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 .
Cancer Spreading To The Lymph Nodes
Cancer appearing in the lymph nodes is an indicator of how the cancer is spreading. If cancer cells are only found in the lymph nodes near the original tumor, it may indicate the cancer is in an earlier stage and has not spread far beyond its primary area.
On the other hand, if your doctor finds the cancer cells have traveled to lymph nodes far from the initial tumor, the cancer may be spreading at a faster rate and could be in a later stage.
Additionally, its important to know how many cancer cells have traveled to the respective lymph node. If theres visible or palpable cancer in lymph nodes, or the cancer has grown outside the lymph node walls, the cancer may have progressed further and may require a different treatment plan.
If cancer cells have spread to your lymph nodes , symptoms may include:
- lump or swelling in your neck, under your arm, or in your groin
- shortness of breath
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Questions For Your Team
Asking questions will help you understand more about your bladder cancer, the treatment and how you can improve your prognosis. We have pulled together the most important common questions that you might want to ask, and we also cover what the answers might be. We always suggest taking someone with you for these appointments to help remember everything that you are told.
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Incidence Of Metastatic Bladder Cancer Vs Synchronous Second Primary Lung Cancer
Among adults with NMIBC, 0.8% had metastatic bladder cancer and 0.3% had bladder cancer metastatic to the lungs at diagnosis. Accordingly, 0.4% had a synchronous lung cancer diagnosis. For those with MIBC, 11.6% had metastatic bladder cancer at diagnosis and 3.9% had bladder cancer metastases in the lungs. Among adults with MIBC, 0.7% were diagnosed with a synchronous lung cancer .
How Long Does It Take For Bladder Cancer To Metastasize
As many as 50% of patients with muscle-invasive bladder cancer may have occult metastases that become clinically apparent within 5 years of initial diagnosis and around 5% will have distant metastasis at the time of initial diagnosis. Most patients with overt metastatic disease die within 2 years despite chemotherapy.
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Metastatic Vs Second Primary Cancer
Metastatic cancers take the name of the primary cancer instead of the name of the organ theyve spread to. For instance, if you have lung cancer, but it has metastasized to the brain, it would still be called lung cancer.
Second primary cancer refers to a second type of cancer in a different primary site. A second primary cancer can occur at the same time or be identified later.
Prognosis And Survival For Bladder Cancer
If you have bladder cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the person that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for bladder cancer.
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What You Need To Know
- The most common types of lung cancer include lung nodules, non-small cell lung cancer, small cell lung cancer and mesothelioma.
- Rare lung cancers often don’t originate in the lung.
- Rare lung cancers vary according to size, recommended treatment options and rate of metastasis.
The most common types of lung cancer are those found right in the lungs. Other rarer types of cancer may also occur in the lungs and chest wall.
Recurrent Urothelial Carcinoma With Pulmonary Metastasis
Shandra S. Wilson, MDOncology
A 56-year-old woman was referred to our institution for a left nephroureterectomy after the diagnoses of a nonfunctioning left kidney and noninvasive papillary urothelial carcinoma of the distal left ureter . Following the procedure, surveillance cystoscopy and computed tomography scan of the abdomen and pelvis demonstrated a large bladder tumor with pan-urothelial extension.
SECOND OPINIONMultidisciplinary Consultations on Challenging Cases
The University of Colorado Denver School of Medicine faculty holds weekly second opinion conferences focusing on cancer cases that represent most major cancer sites. Patients seen for second opinions are evaluated by an oncologic specialist. Their history, pathology, and radiographs are reviewed during the multidisciplinary conference, and then specific recommendations are made. These cases are usually challenging, and these conferences provide an outstanding educational opportunity for staff, fellows, and residents in training.The second opinion conferences include actual cases from genitourinary, lung, melanoma, breast, neurosurgery, gastrointestinal, and medical oncology. On an occasional basis,
will publish the more interesting case discussions and the resultant recommendations. We would appreciate your feedback please contact us at
University of Colorado Health Sciences Centerand Univeristy of Colorado Cancer CenterDenver, Colorado
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Where Do These Numbers Come From
The American Cancer Society relies on information from the SEER* database, maintained by the National Cancer Institute , to provide survival statistics for different types of cancer.
The SEER database tracks 5-year relative survival rates for bladder cancer in the United States, based on how far the cancer has spread. The SEER database, however, does not group cancers by AJCC TNM stages . Instead, it groups cancers into localized, regional, and distant stages:
- Localized: There is no sign that the cancer has spread outside of the bladder.
- Regional: The cancer has spread from the bladder to nearby structures or lymph nodes.
- Distant: The cancer has spread to distant parts of the body such as the lungs, liver or bones.
What Are Bone Metastases With Prostate Cancer
The ACS describes bone metastases as areas of bone containing cancer cells that have spread from another place in the body. In the case of prostate cancer, the cells have spread beyond the prostate gland. Since the cancer cells originated in the prostate gland, the cancer is referred to as metastatic prostate cancer.
The cancer cells spread to the bones by breaking away from the prostate gland and escaping attack from your immune system as they travel to your bones.
These cancer cells then grow new tumors in your bones. Cancer can spread to any bone in the body, but the spine is most often affected. Other areas cancer cells commonly travel to, according to the ACS, include the pelvis, upper legs and arms, and the ribs.
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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.
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,
What about Clinical Trials?
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Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place .
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options.
People with recurrent cancer often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.
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What Screening Tests Are Used For Bladder Cancer
It is not standard to screen for bladder cancer. Bladder cancer screening may be used in people who are considered high risk. If you have a history of bladder cancer, a history of a birth defect of the bladder, or have been exposed to certain chemicals at work, you may be considered high-risk. You should ask your provider if screening tests are right for you.
Testing the urine for blood, abnormal cells, and tumor markers can help find some bladder cancers early but the results vary. Not all bladder cancers are found, and some people may have changes in their urine but do not have bladder cancer. These tests can be used in those who already have signs of bladder cancer or if the cancer has returned. However, more research is needed to determine how useful testing the urine is as a screening test.
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What Are The 5
In 2020, approximately 17,980 deaths in the United States are predicted to be attributed to bladder cancer1. This represents the eighth most common cause of cancer deaths in men.
The general 5-year survival rate for people with bladder cancer is 77%, while the 10-year survival rate is 70% and the 15-year survival rate is 65%1. Notably, as each patient and cancer are different, it is not possible to definitely know the disease course for an individual patient.
When To Contact A Doctor
If a person notices any signs of cancer having spread to their lymph nodes, they should speak with a doctor immediately.
Additionally, if a person with cancer notices any unusual new symptoms, they should contact a doctor. The sooner a person receives treatment for cancer that has spread, the better their chances of survival.
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Urothelial Bladder Cancer With Cavitary Lung Metastases
Transitional cell carcinoma of the bladder tends to remain superficial however, in 5% to 20% of cases, it progresses to muscle invasion and, more rarely, can metastasize. TCC of the bladder primarily spreads via regional lymphatics. The most common sites of distant metastases of TCC are the liver, lung, mediastinum and bone. Long-term survival of patients with metastatic bladder cancer is rare. Patterns of pulmonary metastasis include multiple nodules, a solitary mass or interstitial micronodule. When multiple nodules are present, they are round and well-circumscribed, without calcification or cavitation. An unusual case of rapidly metastatic TCC to the lung causing large cavitary masses and nodules is presented. Imaging performed after the patient began chemotherapy revealed widespread necrosis of the metastatic cavitary masses causing moderate volume hemoptysis.
Major Study Stops Bladder Cancer From Metastasizing To Lungs
- University of Colorado Denver
- A new study shows that the protein versican aids bladder cancer metastasis to the lungs and that high levels of versican are associated with poor prognosis in bladder cancer. The study also shows that versican signaling is reduced by adding RhoDGI2 or by blocking CCL2, leading to decreased bladder cancer metastasis to the lungs.
The diagnosis of localized bladder cancer carries an 80 percent five-year survival rate, but once the cancer spreads, the survival rate at even three years is only 20 percent. A major study recently published in the Journal of Clinical Investigation not only shows how bladder cancer metastasizes to the lungs but pinpoints a method for stopping this spread.
Specifically, the study shows that versican, a protein involved in cancer cell migration, is a driver of lung metastasis and that high levels of versican are associated with poor prognosis in bladder cancer patients. The study is the first to show how that when a cancer cell makes the protein RhoGDI2, it reduces the cells production of versican, thus blocking the ability of the cancer cell to grow in the lungs.
When the first cancer cells to attach to, say, the lung, they have a tough time they become distressed. Cancer cells express this distress in the form of versican. And the more versican they express, the more help they get, which arrives in the form of macrophages, a part of the bodys immune response that eat pathogens and other debris.
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Treatment For Bladder Cancer
Treatment for bladder cancer depends on how quickly the cancer is growing. Treatment is different for non-muscle invasive bladder cancer and muscle-invasive bladder cancer. You might feel confused or unsure about your treatment options and decisions. Its okay to ask your treatment team to explain the information to you more than once. Its often okay to take some time to think about your decisions.
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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.
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Disclosures For Gary D Steinberg:
Is a member of Clinical Trial Protocol Committees for the following companies: Merck, BMS, Janssen, Cold Genesys, Pfizer, PhotoCure, Fidia
He has or has been a scientific advisor/consultant within the past 5 years for the following companies: Heat Biologics, Cold Genesys, PhotoCure, Merck, Roche/Genentech, Ciclomed, Taris Biomedical, MDxHealth, Fidia Farmaceuticals, Urogen, Ferring, Aduro, Boston Scientific, Bristol Myers Squibb, Astra Zeneca, Pfizer, Janssen, Epivax Oncology, Natera, FKD, Ferring, EnGene Bio, SesenBio, BioCanCell, Nucleix, Ipsen, Combat Medical, Astellas, Fergene, Dendreon, Abbvie, Seattle Genetics.
He has equity stock/options: Epivax Oncology, Urogen