Types Of Bone Metastases
Normally your bones are constantly changing. New bone tissue is being formed and old bone tissue is breaking down into minerals that circulate in your blood. This process is called remodeling.
Cancer cells upset the normal process of bone remodeling, causing bones to become weak or too dense, depending on the type of bone cells affected.
Your bone metastases may be:
- osteoblastic, if there are too many new bone cells
- osteolytic, if too much bone is destroyed
In some cases, your bones may have both types of metastases.
Outlook For Locally Advanced Prostate Cancer
Many men with locally advanced prostate cancer have treatment that aims to get rid of their cancer. For some men, this treatment can be very successful and they may live for many years without their cancer coming back or causing them any problems. For others, treatment may be less successful and the cancer may come back. If this happens, you might need further treatment. Read more about the risk of your cancer coming back.
Some men with locally advanced prostate cancer will have treatment that aims to help keep their cancer under control rather than get rid of it completely. For example, if you have hormone therapy on its own, it can help to keep the cancer under control, usually for several years. And there are other treatments available if your hormone therapy stops working.
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.
Recommended Reading: What Causes Weak Bladder Muscles
Treatment Of Invasive Bladder Cancer In The Elderly And Frail Patient
I think this is a very contemporary topic because we are living in an aging society. If you look here, and you know if you really want to look at the life expectancy you should look at charts of the insurance company and governmental agencies rather than medical reports. And this is the life expectancy nowadays where in North America. So, you can see that if you are at the octogenarians, octogenarians for the sake of this talk is 80 years old, 80 to 90, and nonagenarians are 90 and plus. And you see so when you hit 80 you still have at least seven years as a male, and nine years or more as a female. So, we are actually talking about increased population that, and Ill show you data, has more bladder cancer, and theyre actually destined to live quite long if they are in the average risk. So, if you live for example to 90 years old youre expected to live about four years if youre a male and four and a half or five years if youre a female. So, we have to bear these figures in mind.
But once its diagnosed we have a very poor, we poorly address that. This is a paper by Gore et al, and it shows that only 21% of muscle invasive bladder cancer patients over the age of 65 here actually received radical cystectomy. He shows also that there was a better overall survival, but obviously this is biased by selection.
Partial cystectomy there is very few data, none in octogenarian. This is just a series from Wes Kassouf, so I will omit that because we really dont have enough data.
Intermediate Risk Early Bladder Cancer
People with intermediate-risk non-muscle-invasive bladder cancer should be offered a course of at least 6 doses of chemotherapy. The liquid is placed directly into your bladder, using a catheter, and kept there for around an hour before being drained away.
You should be offered follow-up appointments at 3, 9 and 18 months, then once every year. At these appointments, your bladder will be checked using a cystoscopy. If your cancer returns within 5 years, you’ll be referred back to a specialist urology team.
Some of the chemotherapy medicine may be left in your urine after treatment, which could severely irritate your skin.
It helps if you sit down to urinate and that you’re careful not to splash yourself or the toilet seat. Always wash the skin around your genitals with soap and water afterwards.
If you’re sexually active, it’s important to use a barrier method of contraception, such as a condom. This is because the medicines may be present in your semen or vaginal fluids, which can cause irritation.
You also shouldn’t try to get pregnant or father a child while having chemotherapy for bladder cancer, as the medicines can increase the risk of having a child with birth defects.
Recommended Reading: Best Supplement For Overactive Bladder
Symptoms Of Oral Cancer
Here are some most common symptoms of mouth cancer:
If you experience any of the above symptoms, you should immediately consult your dentist or any doctor. Rajiv Gandhi Cancer Institute and Research Centre is one of the best centres that provide effective treatment for mouth cancer.
You May Like: Causes Of Weak Bladder Muscles
Can I Travel With A Urostomy
Yes, it just takes a little planning. Make sure to take about double the supplies you think youâll need.
If youâre traveling by car:
- Have a good idea of where you may stop for bathroom breaks.
- Donât leave your supplies in a hot car — they could melt.
If youâre flying:
- Travel with a doctorâs note saying you have a urostomy. This can clear up any questions as you go through security.
- Ask airport screeners for privacy.
- Put your supplies in your carry-on bag.
You May Like: Bladder Frequent Urination At Night
In The Last Days Of Life Patients And Family Members Are Faced With Making Decisions About Treatments To Keep The Patient Alive
Decisions about whether to use life-sustaining treatments that may extend life in the final weeks or days cause a great deal of confusion and anxiety. Some of these treatments are ventilator use, parenteral nutrition, and dialysis.
Patients may be guided by their oncologist, but have the right to make their own choices about life-sustaining treatments. The following are some of the questions to discuss:
- What are the patients goals of care?
- How would the possible benefits of life-sustaining treatments help reach the patient’s goals of care, and how likely would this be?
- How would the possible harms of life-sustaining treatments affect the patient’s goals of care? Is the possible benefit worth the possible harm?
- Besides possible benefits and harms of life-sustaining treatments, what else can affect the decision?
- Are there other resources, such as palliative care, a chaplain, or a medical ethicist, that could help the patient or family decide about life-sustaining treatments?
Outcome Analysis Of Breast Cancer Patients Who Declined Evidence
Here is the recent paper I referred to above, which studied women with breast cancer in Northern Alberta who refused standard treatments. It was also a chart review with a matched pair analysis that compared survival with those that received conventional cancer care. Between 1980 and 2006 they identified 185 women that refused cancer care following diagnosis by biopsy. Women older than 75 were excluded from the analysis because this population is generally not included in clinical trials and active treatment regimens. In addition, women that accepted surgery, but rejected chemotherapy/radiation were excluded from the analysis. To qualify, women had to have rejected all conventional care. The final population studied was 87 women, most of whom presented with early disease. Most were married, over the age of 50, and urban residents. In this group, the primary treatment was CAM in 58%, and was unknown in the remainder. Some women in this group eventually accepted cancer care, and the average delay was 20-30 weeks due to CAM use.
The results were grim. The 5 year overall survival was 43% for women that declined cancer care, and 86% for women that received conventional cancer care. For cancer-specific survival survival was 46% vs. 85% in those that took cancer care. The survival curves are ugly:
All causes of deaths and deaths due to breast cancer only
The authors compared the CAM group to those where treatment plan was not known:
Read Also: Where Do You Feel Bladder Spasms
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 .
What Is Stage 4 Bladder Cancer
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.
Recommended Reading: Will Augmentin Treat A Bladder Infection
Survival Rates For Bladder Cancer
Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time after they were diagnosed. They cant tell you how long you will live, but they may help give you a better understanding of how likely it is that your treatment will be successful.
Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any particular persons case. These statistics can be confusing and may lead you to have more questions. Talk with your doctor about how these numbers may apply to you, as he or she is familiar with your situation.
You May Like: How To Improve Bladder Control After Pregnancy
Should I Be Careful With What I Eat Or Drink With A Urostomy
Go easy on beverages near bedtime, and attach a larger night drainage bag to hold more urine while you sleep.
Your pouch is odor-proof, so you wonât smell anything until you empty it. If your pee has a very strong odor, it could be a sign of an infection. But other things can affect the smell, too:
- Foods, like asparagus, coffee, fish, garlic, and onions
- Medicines, such as antibiotics
- Supplements, like vitamins
Read Also: Can A Bladder Infection Cause Dizziness
Emotional And Spiritual Changes
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.
Recommended Reading: Whats The Difference Between A Uti And A Bladder Infection
Monitoring For Bladder Cancer Recurrence
Those who have already been treated for bladder cancer have unique monitoring needs to protect against the threat of recurrence. Generally doctors recommend a cystoscopy to examine the inside of the bladder and urethra every 3 to 12 months, depending on your risk of recurrence, for several years after bladder cancer treatment. If several years of surveillance have gone by and no cancer recurrence has been detected, a cystoscopy once a year may be enough, though the final decision rests with the doctor and additional testing may be required depending on the nature and severity of the original cancer.
If you’re recovering from treatment, ask your doctor about Cxbladder. Cxbladder is an accurate and non-invasive surveillance alternative designed to detect or rule out the return of bladder cancer. The test provides reliable results with a single urine sample, reducing the need for frequent cystoscopies in some patients, which can be both uncomfortable and inconvenient.Learn more about Cxbladder
Read Also: Causes Of Weak Bladder Control
Dealing With Bladder Removal
Removal of the bladder will affect your normal pattern of life. There will be changes in the way that you will pass urine. You may also experience problems such as incontinence at night or leaking of urine at any time of the day. Living without a bladder may not only affect your social life but may also affect your sexual life.
Make sure that you will master the techniques on how to properly manage yourself when it is time to pass urine. Learn how to appropriately use the pouches and carefully follow the steps to carry out the urine draining procedures. In addition, you can improve your sexual life through the following ways:
- Empty the pouch and fixing it correctly before sexual intercourse.
- Use a pouch cover.
- Choose sex positions that will keep your partner’s weight from overlying the pouch.
Treating Stage Iv Bladder Cancer
These cancers have reached the pelvic or abdominal wall , may have spread to nearby lymph nodes , and/or have spread to distant parts of the body . Stage IV cancers are very hard to get rid of completely.
Chemotherapy is usually the first treatment if the cancer has not spread to distant parts of the body . The tumor is then rechecked. If it appears to be gone, chemo with or without radiation or cystectomy are options. If there are still signs of cancer in the bladder, chemo with or without radiation, changing to another kind of chemo, trying an immunotherapy drug, or cystectomy may be recommended.
Chemo is typically the first treatment when bladder cancer has spread to distant parts of the body . After this treatment the cancer is rechecked. If it looks like it’s gone, a boost of radiation to the bladder may be given or cystectomy might be done. If there are still signs of cancer, options might include chemo, radiation, both at the same time, or immunotherapy.
In most cases surgery cant remove all of the cancer, so treatment is usually aimed at slowing the cancers growth and spread to help people live longer and feel better. If surgery is a treatment option, it’s important to understand the goal of the operation whether it’s to try to cure the cancer, to help a person live longer, or to help prevent or relieve symptoms from the cancer.
Because treatment is unlikely to cure these cancers, many experts recommend taking part in a clinical trial.
Recommended Reading: Why Is My Bladder Not Emptying