How Soon Can We Detect This
One of the main advantages of surgery over radiotherapy for prostate cancer is that following prostate removal, the PSA should be very low , which we can of course detect with blood tests. If metastasis occurs, because the metastatic cells originated in the prostate and therefore make PSA, the PSA level in the blood starts to rise. Once it has reached a given threshold additional or salvage treatment will be discussed.
A PSA level of more than 0.2 ng/ml defines biochemical recurrence. At this stage the cancer is still much too small to be seen on scanning. If it can be seen on a scan it is termed clinical recurrence, which generally does not occur until the PSA level is more than 0.5 ng/ml. Symptoms, such as bone pain, dont usually occur until the PSA is more than 20 ng/ml.
When Bladder Cancer Spreads To Other Parts Of The Body
When cancer cells break away from where they started to grow and start spreading to other parts of the body, it is called metastasis. Metastatic bladder cancer is the name for bladder cancer that has spread to other parts of the body, such as the lungs, the liver, or the bones. Even if the cancer cells are first discovered in the bones, for example, if they first started growing in the bladder it is still called metastatic bladder cancer.1
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.
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Bone Scan For Bladder Cancer
You might have this test to check whether the bladder cancer has spread to your bones. Get information about what happens.
A bone scan shows up changes or abnormalities in the bones. It is also called:
- a radionuclide scan
- bone scintigraphy
- nuclear medicine bone scan
A bone scan can look at a particular joint or bone. In cancer it is more usual to scan the whole body.
A large camera scans you and picks up radioactivity.
You have the scan in either the medical physics, nuclear medicine or x-ray department at the hospital. The scan can take between 30 to 60 minutes, but youll be at the hospital for several hours.
If there are changes on the scan they may be called hot spots. These are not always cancer. Bone changes can happen for other reasons like arthritis. You might need to have a CT scan to know exactly where these abnormal areas are.
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Can I Survive Advanced Prostate Cancer Whats The Prognosis
Prostate cancer is the second leading cause of death from cancer in men, according to the National Cancer Institute. While theres no cure, men can live with it for years if they get the right treatment. Each man with advanced prostate cancer is different, of course. You and your cancer have unique qualities that your doctor takes into consideration when planning the best treatment strategy for you.
According to Harvard Medical School, the prognosis for men with advanced prostate cancer is improving because of newer medications that help them get past a resistance to androgen-deprivation therapy that typically develops after a few years of treatment. With these medications, many men are living longer, and a number of men diagnosed with advanced prostate cancer are dying with the cancer, not from it.
Promptly treating prostate cancer bone metastases with the newest medication can help change a mans prognosis dramatically, Tagawa says. There are men who do well for decades, he says. Some men can even stop treatment, go on to live many years, and actually die of something unrelated.
Tagawa says that cancer specialists who use sophisticated imaging technologies, like positron-emission tomography scans, have gotten very good at finding even tiny bone metastases, which is valuable in diagnosing and removing early stage metastases.
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Can You Live Without A Prostate
Although the prostate is essential for reproduction, it is not essential to live.
In cases where the cancer is contained to the prostate it can be surgically removed through a prostatectomy.
A radical prostatectomy involves removing the entire prostate gland, the surrounding tissue, and some of the seminal vesicles.
Alternatively, laser prostatectomies can be effective as the least invasive type of prostate removal.
The most common prostatectomy is the transurethral resection of the prostate .
TURPs involve removing part of the prostate gland using a resectoscope which is passed through the urethra â this procedure is commonly used for people with an enlarged prostate.
In come cases prostate cancer can be treated with radiotherapy.
Radiation therapy for prostate cancer can irritate the bowel, the bladder, or both.
A person can develop:
Radiation proctitis: Symptoms include diarrhea and blood in the stool.
Radiation cystitis: Symptoms include a need to urinate more often, a burning sensation when urinating, and blood in the urine.
Bladder problems may improve after treatment, but they may not go away completely.
What Are The Signs Of Bladder Cancer
The most common sign of bladder cancer is blood in the urine, called hematuria. Gross hematuria is blood that can be seen in the urine. Your urine can be pink, red, or dark red. In some cases, urine can only be seen with a microscope, called microscopic hematuria. Other signs of bladder cancer include increased frequency of urination, a feeling of urgency to urinate, nocturia , pain with urination, and feeling like your bladder is not empty. These can all be caused by irritation of the bladder wall by the tumor, but can also be signs of infection or other bladder problems.
In advanced cases of bladder cancer, the tumor can stop urine from entering the bladder, or from exiting the bladder. This may cause severe flank pain, infection, and damage to the kidneys. Other signs of advanced bladder cancer are loss of appetite, weight loss, feeling tired, bone pain, and swelling in the feet.
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What Is The Prognosis For Bladder Cancer
If you have been diagnosed with bladder cancer, the first step is choosing a treatment. This may include surgery, chemotherapy, or a combination of both. Each treatment has its benefits and risks. It is important to know what each option is and the side effects before you begin treatment. The most common form of treatment for bladder cancer is chemotherapy. Chemotherapy involves the use of chemicals that inhibit the normal function of cells. These drugs kill cancer cells and shrink the tumor. Chemotherapy drugs are often given in combination with each other for the greatest effect.
Most patients will undergo several treatments to treat their cancer. Cystologists often recommend chemotherapy after surgery, especially for patients with stage 0 or stage 1. Intravesical chemotherapy involves injecting special medicine directly into the bladder. Patients with stage 1 or stage 0 cancer may also be offered surgery to remove the bladder. In addition, some patients may opt to participate in clinical trials.
Where Can I Find A Support Group
To find a local group, talk to your healthcare provider. Local and Zoom meeting lists are also available through organizations such as CancerCare.
Joining a support group of people dealing with advanced cancer may help provide camaraderie and knowledge. You can connect with people who understand what youre going through.
Treating cancer means looking after your whole self. This includes keeping an active lifestyle, eating healthy, practicing mindfulness, and socializing with family and friends to improve your mood and overall health. If you smoke cigarettes or use nicotine products, this is a good time to try to quit or cut down.
Its also important to look after your mental health. Meeting with a therapist can help you navigate intense emotions and provide you with tools to feel more in control of your daily life.
Palliative care may also be beneficial. Your palliative care provider can help you learn about pain management options. Palliative care providers can also assist with finding mental health services, such as counseling.
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How Is The Pain Evaluated
The symptom of bone pain refers to feelings of pain, tenderness, aching, or discomfort in the bone.1,2 To find out what may be causing bone pain, healthcare providers usually perform a physical evaluation in addition to other types of testing to help make a diagnosis. If you have bone pain as well as problems or changes related to urination, then a urine sample can be tested to check for signs of infection or other problems.
A procedure called cystoscopy can be used to examine the inside lining of the urethra and the bladder. It can also be used to take tissue samples for analysis to detect the possible presence of cancer cells.
Patients who receive a diagnosis of bladder cancer usually undergo further testing to find out if the bladder cancer cells have spread to other parts of the body. This may include imaging scans, such as MRI, CT/CAT scans, and/or x-rays. For patients with the symptom of bone pain, bone scans may be used to see if the cancer cells have spread to bones.
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Understanding 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 .
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Questions To Ask The Doctor
- What treatment do you think is best for me?
- Whats the goal of this treatment? Do you think it could cure the cancer?
- Will treatment include surgery? If so, who will do the surgery?
- What will the surgery be like?
- How will I pee after surgery?
- Will I have other types of treatment, too?
- Whats the goal of these treatments?
- What side effects could I have from these treatments?
- Is there a clinical trial that might be right for me?
- What about treatments like special vitamins or diets that friends tell me about? How will I know if they are safe?
- What should I do to be ready for treatment?
- Is there anything I can do to help the treatment work better?
- Whats the next step?
How Do I Take Care Of Myself
About half of all people with bladder cancer have early-stage cancer thats relatively easy to treat. But bladder cancer often comes back . People whove had bladder cancer will need regular checkups after treatment. Being vigilant about follow-up care is one thing you can do to take care of yourself. Here are some other suggestions from the Bladder Cancer Advocacy Network include:
- Follow a heart-healthy diet: Plan menus that include skinless poultry and fish, low-fat dairy products, nuts and legumes, and a variety of fruits and vegetables.
- Focus on high-fiber foods: Bladder cancer treatment may cause digestive issues and a fiber-rich diet may help.
- Get some exercise: Gentle exercise may help manage stress.
- Connect with others: Bladder cancer often comes back. Its not easy to have a rare disease thats likely to return. Connecting with people who understand what youre going through may help.
Some people with bladder cancer need surgery that removes their bladder and their bodies natural reservoir for pee. There are three types of urinary diversion surgeries. All three types involve surgically converting part of your intestine to become a passage tube for pee or a reservoir for storing pee.
Urinary diversion may be a challenging lifestyle change. If youll need urinary diversion surgery, ask your healthcare provider to explain each surgery types advantages and disadvantages. That way, youll know what to expect and how to take care of yourself.
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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.
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.
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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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Can You Notice Prostate Cancer
Medically reviewed by Elaine K. Luo, M.D. Written by Rena Goldman Updated on April 1, 2019. In the early stages, you may not notice any symptoms related to prostate cancer. This is why screenings are important. Symptoms can sometimes be noticed for the first time when the cancer advances. Advanced prostate cancer, also called metastatic cancer,
Questions To Ask Your Doctor Or Nurse
- What type of hormone therapy are you offering me and why?
- Are there other treatments I can have?
- What are the advantages and disadvantages of my treatment?
- What treatments and support are available to help manage side effects?
- Are there any lifestyle changes that might help me manage my cancer, symptoms, or side effects?
- How often will I have check-ups and what will this involve?
- How will we know if my cancer starts to grow again?
- What other treatments are available if that happens?
- Can I join any clinical trials?
- If I have any questions or get any new symptoms, who should I contact?
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What About Other Treatments That I Hear About
When you have cancer you might hear about other ways to treat cancer or treat your symptoms. These may not always be standard medical treatments. These treatments can be vitamins, herbs, special diets, and other things. You may be curious about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to be helpful. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether its a vitamin, a diet, or anything else.