Removing the tumor from the inside bladder is the most common surgery for early bladder cancer. This can be done during a cystoscopy. A a cystoscope with a looped wire on the end is used to remove the tumor.
When the cancer is more invasive, the cancer is removed along with part of the bladder or the entire bladder.
If only part of the bladder is removed, you’ll still be able to hold and release urine as normal, though in smaller amounts. If the entire bladder is removed, you’ll need another way to store and pass urine. Your doctor can explain the options for this.
Side effects of surgery
Any type of surgery can have some risks and side effects. For instance, removing the bladder not only changes how your body passes urine, but it can also cause sexual side effects. If you have these or any other problems, let your doctors know. There are ways to help deal with many side effects.
Early Bone Metastases Are Associated With Worse Outcomes In Metastatic Urothelial Carcinoma
Article type: Research Article
Authors: Nelson, Ariel A.a f 1 | Cronk, Robert J.a | Lemke, Emily A.a | Szabo, Anikob | Khaki, Ali R.c | Diamantopoulos, Leonidas N.c d 2 | Grivas, Petrosc | Nezami, Behtash Ghazie | MacLennan, Gregory T.e | Zhang, Tiang h | Hoimes, Christopher J.f g h *
Affiliations: Division of Hematology & Oncology, Department of Medicine, The Medical College of Wisconsin, Milwaukee, WI, USA | Division of Biostatistics, The Medical College of Wisconsin, Milwaukee, WI, USA | Division of Oncology, Department of Medicine, University of Washington, Seattle Cancer Care Alliance, Fred Hutchinson Cancer Research Center, Seattle, WA, USA | Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA | Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA | Division of Medical Oncology, Seidman Cancer Center at Case Comprehensive Cancer Center, Cleveland, OH, USA | Division of Medical Oncology, Department of Medicine, Duke University, Durham, NC, USA | Duke Cancer Institute Center for Prostate and Urologic Cancers, Durham, NC, USA
Correspondence: Correspondence to: Christopher J. Hoimes, Duke University, GSRB1, 905 S LaSalle St, Durham, NC 27110, USA. Tel.: +1 919 681 8602 Fax: +1 919 660 0178 E-mail: .
Note: Present address: Medical College of Wisconsin, Division of Hematology & Oncology, 8800 W Doyne Ave, Milwaukee, WI 53226, USA.
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What Is The Prognosis For Metastatic Bladder Cancer
Most people with metastatic bladder cancer cannot be cured. The 5-year relative survival rates for people with distant bladder cancer, meaning the cancer has spread to distant parts of the body such as the lungs, liver, or bones, is about 5 percent. This means that people with metastatic bladder cancer are, on average, about 5 percent as likely as people who do not have this form of cancer to live for at least 5 years after being diagnosed.1,5
However, there are treatments available that can help some people with metastatic bladder cancer to live longer and improve their quality of life.1
What Will Happen After Treatment
You’ll be glad when treatment is over. But its hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about this. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of your follow-up visits. People who have had bladder cancer are at high risk of having a second bladder cancer.
If you have no signs of cancer, most experts advise seeing with your doctor every 3 to 6 months. These visits might include urine tests, blood work, and other tests. If you still have your bladder, you will need regular exams of your bladder, too. The time between doctor visits may be longer after a few years if no new cancers are seen.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
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What Is Bladder Cancer
Cancer can start any place in the body. Cancer that starts in the bladder is called bladder cancer. It starts when cells in the bladder grow out of control and crowd out normal cells. This makes it hard for the body to work the way it should.
Cancer cells can spread to other parts of the body. For instance, cancer cells in the bladder can travel to the bone and grow there. When cancer cells spread, its called metastasis.
Cancer is always named for the place where it starts. So when bladder cancer spreads to the bone , it’s still called bladder cancer. Its not called bone cancer unless it starts in the bone.
Living With Bladder Cancer
Bladder cancer symptoms and treatments can be overwhelming. No matter where you are on your treatment journey, youâll need to meet with your healthcare provider for regular checkups and tests. Talking to your healthcare team about the next steps and what to expect can provide a road map during this time.
How Long Can A Dog Live With Bladder Cancer
Being told that your dog has cancer is something that no pet owner ever wants to hear. It can be a terrifying and uncertain experience, with many questions that you need to ask and need answers for.
One of the most obvious ones, is wanting to know how your dog can survive with bladder cancer. Now, it will vary from dog to dog, but there are some generalizations you can make, so heres the short answer, followed by more detail.
How long can a dog live with bladder cancer? Some dogs can live for 6 to 12 months with bladder cancer. Providing it is diagnosed early enough, some dogs can benefit from cancer treatment, with their life expectancy sometimes being extended by a further 6 months.
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Transurethral Resection Of A Bladder Tumor
A procedure called transurethral resection is commonly used to learn more about the bladder cancer. This procedure is often also part of treatment for early-stage or non-muscle invasive bladder cancer. During this procedure, a telescope is inserted into your bladder, and the tumor is then removed by scraping it from the bladder wall. Other tests may include a CT scan of the abdomen and pelvis, MRI scans, X-rays, and bone scans.3
Bone Metastases In Bladder Cancer Predict Worse Outcomes
Stecca C, et al. Poster #4564. Presented at: ASCO Annual Meeting June 3-7, 2022 Chicago.
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CHICAGO Patients with bone metastases due to urothelial carcinoma had worse outcomes than those without bone metastasis, regardless of treatment or PD-L1 expression, according to a poster presentation at ASCO Annual Meeting.
However, median overall survival was better in patients with high PD-L1 expression treated with durvalumab monotherapy or durvalumab plus tremelimumab in patients with and without bone metastases.
Bone metastases are associated with significant morbidity and mortality in metastatic urothelial carcinoma. Despite this, the independent impact of bone metastases on clinical outcomes is not well understood,Carlos Stecca, MD, from the division of medical oncology and hematology at Princess Margaret Cancer Centre, Toronto, said in the presentation. This is especially true in the current era of immune checkpoint inhibitors, and it is unknown whether the same level of response to oncology regimens can be achieved in patients with and without bone metastases.
Among all patients with bone metastases, median OS was lower than in those without , as was progression-free survival .
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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,
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Liver And Gallbladder Cancer
Malignancies confined to the liver are one of the most common forms of cancer. There are two basic types of the disease:primary liver cancer originates in the tissues of the liver itself, while metastatic liver cancer occurs when cancer cells spread from other parts of the body, most commonly from the stomach, pancreas, breast or lung. Ultimately, about a thirdof all cancers will spread to the liver.
Surgery usually provides the best chance for a cure, and our surgicalspecialists are among the best in the country. In some cases, however, tumorsdevelop internally within the liver and complete surgical removal is not possible.
The University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center offers a comprehensive Liver-Directed Therapies Program, providingthe most advanced treatments available from complete or partial surgicalremoval to systemic, combination therapies to regional, targeted treatment options to provide the very best outcomes possible for patients with all forms ofliver cancer.
Our multidisciplinary Liver-Directed Therapies Program team consists of expertsin medical oncology, radiation oncology, surgical oncology,interventional radiology, nuclear medicine, gastroenterology, hepatology andpathology. These specialists meet and consult weekly to develop the bestplan of treatment for each individual patient.
How Is Bladder Cancer In Dogs Treated
TCC is a difficult disease to treat surgically, but if the tumor is localized to a specific area, surgical removal with or without a tube cystostomy may be an option.
Some of the common chemotherapeutic agents used for treatment of TCC are:
These are often given in combination with nonsteroidal anti-inflammatories that also have some anti-TCC activity.
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Palliative Radiotherapy For Painful Bone Metastases
External beam radiotherapy is an effective option for pain relief in patients with painful bone metastases. It may significantly improve symptoms in up to 80% and completely control pain in about one third of patients . Various schemes of fractionation have been tested. Data from randomized trials showed that 30 Gy in ten fractions, 24 Gy in six fractions, 20 Gy in five fractions or 8 Gy in a single fraction may provide excellent pain relief with minimal toxicity . Also, palliative external beam radiotherapy may be repeatedly applied in case of recurrent pain. In this situation, data from a randomized trial suggested that treatment with 8 Gy in a single fraction is not inferior and less toxic compared to 20 Gy given in multiple fractions . Patients with multiple painful osteoplastic metastases which could not be conveniently and safely treated by external beam radiotherapy are candidates for radionuclide treatment .
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.
Medically Reviewed by, Scott Gilbert, MD, Department of Genitourinary Oncology.
At Moffitt Cancer Center, we offer a comprehensive range of bladder cancer tests and treatments, welcoming patients with all stages of the condition. If youd like to have your symptoms evaluated by an oncologist who specializes in metastatic bladder cancer, call or submit a new patient registration form online to request an appointment. No referral is required to consult with our team.
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