Monday, February 26, 2024

Superficial Bladder Cancer Survival Rates

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What Are Types Of Bladder Cancer

Case 1: Novel Agents in Superficial Bladder Cancer

There are two types of Superficial Bladder Cancer:

1) Papillary carcinoma

2) Flat carcinoma

Papillary carcinoma: Papillary Cancer, which grows thinner like projections, usually grows to the center of the Bladder, and it is known as Non- invasive papillary Cancer. A slow-growing non-invasive papillary does not refer to PUNLMP or urothelial neoplasm of the lower malignant Potential.

Flat carcinoma: it does not grow towards the center of the Bladder but remains in the inner part of the Bladder cells. It is known as flat Cancer in situ or non-invasive flat cancer.

Either if the cancer cells grow deeper into the bladder, it is called transitional cancer or carcinoma. Nearly 90% of bladder cancer is known as transitional cells cancer or known urothelial cancer. This type of cancer starts in the urothelial cells, which lay inside your Bladder, and the same type of cells can also be found in your urinary tract.

Cancer Stages For Superficial Bladder Cancer

Ta: The most common superficial bladder cancer is stage Ta. This tumor looks like a cauliflower in the bladder, and it does not grow into any of the layers of the bladder. Further treatments for single Ta tumors are usually not needed. Patients do need to come back for regular cystoscopy to make sure the tumor does not come back. In patients with tumors that come back, or patients with many of these tumors at the initial surgery, medicine can be given inside the bladder to prevent cancer from coming back. Stage Ta cancers do come back with some regularity, but they rarely change into cancers that can grow into the bladder wall or go to other parts of the body.

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.

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Carcinogenesis And Risk Factors

Increasing age is the most important risk factor for most cancers. Other risk factors for bladder cancer include the following:

  • Use of tobacco, especially cigarettes.
  • Family history of bladder cancer.
  • HRAS mutation .
  • Rb1 mutation.
  • Occupational exposure to chemicals in processed paint, dye, metal, and petroleum products that include:
  • Aluminum production .
  • Aminobiphenyl and its metabolites.
  • Aromatic amines, benzidine and its derivatives.
  • Treatment with cyclophosphamide, ifosfamide, or pelvic radiation for other malignancies.
  • Use of Chinese herbs: aristolochic acid extracted from species of Aristolochia fangchi.
  • Exposure to arsenic.
  • Arsenic in well water.
  • Inorganic arsenic compounds .
  • Exposure to chlorinated aliphatic hydrocarbons and chlorination by-products in treated water.
  • Schistosoma haematobium bladder infections .
  • Neurogenic bladder and associated use of indwelling catheters.
  • There is strong evidence linking exposure to carcinogens to bladder cancer. The most common risk factor for bladder cancer in the United States is cigarette smoking. It is estimated that up to half of all bladder cancers are caused by cigarette smoking and that smoking increases a persons risk of bladder cancer two to four times above baseline risk. Smokers with less functional polymorphisms of N-acetyltransferase-2 have a higher risk of bladder cancer than other smokers, presumably because of their reduced ability to detoxify carcinogens.

    What Are The Facts About Superficial Bladder Cancer

    Superficial bladder cancer

    Superficial Bladder Cancer is the most common type of cancer, and the symptoms of Bladder Cancer are bleeding in the urine, known as hematuria.

    Smoking is the major risk factor of superficial Bladder cancer, the risk factor increasing by 3 to 4 times more likely to get the disease.

    There are two types of sub-divisions of superficial Bladder Cancer known as non- Invasive or superficial and Invasion.

    Treatment for superficial Bladder cancer is known as Transurethral Resection of the Bladder Tumor it removes the tumor from the Bladder through Urethra and provides instructions to both stages and grades of the tumor.

    Superficial Bladder cancer is staged and classified to the extent of the spread of cancer and grades how abnormal cells appear below the microscope to determine the treatment for patients.

    T1 Tumor has a high risk of recurrence and progression and might need additional treatment in the form of chemotherapy or BCG instillation in the bladder.

    Radical Cystectomy is a bladder removal that is an option for patients who are not responding to other treatments.

    Risk factor for superficial bladder cancer increases with age, and it is more common in men than in women.

    Can diagnose superficial bladder cancer in many ways. Your doctor will recommend a complete medical history, and they may tell you to perform a rectal or vaginal test to check for tumors.

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    Bladder Instillation Of Chemotherapy

    Instillation of chemotherapy drugs into the bladder can reduce the incidence of superficial cancer recurrences, but no single drug has been confirmed to reduce progression of superficial cancer to invasive bladder cancer. This means that multiple small new cancers can be prevented, but progression to a more invasive bladder cancer may occur despite treatment.

    The optimal time to administer chemotherapy is immediately after TUR, as the drugs might prevent reseeding of cancer cells that were disrupted with surgery. Mitomycin is probably the preferred drug because it produces few side effects and is not well absorbed into the system, which allows more of the drug to remain in the bladder to treat the cancer. Thiotepa is rapidly absorbed and produces low blood counts. Doxorubicin produces the most local side effects.

    Tests For Bladder Cancer

    Your doctor may do some tests to check for bladder cancer:

    • internal examination the doctor may check inside your bottom or vagina with their finger, using gloves
    • urine tests your urine will be checked for signs of bladder cancer
    • blood tests to check your general health
    • ultrasound a scan on the outside of your abdomen to check for cancer
    • cystoscopy the doctor puts a small camera into your bladder to see inside
    • biopsy the doctor takes a small sample of the cells from the bladder to check for signs of cancer.

    Your doctor might ask you to have further tests. These can include:

    • CT scan and x-rays scans that take pictures of the inside of the body, sometimes also called a CT-IVP or a triple phase abdominal-pelvic CT scan
    • MRI scan a scan that uses magnetism and radio waves to take pictures of the inside of the body
    • bone scan a scan that uses dye to show changes in your bones
    • FDG-PET scan a scan that uses an injection of liquid to show cancer cells.

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    Living With Advanced Cancer

    Advanced cancer usually means cancer that is unlikely to be cured. Some people can live for many months or years with advanced cancer. During this time palliative care services can help.

    Most people continue to have treatment for advanced cancer as part of palliative care, as it helps manage the cancer and improve their day-to-day lives. Many people think that palliative care is for people who are dying but palliative care is for any stage of advanced cancer. There are doctors, nurses and other people who specialise in palliative care.

    Treatment may include chemotherapy, radiation therapy or another type of treatment. It can help in these ways:

    • slow down how fast the cancer is growing
    • shrink the cancer
    • help you to live more comfortably by managing symptoms, like pain.

    Treatment depends on:

    • how far it has spread
    • your general health

    Treatment For Advanced Bladder Cancer

    LATEST TREATMENT OPTIONS in Superficial Bladder Cancer – Dr. Girish Nelivigi | Doctors’ Circle

    If bladder cancer has spread to other parts of the body, it is known as advanced or metastatic bladder cancer. You may be offered one or a combination of the following treatments to help control the cancer and ease symptoms:

    • systemic chemotherapy
    • surgery
    • radiation therapy.

    Immunotherapy uses the bodys own immune system to fight cancer. BCG is a type of immunotherapy treatment that has been used for many years to treat non-muscle-invasive bladder cancer.

    A new group of immunotherapy drugs called checkpoint inhibitors work by helping the immune system to recognise and attack the cancer. A checkpoint immunotherapy drug called pembrolizumab is now available in Australia for some people with urothelial cancer that has spread beyond the bladder. The drug is given directly into a vein through a drip, and the treatment may be repeated every 2 to 4 weeks for up to 2 years.

    Other types of checkpoint immunotherapy drugs may become available soon.

    Read Also: Prognosis Of Bladder Cancer In Females

    Expectancy Rate In Relation To Risk Factors

    In most cases, the development of bladder cancer from one stage to another is due to having the following risk factors:

    • Age – As people grow older with the disease, their bodies become weaker to fight off infections. Moreover, being diagnosed with the disease in old age lowers the rate of survival.
    • Family history – Having a history of bladder cancer within the family can increase the people’s risk of getting the same type of cancer.
    • Occupational exposure – According to a scientific research, people who are exposed to certain chemicals can increase their risk of developing bladder cancer. Some of these chemicals can also increase the effects of cancer in the body. These are the chemicals that are contained in dyes, metals, paints, as well as petroleum products.
    • Genetic mutations – a genetic mutation is a big factor in cancer determination. If there is a genetic mutation, this means that most of your functions are altered. Having genetic mutations in the bladder can result in either positive or negative effects. The negative effects will reduce the survival rate of a person with bladder cancer.

    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.

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    How Is Bladder Cancer Treated

    Treatment for bladder cancer depends on

    • The stage of cancer.
    • If cancer has spread beyond the lining of the bladder.
    • The extent of cancer spread.

    Treatment options based on tumor grade

    • High-grade bladder cancer: High-grade cancers that are life-threatening and spread quickly need to be treated with chemotherapy, radiation or surgery.
    • Low-grade cancers: Less aggressive cancers have a low chance of becoming high grade and do not require aggressive treatments, such as radiation or bladder removal.

    Treatment options may vary depending on the tumor stage.

    Treating Stage 0 Bladder Cancer

    Superficial bladder cancer

    Stage 0 bladder cancer includes non-invasive papillary carcinoma and flat non-invasive carcinoma . In either case, the cancer is only in the inner lining layer of the bladder. It has not invaded the bladder wall.

    This early stage of bladder cancer is most often treated with transurethral resection with fulguration followed by intravesical therapy within 24 hours.

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    What Is A Bladder

    The bladder can be described as a hollow organ, which is located next to the kidneys. The bladder functions by collecting all the urine coming from the kidneys through the ureter. It then stores the urine until it is removed from the body.

    Having a bladder cancer causes an uncontrolled growth and development of cells in the bladder. The increasing production of cells is abnormal. Once the cells have grown, they can cause some complications in the person’s body including pain.

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    How Is Bladder Cancer Diagnosed

    Several different diagnostic tests and procedures may be used to detect bladder cancer, often in combination. They are selected based on a patients symptoms and risk factors and may include:

    • Urinalysis: a quick test used to detect blood and other substances in urine.
    • Urine cytology: urine is examined microscopically to see if cancer cells are present.
    • Genomic urine tests: non-invasive molecular tests, such as Cxbladder, which measure gene expression to detect or rule out bladder cancer.
    • Cystoscopy: a thin, flexible tube with a light and camera is inserted into the bladder through the urethra. If an abnormal area is seen, a small sample of tissue is usually collected for laboratory examination.
    • Imaging: several types of imaging test can be used to visualize the inside of the body, such as ultrasound, CT scan, MRI scan, and x-ray.

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    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

    Treatment Of Stage 0 Bladder Cancer

    Differences in survival rates among non-urothelial bladder cancers
    In This Section
  • Radical cystectomy .
  • Transurethral resection with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy

    TUR and fulguration are the most common and conservative forms of management. Careful surveillance of subsequent bladdertumor progression is important. Because most bladder cancers recur after TUR, one immediate intravesical instillation of chemotherapy after TUR is often administered. Numerous randomized controlled trials have evaluated this practice, and a meta-analysis of seven trials reported that a single intravesical treatment with chemotherapy reduced the odds of recurrence by 39% . However, although a single instillation of chemotherapy lowers the relapse rate in patients with multiple tumors, the majority still relapse. Such treatment is thus not sufficient by itself for these patients.

    One retrospective series addressed the valueof performing a second TUR within 2 to 6 weeks of the first TUR. A second TUR performed on 38 patients with Tis or Tadisease revealed that nine patients had lamina propria invasion and threepatients had muscle invasion .

    Such information may change thedefinitive management options in these individuals. Patients with extensive multifocal recurrent disease and/or other unfavorable prognostic features require moreaggressive forms of treatment.

    Evidence :

  • Agents studied included epirubicin, mitomycin , thiotepa, and pirarubicin.
  • Evidence :

    Intravesical chemotherapy

    Segmental cystectomy

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    What Are The Survival Rates For Superficial Bladder Cancer

    Can compare the survival rate for superficial bladder cancer with people with the same type & stage of Bladder cancer in people overall. If a 5-year survival rate is there for a specific stage of superficial bladder cancer, then the survival rate is 90%. That means people who are at that stage are, on average. Doctors can tell you how long youre going to live, but they will help you better understand how likely it is that our treatment will be successful.

    What Is The First Sign Of Bladder Cancer

    Blood in the urine, referred to as hematuria, is usually the first sign of bladder cancer. This is because early bladder cancer commonly causes bleeding without associated pain or other symptoms.

    • Depending on the amount of blood present, urine may appear pink, red, or brownish in color.
    • Blood may not be present all the time – there may be relatively long periods of clear urine .

    If you have noticed blood in your urine it is important to speak to your doctor as soon as possible.

    Other early symptoms of bladder cancer that may be experienced are urinary irritation or changes in bladder habits, such as increased urination frequency and/or urgency, pain or a burning sensation during urination, or difficulty passing urine.

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    What Goes Into A Prognosis

    When figuring out your prognosis, your healthcare provider will consider all the things that could affect the cancer and its treatment. He or she will look at risk estimates about the exact type and stage of the cancer you have. These estimates are based on what results researchers have seen over many years in thousands of people with the same type and stage of cancer.

    If your cancer is likely to respond well to treatment, your healthcare provider will say you have a favorable prognosis. This means youre expected to live many years and may even be cured. If your cancer is likely to be hard to control, your prognosis may be less favorable. The cancer may shorten your life. Its important to keep in mind that a prognosis states whats likely or probable. It’s not a prediction of what will definitely happen. No healthcare provider can be fully certain about an outcome.

    Your prognosis depends mainly on:

    • The type and location of the cancer

    • The stage of the cancer

    • Your overall health

    • Your treatment decisions

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