Monday, November 27, 2023

Bladder Cancer Prognosis And Treatment

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Bladder Cancer – Overview (types, pathophysiology, diagnosis, treatment)

Surgical procedures to remove the diseased prostate are usually necessary. Surgical procedures are not always necessary. If the disease is caused by bacterial infections, a doctor can treat the symptoms using alpha-blockers or surgery. Physical therapy, relaxation exercises, and warm baths are all recommended. A physician may also prescribe antibiotics to cure the infection. A bacterial infection can also cause a recurrence of the condition.

An enlarged prostate can be uncomfortable for both men and women. Some of the symptoms of an enlarged male reproductive organ include a weakened urine stream, urgent need to urinate, and urinary tract infections. BPH can also cause damage to the kidneys. A sudden inability to urinate can be life-threatening, as it can lead to bladder and kidney damage. Unfortunately, most men with enlarged prostrates put up with the symptoms for years before they seek treatment. However, many of the men with symptoms finally decide to go to a doctor for proper gynecological evaluation and to begin enlarged prostatic therapy.

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What Are The Survival Rates For Bladder Cancer

If the cancer is just on the inner lining of the bladder , the 5-year survival rate is about 98%.

If the cancer is growing just beyond the inner lining into the bladder wall, but is still just in the bladder , the 5-year survival rate is about 88%.

Those with bladder cancer that’s spread into the muscular wall of the bladder, but not outside the bladder, or to nearby lymph nodes or organs have a 5-year survival rate of about 63%.

If the cancer has spread through the bladder muscle into the layer of tissue around the bladder and maybe to nearby organs , but has not spread to lymph nodes or other organs , the 5-year survival rate is about 46%.

When bladder cancer has moved beyond the bladder to the pelvic or abdominal wall, to lymph nodes, or to distant parts of the body , the 5-year survival rate is about 15%.

What Can I Do To Prevent Bladder Cancer In Dogs

There is no one particular thing you can do to protect your dog from bladder cancer. You can however provide a life that supports good health and lowers your dogs risk of getting bladder cancer and disease in general.

So, if you are wondering how to prevent cancer in dogs, follow some of these helpful tips:

  • Limit Exposure to Lawn Chemicals. If you need to use pesticides, herbicides, and other chemicals for your lawn, inquire from your vet which options on the market are the most pet-friendly. After applying thechemicals, keep your dog indoors at least until the concentration of the chemicals goes down.
  • Provide a Healthy Lifestyle. A healthy lifestyle is a key to preventing all diseases. A healthy lifestyle includes a healthy diet, regular physical exercise, pet-safe products, avoiding cancer-causing environmental factors such as cigarette smoke, asbestos, etc. These precautions can go a long way in preventing health issues.
  • Frequent Vet Checkups. Early detection is essential to getting a good prognosis for your dog. See your vet as often as you need to to ensure that your dog is in good health and if not, the right treatment is provided as soon as possible. This is especially important for dog breeds that have a genetic predisposition to bladder cancer.
  • Responsible Breeding. Inquire from your breeder about the history of the parents of a dog before taking her home. If your dog has a history of bladder cancer, early castration or spaying is highly advisable.

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Whats Usually The First Symptom Of Bladder Cancer

Blood in your pee is the most common bladder cancer symptom. That said, simply having blood in your pee isnt a sure sign of bladder cancer. Other conditions cause this issue, too. But you should contact a healthcare provider whenever you spot blood in your pee. Other bladder cancer symptoms include:

Bladder Cancer Is A Disease In Which Malignant Cells Form In The Tissues Of The Bladder

Bladder Cancer

The bladder is a hollow organ in the lower part of the abdomen. It is shaped like a small balloon and has a muscular wall that allows it to get larger or smaller to store urine made by the kidneys. There are two kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the blood. They take out waste products and make urine. The urine passes from each kidney through a long tube called a ureter into the bladder. The bladder holds the urine until it passes through the urethra and leaves the body.

There are three types of bladder cancer that begin in cells in the lining of the bladder. These cancers are named for the type of cells that become malignant :

  • Transitional cell carcinoma: Cancer that begins in cells in the innermost tissue layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the transitional cells. Transitional cell carcinoma can be low-grade or high-grade:
  • Low-grade transitional cell carcinoma often recurs after treatment, but rarely spreads into the muscle layer of the bladder or to other parts of the body.
  • High-grade transitional cell carcinoma often recurs after treatment and often spreads into the muscle layer of the bladder, to other parts of the body, and to lymph nodes. Almost all deaths from bladder cancer are due to high-grade disease.

See the following PDQ summaries for more information:

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Types Of Bladder Cancer

Bladder cancer can be described based on where it is found:

  • non-muscle invasive the cancer has not spread to other layers of the bladder or muscle
  • muscle-invasive the cancer has spread to other layers of the bladder, muscle or other parts of the body.

There are 3 main types of bladder cancer:

  • urothelial carcinoma 80 to 90% of bladder cancers sometimes called transitional cell carcinoma
  • squamous cell carcinoma 1 to 2% of all bladder cancers. It is more likely to be invasive
  • adenocarcinoma 1 to 2% of all bladder cancers. It is more likely to be invasive .

There are other, less common types of bladder cancer. Treatment for these may be different. Speak to your doctor or nurse for information about these types of cancer.

Smoking Can Affect The Risk Of Bladder Cancer

Anything that increases your chance of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer not having risk factors doesn’t mean that you will not get cancer. Talk to your doctor if you think you may be at risk for bladder cancer.

Risk factors for bladder cancer include the following:

  • Using tobacco, especially smoking cigarettes.
  • Having a family history of bladder cancer.
  • Having certain changes in the genes that are linked to bladder cancer.
  • Being exposed to paints, dyes, metals, or petroleum products in the workplace.
  • Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, such as cyclophosphamide or ifosfamide.
  • Taking Aristolochia fangchi, a Chinese herb.
  • Drinking water from a well that has high levels of arsenic.
  • Drinking water that has been treated with chlorine.
  • Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium.
  • Using urinarycatheters for a long time.

Older age is a risk factor for most cancers. The chance of getting cancer increases as you get older.

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Stages Of Bladder Cancer

After diagnosing bladder cancer, the doctor will identify the stage of the disease. The stage is determined by several factors, including the size of the tumor and how far it has spread within or beyond the bladder. The stage impacts both the prognosis and treatment options.

Many of the same procedures used to diagnose bladder cancer are also used to identify the stage. Staging may also require additional tests, such as x-rays, computed tomography scans, magnetic resonance imaging , positron emission tomography scans, ultrasounds, and bone scans.

PET scans for bladder cancer are usually only recommended when there is an abnormality on a CT or MRI scan of possible bladder cancer spread.

Doctors usually use the TNM system to determine the stage of bladder cancer. The TNM system assesses the size and extent of the tumor and whether it has ulcerated whether the cancer has spread to nearby lymph nodes and the presence and extent of metastasis to distant lymph nodes, bones, and organs

After the TNM assessment, the doctor will assign an overall stage number from 0 to 4, which can be further broken down based on the size of the original tumor and the extent to which the cancer has spread. In general, the lower the stage the better the prognosis and treatment options.

Treating Stage I Bladder Cancer

Bladder Cancer: Basics of Diagnosis, Workup, Pathology, and Treatment

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 it’s 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 wasn’t 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 it’s 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.

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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.

What Happens When A Dog Gets Bladder Cancer

In the early stages of urinary bladder cancer, there are usually no serious signs and symptoms. As the disease progresses, it starts to show signs identical to those of a urinary tract infection. The signs include frequent urination, painful urination, bloody urine, producing larger volumes of urine, and more accidents in the house.

Symptoms will improve with anti-bacterial treatment but will soon reemerge. In the event of a bladder infection whose signs persist after treatment, you should seek medical advice and ask your vet to test for bladder cancer.

If treatment for bladder cancer doesnt start in time, it will start to spread to other organs outside the urinary system like the lungs, regional lymph nodes, bones, and others. Over 20% of bladder tumors are caught after metastasis which further worsens the prognosis.

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How Do Bladder Cancer Survival Rates Differ By Disease Stage

Staging of bladder cancer provides information on the extent of cancer in the body and whether the cancer has spread beyond the bladder this information helps predict how likely the cancer will respond to treatment.

Approximately half of bladder cancers are found at an early stage, when the cancer is in the surface layer of the bladder only .12 About one third of bladder cancers have spread to the deeper layers of the bladder wall but are still only in the bladder the remainder of cancers have spread into nearby tissues or lymph nodes or, rarely, to distant parts of the body.

The 5-year survival rate for bladder cancer varies by stage of the disease at diagnosis, which emphasizes the importance of detecting bladder cancer at an early stage.13

Note: In situ = cancer is confined to the surface layer of the bladder Localized = cancer has not spread outside of the bladder Regional = cancer has spread to nearby structures or lymph nodes Distant = cancer has spread to distant parts of the body

How Do Healthcare Providers Diagnose Bladder Cancer

HLA

Healthcare providers do a series of tests to diagnose bladder cancer, including:

  • Urinalysis: Providers use a variety of tests to analyze your pee. In this case, they may do urinalysis to rule out infection.
  • Cytology: Providers examine cells under a microscope for signs of cancer.
  • Cystoscopy: This is the primary test to identify and diagnose bladder cancer. For this test, providers use a pencil-sized lighted tube called a cystoscope to view the inside of your bladder and urethra. They may use a fluorescent dye and a special blue light that makes it easier to see cancer in your bladder. Providers may also take tissue samples while doing cystoscopies.

If urinalysis, cytology and cystoscopy results show you have bladder cancer, healthcare providers then do tests to learn more about the cancer, including:

Healthcare providers then use what they learn about the cancer to stage the disease. Staging cancer helps providers plan treatment and develop a potential prognosis or expected outcome.

Bladder cancer can be either early stage or invasive .

The stages range from TA to IV . In the earliest stages , the cancer is confined to the lining of your bladder or in the connective tissue just below the lining, but hasnt invaded the main muscle wall of your bladder.

Stages II to IV denote invasive cancer:

A more sophisticated and preferred staging system is TNM, which stands for tumor, node involvement and metastases. In this system:

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Treatment Of Stage 0 Bladder Cancer

In This Section
  • Radical cystectomy .
  • Transurethral resection with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy

    TUR and fulguration are the most common and conservative forms of management. Careful surveillance of subsequent bladdertumor progression is important. Because most bladder cancers recur after TUR, one immediate intravesical instillation of chemotherapy after TUR is often administered. Numerous randomized controlled trials have evaluated this practice, and a meta-analysis of seven trials reported that a single intravesical treatment with chemotherapy reduced the odds of recurrence by 39% . However, although a single instillation of chemotherapy lowers the relapse rate in patients with multiple tumors, the majority still relapse. Such treatment is thus not sufficient by itself for these patients.

    One retrospective series addressed the valueof performing a second TUR within 2 to 6 weeks of the first TUR. A second TUR performed on 38 patients with Tis or Tadisease revealed that nine patients had lamina propria invasion and threepatients had muscle invasion .

    Such information may change thedefinitive management options in these individuals. Patients with extensive multifocal recurrent disease and/or other unfavorable prognostic features require moreaggressive forms of treatment.

    Evidence :

  • Agents studied included epirubicin, mitomycin , thiotepa, and pirarubicin.
  • Evidence :

    Intravesical chemotherapy

    Segmental cystectomy

    How Long Can Someone Live With Stage 4 Cancer

    Doctors usually describe a persons outlook using the 5-year survival rate. These are calculated based on data from thousands of other people with a similar cancer at a similar stage.

    The original location of the cancer determines its type. Survival rates vary, depending on the type of cancer and how far it has spread within the body.

    Below, we describe the survival rates for some of the most common forms of cancer in stage 4:

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    What Increases Your Chances Of Getting Bladder Cancer

    Anything that increases your chances of getting a disease is called a risk factor. The main risk factors for bladder cancer include:

    • Smoking. Cigarette smokers are much more likely than other people to get bladder cancer.
    • Being older than 40, being male, or being white .
    • Being exposed to cancer-causing chemicals, such as those used in the wood, rubber, and textile industries.
    • What you eat. A diet high in fried meats and fats increases your risk for bladder cancer.
    • Parasites. There is a parasite that causes schistosomiasis, which can increase your risk. This condition is sometimes found in developing countries and rarely occurs in North America.

    What Is Stage 4 Bladder Cancer

    New treatments for bladder cancer patients

    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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