Igniting A New Field Of Research
To address these questions, NCI sponsored a virtual meeting that brought together researchers, health care providers, patient advocates, and people like Ross who are living with advanced or metastatic cancer.
The meeting featured presentations by survivorship researchers and people living with advanced or metastatic disease, as well as panel discussions. Each panel included at least one person living with cancer.
We came together to exchange ideas about how we are caring for these patients and what we can do better, said Temel. Our goal is to ignite a new field of research to better support and address the care needs of patients with advanced cancers.
People living with advanced or metastatic cancer have needs that may differ from those of people who have been treated for early-stage cancers, noted Lisa Gallicchio, Ph.D., of NCIs Division of Cancer Control and Population Sciences , who co-led the meeting.
Examples of these needs include the management of chronic conditions, psychosocial support, caregiver support, financial support, and communication around the goals of care.
People with advanced or metastatic cancer might require treatment for the disease indefinitely, or they might be on and off treatment for the rest of their lives, Dr. Gallicchio said. They will also likely undergo regular testing to identify signs of a recurrence.
Stages Of Prostate Cancer
In order to determine the stage of a patients prostate cancer, most doctors start by using the TNM staging system, which helps describe different aspects of the cancers growth.
- T the T category measures the size and extent of the Tumor
- N the N category measures whether and how far the cancer has spread to the Lymph Nodes
- M the M category whether the cancer has spread to other organs in the body (a process called Metastasis
The score for each of these categories is determined based on a pre-determined set of criteria. Your doctor cannot feel or see the tumor with a score of T1. A score of T3 means that the tumor has begun to grow outside of the prostate.
After calculating the TNM categories, doctors will combine the TNM score with the patients Gleason score and PSA levels assigning of a specific stage to the patients cancer.
Prostate cancer prognosis and survival rates can help give patients an idea of their chances of surviving the disease based on the stage and time of diagnosis. While some patients may find this information helpful, others may not want to know.
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Stage 0 Bladder Cancer
Stage 0 describes non-muscle-invasive bladder cancer. It is found only on the surface of the inner lining of the bladder. This stage is also known as in situ. Stage 0 bladder cancer is typically treated with transurethral resection , followed by either close follow-up without further treatment or intravesical therapy using bacillus Calmette-Guérin therapy to try to keep the cancer from coming back.
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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 Is The Survival Rate
Metastatic bladder cancer is difficult to cure because it has already traveled to other parts of the body. The later you receive a diagnosis and the farther the cancer has traveled, the less chance it can be cured.
The 5-year survival rate is the proportion of people who survive for 5 years after a cancer diagnosis.
For bladder cancer, if the cancer has spread to the regional lymph nodes, the 5-year survival rate is
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Whats The Treatment For Stage 3 Bladder Cancer
The standard treatment for stage 3 bladder cancer is surgery, usually in combination with other therapies.
Be sure to discuss your treatment goals with your doctor. Assess all the potential benefits and risks of each therapy. Some treatments aim for a cure. Others work to slow progression or relieve symptoms. The recommended treatment may depend on your overall health.
If cancer continues to progress or comes back during treatment, you may have to reconsider your options.
Treatment For Metastatic Cancer
There are treatments for most types of metastatic cancer. Often, the goal of treating metastatic cancer is to control it by stopping or slowing its growth. Some people can live for years with metastatic cancer that is well controlled. Other treatments may improve the quality of life by relieving symptoms. This type of care is called palliative care. It can be given at any point during treatment for cancer.
The treatment that you may have depends on your type of primary cancer, where it has spread, treatments youve had in the past, and your general health. To learn about treatment options, including clinical trials, find your type of cancer among the PDQ® Cancer Information Summaries for Adult Treatment and Pediatric Treatment.
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Signs Of Approaching Death
Death from cancer usually occurs after a person has become weaker and more tired over several weeks or months. It is not always possible to predict how long someone will live. But some common signs and symptoms show that a person is entering the final weeks and days of life. Knowing what to expect helps relieve anxiety and allows better planning.
The following are signs and symptoms that suggest a person with cancer may be entering the final weeks of life:
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Worsening weakness and exhaustion.
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A need to sleep much of the time, often spending most of the day in bed or resting.
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Weight loss and muscle thinning or loss.
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Minimal or no appetite and difficulty eating or swallowing fluids.
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Little interest in doing things that were previously important.
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Loss of interest in the outside world, news, politics, entertainment, and local events.
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Wanting to have only a few people nearby and limiting time spent with visitors.
As the last days of life approach, you may see the following signs and symptoms:
Of course, every person is different. The signs and symptoms that people experience vary. And the order in which signs and symptoms occur may differ.
Combination With Conventional Treatments
Far safer ground is to use phytotherapy to support the cancer patient undergoing conventional treatments. Phytotherapy may be given prior to conventional treatments to help the patient prepare for them . They may also be given during conventional treatments to improve treatment outcomes, QOL and reduce side effects. They may be given after conventional treatment for all the above reasons, but also to prevent cancer recurrence and improve survival prospects. This is the most active area of research for phytotherapy in cancer and some relevant clinical studies will be reviewed.
Twenty-five patients with a variety of very advanced cancers of the gastrointestinal tract undergoing palliative radio- or chemotherapy received up to 3 g/day of GLA as evening primrose oil . They were matched to 25 controls.45 The group receiving EPO exhibited highly statistically significant and clinically relevant survival differences and fewer adverse effects were noted from concurrent conventional treatment. Cancer markers also fell in some patients .
Codonopsis is a widely prescribed adaptogen in China, used in conjunction with conventional cancer therapies to reduce side effects and support immunity.58 It was used as an adjuvant in 76 cancer patients during radiotherapy and reduced its immunosuppressive effect.59 Pharmacological studies suggest it can help both white and red blood cell production.60
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Management Of Patients With Muscle
Maha H. Hussain, MDOncology
Bladder cancer is the fifth most common cancer diagnosed in theUnited States. Prognosis for this disease is dependent on both tumorstage and grade. Radical cystectomy has been the standard treatmentfor muscle-invasive local disease however, combined-modality approacheswith the use of chemotherapy are gaining momentum withdata suggesting survival improvement. Patients with metastatic diseasehave poor long-term survival rates despite systemic multiagent chemotherapy.A variety of agents, including newer cytotoxic drugs and biologicallytargeted agents, are under investigation to determine the mosteffective regimen. The special needs of specific patient populations,such as the elderly, those with a suboptimal performance status, andpatients with medical comorbidities have gained more attention.Progress in the treatment of this disease is dependent on supportingongoing and future clinical trials.
- Patients must be carefully selected for bladder-preservation protocols. Ideal candidates have minimal or no carcinoma in situ, have small-volume unifocal disease, have no poor risk features such as hydronephrosis, have undergone maximum TUR, and are motivated to participate in regular follow-up.
Disclosures:
Dr. Hussain receives research support from and is a consultant for Bristol-Myers Squibb, and has received research support from Genentech.
How Can I Prevent Bladder Cancer
You may not be able to prevent bladder cancer, but it may be helpful to know the risk factors that may increase the chance youll develop bladder cancer. Bladder cancer risk factors may include:
- Smoking cigarettes: Cigarette smoking more than doubles the risk of developing bladder cancer. Smoking pipes and cigars or being exposed to second-hand smoke also increases that risk.
- Cancer treatments: Radiation therapy is the second-most common risk factor. People who have certain chemotherapy drugs may also develop an increased risk of bladder cancer.
- Exposure to certain chemicals: People who work with chemicals, such as aromatic amines , are at an increased risk. Extensive exposure to rubber, leather, some textiles, paint and hairdressing supplies, typically related to occupational exposure, also appears to increase the risk.
- Infections: People who have frequent bladder infections, bladder stones or other urinary tract diseases may have an increased risk of developing bladder cancer.
- Past bladder cancer: People with a previous bladder cancer are at increased risk to form new or recurrent bladder tumors.
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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.
What Types Of Testing Should I Expect For Monitoring My Condition
Since metastatic prostate cancer isnt curable, your doctor will most likely set up regular visits to check the cancers location, and to manage any long-term side effects from the cancer or any medication youre taking.
And since treatments for advanced prostate cancer are changing so fast and need to be given in a certain sequence to be the most effective, youll probably have not only a prostate cancer doctor but other specialists taking care of you. Your care team should coordinate closely, say the authors of a major study of such teams published in August 2015 in the journal Annals of Oncology.
Along with regularly testing your prostate-specific antigen levels, your care team may request blood tests that measure such prostate cancer indicators as alkaline phosphatase and lactate dehydrogenase. Magnetic resonance imaging or PET scans of the spine or other bones can also help identify how your cancer responds to treatment.
If youve had radiation, youre at an increased risk for bladder and colorectal cancer and should get screened regularly for these as well.
The tests youll have and how often youll need them should be customized to you. Your care team will consider your overall health, medications that are safe for you to take, other health conditions you might have, and what stage your cancer was when you were diagnosed.
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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 .
Signs Vs Symptoms Of Cancer
Signs and symptoms of disease can be two different things:
- A sign is something that can be observed by another person, such as a change in skin color or wheezing.
- A symptom is something you feel, such as fatigue or pain, that isnt obvious to others.
The nature of cancer signs and symptoms differ greatly, depending on where the cancer is located.
Bladder cancer, for instance, causes blood in the urine, while brain cancer triggers terrible headaches.
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Helping Patients With Scanxiety
The stress that often accompanies the routine imaging scans that patients undergo to monitor changes in their health is sometimes called scanxiety.
Scanxiety is a real phenomenon, said Dr. Temel. Its natural to feel anxious when youre waiting for an important test result, and I dont think theres a quick fix to it.
Providing patients with information they can understand about their diagnosis and treatment is one way that Dr. Temel tries to support her patients and lessen their stress. We know that when patients have accurate information, they are better prepared and make more appropriate decisions about the future, she said.
She also conveys a message to her patients and families: Were going to be here for you whether the scan result is good news or bad news, and we have a plan for the future.
This reassurance may make the period of anxiety and worry slightly less distressing, Dr. Temel said. Then she added, I hate waiting for test results, too. Its part of being human.
What Is The Most Aggressive Breast Cancer
Triple-negative breast cancer is considered an aggressive cancer because it grows quickly, is more likely to have spread at the time its found and is more likely to come back after treatment than other types of breast cancer. The outlook is generally not as good as it is for other types of breast cancer.
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Patient Characteristics And Outcome Parameters
The NCR database contained date of birth, vitality status, date of death, morphology, and tumour cTNM stage. By manual chart review, the following variables were extracted: treatment received, date of cystectomy, pTNMR stage after cystectomy, date start chemotherapy, kidney function at start chemotherapy, chemotherapy cycles planned, chemotherapy cycles received, complications during chemotherapy , response to chemotherapy by imaging using the Response Evaluation Criteria in Solid Tumors criteria, recurrence of disease, date of recurrence, treatment for recurrent disease. cTNM stage was checked for authenticity.
Topography and morphology were classified according to the International Classification of Diseases of Oncology and tumour stage according to the TNM classification system.
Progression-free survival was calculated as time difference between start of treatment and first radiological evidence of progression. OS was calculated as the time difference between start treatment and date of death . For BSC, date of diagnosis was used.
Metastatic Cancer Life Expectancy
Metastatic cancer life expectancy is an issue for all patients. They are interested to know the survival rate of this cancer because their lives are at stake.
Metastatic Cancer Life Expectancy
Knowing the percentage to survive from this metastatic stage would surely give hopes for patients to strive keeping on.
Metastatic cancer life expectancy breast cancer and ovarian are somewhat among the most critical conditions you should know. The reason is because both cancers are very extreme. Cancerous cells at these diseases have already spread to other parts of the body. Increasing metastatic cancer life expectancy ovarian and breast cancer is surely important.
In our world today, there are lots of diseases that affect the race of human. Metastatic cancer or also known as metastasis is the most dreadful one. This is serious medical condition wherein cancerous cells have already reached to other tissues or organs of the body. For example, metastatic colon cancer may have affected the appendix and other nearby body parts. Having an idea about metastatic cancer life expectancy colon could be very helpful so patients can have the option to take proper treatments.
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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 drug’s 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.