Thursday, September 21, 2023

Bladder Cancer What To Expect

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Bladder Reconstructions And Stomas

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If you have had your bladder removed, the way you pass urine will change. There are several options that your treatment team will talk to you about:

  • Urostomy is where doctors create a new hole in your abdomen called a stoma. Urine drains from the stoma to the outside of your abdomen into a special bag.
  • Neobladder is where a new bladder made from your small bowel forms a pouch inside your body to store urine. You will pass urine by squeezing your abdominal muscles. You will also pass a small tube into the neobladder each day to help drain the urine.
  • Continent urinary diversion is a pouch made from your small bowel inside your body to store urine. The urine empties through a hole called a stoma to the outside of your abdomen into a special bag.

A bladder reconstruction is a big change in your life. You can speak with a continence or stomal therapy nurse for help, support and information. You can also call Cancer Council (. You may be able to speak with a trained Cancer Council volunteer who has had cancer for tips and support. If you find it difficult to adjust after your bladder reconstruction, it may help to be referred to a psychologist or counsellor.

Note: If you have a stoma, you can join a stoma association for support and free supplies. For more information about stoma associations, visit the Australian Council of Stoma Associations.

Cancer May Spread From Where It Began To Other Parts Of The Body

When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began and travel through the lymph system or blood.

  • Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
  • Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.

The metastatic tumor is the same type of cancer as the primary tumor. For example, if bladder cancer spreads to the bone, the cancer cells in the bone are actually bladder cancer cells. The disease is metastatic bladder cancer, not bone cancer.

Prognosis And Survival Rates For Bladder Cancer

When someone is diagnosed with bladder cancer, their doctor will give them a prognosis. A prognosis is the doctors opinion of how likely the cancer will spread and the chances of getting better. A prognosis depends on the type and stage of cancer, as well as the persons age and general health.

Bladder cancer can usually be effectively treated if it is found before it spreads outside the bladder.

If you have bladder cancer, your doctor will talk to you about your individual situation when working out your prognosis. Every persons experience is different, and there is support available to you.

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Treating Stage Iii Bladder Cancer

These cancers have reached the outside of the bladder and might have grown into nearby tissues or organs and/or lymph nodes . They have not spread to distant parts of the body.

Transurethral resection is often done first to find out how far the cancer has grown into the bladder wall. Chemotherapy followed by radical cystectomy is then the standard treatment.Partial cystectomy is rarely an option for stage III cancers.

Chemotherapy before surgery can shrink the tumor, which may make surgery easier. Chemo can also kill any cancer cells that could already have spread to other areas of the body and help people live longer. It can be especially useful for T4 tumors, which have spread outside the bladder. When chemo is given first, surgery to remove the bladder is delayed. The delay is not a problem if the chemo shrinks the cancer, but it can be harmful if it continues to grow during chemo. Sometimes the chemo shrinks the tumor enough that intravesical therapy or chemo with radiation is possible instead of surgery.

Some patients get chemo after surgery to kill any cancer cells left after surgery that are too small to see. Chemo given after cystectomy may help patients stay cancer-free longer, but so far its not clear if it helps them live longer. If cancer is found in nearby lymph nodes, radiation may be needed after surgery. Another option is chemo, but only if it wasn’t given before surgery.

Emotional And Spiritual Changes

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Everyone will feel different emotions when they are dying. A lot depends on:

  • the type of person they are
  • their age
  • how much support they have
  • their religious and spiritual beliefs
  • the experiences they have had in life

Someone dying in their 20s is likely to feel very differently from someone who is 80. And someone leaving behind young children will have different worries from someone whose children are grown up and able to take care of themselves.

As death gets closer they might begin to let go and seem more at peace with things. Others might become very anxious, fearful or angry. Some people could appear to withdraw, even from the people they love and care about. But this doesnt mean that they dont care anymore.

These events are all very normal and are a natural part of dying.

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Symptoms Of Bladder Cancer In Cats

Its good to know early signs of bladder cancer in cats so you can be alert to any warnings and get them checked out as soon as you can. Some of the symptoms to look out for are: difficulty urinating, frequent and painful urination, and bloody urine.

One of the things that makes diagnosing bladder cancer in cats so difficult is that most of the signs are very similar to the symptoms of a urinary tract infection. So, if your cat is showing the symptoms listed above, you should take him/her into the vet, but it doesnt mean cancer! Your vet will do lots of tests to determine whether its a UTI or something more serious.

There Are Different Types Of Treatment For Patients With Bladder Cancer

Different types of treatment are available for patients with bladder cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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Urinary Diversion Surgery Options

When the entire bladder is removed, an alternative way to remove urine from the body is needed. The three different procedure options are:

Complications are not uncommon with any of these procedures, and a careful discussion with your healthcare team is needed to make the right choice for you alone.

Symptoms Of Recurrent Bladder Cancer

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Although seven of every 10 cases of bladder cancer are diagnosed at an early stage when the cancer is treatable, post-treatment recurrence is a particular risk, and the disease has a recurrence rate of about 70%19. Because of this, individuals who have had bladder cancer will require surveillance for years following treatment.

Recurrence happens when you have smaller areas of cancer cells that stay in your body undetected. These cells, over time, might increase in number and eventually cause symptoms or show up on test results. Your doctor, who knows your medical history, will discuss your risk of recurrence during follow-up care.

Symptoms of recurrent bladder cancer often resemble those of early or advanced cancer. Let your doctor know if you develop any new symptoms like frequent urination, blood in your urine, immediate need to urinate or pain while urinating. These symptoms could be signs of bladder cancer recurrence or signs of another health condition.

Knowing the symptoms and signs of bladder cancer, no matter if it’s early, advanced or recurrent, is important and your first step to diagnosis and treatment.

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Whats The Difference Between Muscle

Dr. VanderWeele:As a medical oncologist, most often, I’m seeing patients with muscle-invasive bladder cancer. Those are the cancers that we think have the potential to spread to other places, and therefore to be limiting life expectancy, or are often treated with a multimodal approach. If it has already spread to other places and it’s metastatic, then usually, the medical oncologist is the quarterback. If it’s still within the bladder but is muscle-invasive, it often involves treatment or management with a medical oncologist. And a urologist may also include a radiation oncologist.

For cancers that are not muscle-invasive, and these could be ones that are just kind of growing on the surface of the bladder or growing into sort of the empty space of the bladder sort of growing out from the bladder. Or growing into the bladder, but not very far just on the first layer. Often it’s the urologist alone who is managing these cancers. They can be pretty variable. But often the first line of treatment is just to cut it out. Or maybe, to try to cut it out and give some additional therapy to prevent it from coming back.

Treatment For Transitional Cell Carcinoma

First of all, to diagnose a dog of TCC, the most accurate test is a biopsy which is basically an evaluation of the cancer cells. These cancer cells can either be retrieved through surgery or using a catheter.

Other tests that could be run include blood work ), a urinalysis or a chest imaging .

Once a dog has been diagnosed with TCC, the treatment option will now depend on the size and area of the cancer tumor.

A surgery can be done to remove the tumor. However, because TCC usually appears at the intersection among the ureters, urethra and the bladder, it is almost impossible to get out the entire tumor without messing up something.

If it appears in a localized place, though, your vet might be able to get most of it out. That said, removing most of it is just buying time as the tumor will grow again.

Other treatment options are chemotherapy and radiation therapy. Chemotherapy hasnt been known to work for dogs with TCC.

And while radiation therapy has probably had a few successes, it has some not so encouraging side effects.

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What Is The Bladder

The bladder is an organ found in the lower part of the belly near the pelvic bones. It acts as a holding area for urine. The bladder expands and can hold about half of a liter of urine, but a person usually feels the urge to urinate when the bladder is 25% full. The bladder will contract and become smaller when it is empty. The ureters are two tubes that connect the kidneys to the bladder. They empty urine from the kidneys into the bladder. The urethra is a tube that connects the bladder to the outside of the body and releases urine.

The bladder wall consists of 4 main layers of tissue.

  • The innermost layer is called the urothelium, or transitional epithelium. It is made up of cells called urothelial or transitional cells.
  • Beneath the urothelium is a thin layer called the lamina propria, made up of connective tissue, blood vessels, and nerves.
  • The next layer is called the muscularis propria, made of muscle.
  • The last layer is a layer of fatty tissue that separates the bladder from other surrounding organs.

Dog Bladder Cancer Diagnosis

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The diagnosis of bladder cancer in dogs requires a series of diagnostic tests:

  • A urine test and analysis.
  • A smear test of cells present in the urine sediment.
  • A bladder tumor antigen test, assessing the proteins in a urine sample.
  • Ultrasound of the urinary system, ureters, and urethra.
  • Biopsy .
  • Cadet BRAF test: a urine sample to test DNA mutation.

Most of these tests are straightforward checks with minimal harm to your pet however, traditional biopsy is slightly more invasive with possible risk involved .

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What Kind Of Treatment Will I Need

There are many ways to treat bladder cancer. You might want to get a second opinion about the best treatment plan for you.

Bladder cancer is most often treated with:

  • Surgery
  • Chemo
  • Immunotherapy

Sometimes more than one type is used. The treatment plan thats best for you depends on:

  • The stage and grade of the cancer
  • Whether the cancer has spread into the bladder wall
  • The chance that a type of treatment will cure the cancer or help in some way
  • Other health problems you have
  • Your feelings about the treatment and the side effects that come with it

Bladder Cancer Stages And Survival Rates

Cancer survival rates are also categorized according to the stage of the cancer when it was diagnosed. The stage of cancer generally refers to how far it has progressed, and whether it has spread to other parts of the body. For bladder cancer, the 5-year survival rate for people with:2,3

  • Bladder cancer in situ is around 96 percent
  • Localized bladder cancer is around 70 percent
  • Bladder cancer that has spread to the regional lymph nodes is 35 percent
  • Distant or metastasized bladder cancer is 5 percent

If you would like to learn more about bladder cancer statistics, consider speaking with someone on your health care team. They will be able to explain more about how these statistics apply to your cancer. Tell us about your experience in the comments below, or with the community.

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Who Is At Risk For Bladder Cancer

Bladder cancer can affect anyone, but certain groups are at greater risk. Men are three times more likely than women to get bladder cancer. Around 90% of cases occur in people over age 55, and whites are twice as likely as African Americans to develop the condition.

Other factors that increase the risk of getting bladder cancer include a family history of the condition and previous cancer treatment. Birth defects involving the bladder increase the risk of bladder cancer. When people are born with a visible or invisible defect that connects their bladder with another organ in the abdomen, this leaves the bladder prone to frequent infection. This increases the bladder’s susceptibility to cellular abnormalities that can lead to cancer. Chronic bladder inflammation increase the risk of developing bladder cancer.

What Is Bladder Cancer

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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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Diagnosis Of Bladder Cancer

If you have symptoms, you usually start by seeing your GP. They can do a quick test to find out if there is any blood in a sample of your urine. If there is blood, your GP will make sure there is no obvious reason for this, like an infection.If your GP is not sure what is causing your symptoms, they will usually refer you to a urologist. This is a doctor who specialises in urinary, bladder and kidney problems. Or you may see a nurse called a urology nurse specialist.Most people see the nurse or doctor at a haematuria clinic. At the clinic, you can usually have most of the tests you need on the same day.If tests or symptoms suggest you could have bladder cancer, you should be seen by a specialist within 2 weeks.You may have some of the following tests:

  • Blood tests

    You may have blood tests to check how well your kidneys and liver are working and to show the number of blood cells in the blood.

  • Urine tests

    A sample of your urine may be tested for cancer cells. It may also be tested for substances that are found in bladder cancer. This is called molecular testing.

  • Cystoscopy

    A cystoscopy the main test used to diagnose bladder cancer. A cystoscope is a thin tube with a camera and light on the end. A doctor or specialist nurse uses it to look at the inside of your bladder.

  • Ultrasound scan

Types Of Surgical Techniques

  • Endoscopic surgery: A thin, flexible tube equipped with a camera and surgical tools is inserted into a natural opening so no incision is made in the skin.
  • Keyhole surgery: This minimally invasive procedure involves several small incisions in the skin to access the bladder, and the cancer is removed through these holes using special instruments.
  • Robotic surgery: Similar to keyhole surgery, robotic surgery differs in that the actual surgery is done via mechanized instruments instead of a surgeon’s hands controlling the instruments.
  • Open surgery: With an open approach, a traditional large incision is made in the abdomen to access the bladder.

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Treating Stage I Bladder Cancer

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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