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What Is The Most Aggressive Type Of Bladder Cancer

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Occurrence In The United States

Bladder Cancer – Overview (types, pathophysiology, diagnosis, treatment)

The American Cancer Society estimates that 81,180 new cases of bladder cancer will be diagnosed in the United States in 2022 and that 17,100 people will die of the disease. The incidence of bladder cancer increases with age, with the median age at diagnosis being 73 years bladder cancer is rarely diagnosed before age 40 years.

Bladder cancer is about 4 times more common in men than in women. The male predominance in bladder cancer in the United States reflects the prevalence of transitional cell carcinoma . With small cell carcinomain contrast to TCCthe male-to-female incidence ratio is 1:2.

Bladder cancer is the fourth most common cancer in men in the United States, after prostate, lung, and colorectal cancer, but it is not among the top 10 cancers in women. Accordingly, more men than women are expected to die of bladder cancer in 2022, with 12,120 deaths in men versus 4980 in women. Nevertheless, women generally have a worse prognosis than men.

The incidence of bladder cancer is twice as high in White men as in Black men in the United States. However, Blacks have a worse prognosis than Whites.

Limited data indicate that small cell carcinoma of the urinary bladder probably has the same epidemiologic characteristics as urothelial carcinoma. Patients are more likely to be male and older than 50 years.

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.

Genetic Factors In Pathogenesis

Divergent, yet interconnected and overlapping, molecular pathways are likely responsible for the development of noninvasive and invasive bladder tumors. Somatic mutations in fibroblast growth receptor3 and tumor protein p53 in tumor cells appear to be important early molecular events in the noninvasive and invasive pathways, respectively.

FGFR-3, Ras, and PIK3CA mutations occur with high frequency in noninvasive tumors, leading to upregulation of Akt and mitogen-activated protein kinase . Loss of heterozygosity on chromosome 9 is among the most frequent genetic alterations in bladder tumors and is considered an early event.

Large numbers of genomic changes have been detected using karyotyping and comparative genomic hybridization analysis in urothelial carcinoma. Numerically common are losses of 2q, 5q, 8p, 9p, 10q, 18q, and Y. Gains of 1q, 5p, 8q, and 17q are frequently present, and high-level amplifications can be found however, the target genes in the regions of amplifications have not been conclusively identified.

Alterations in the TP53 gene are noted in approximately 60% of invasive bladder cancers. Progression-free survival is significantly shorter in patients with TP53 mutations and is an independent predictor of death among patients with muscle-invasive bladder cancer.

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How Is Gallbladder Cancer Usually Treated

Treatment for gallbladder cancer may include

  • Surgery: It can be used to remove the gallbladder. If cancer has spread, then surgery can also be used to remove the surrounding tissue, lymph nodes and parts of other organs.
  • Cancer found in the wall of the gallbladder can be completely removed by surgery.
  • Unresectable cancer cannot be removed completely by surgery. Most patients with gallbladder cancer have unresectable cancer.
  • Recurrent cancer is cancer that has recurred after it has been treated. GBC may come back in the gallbladder or in other parts of the body.
  • Chemotherapy: This usually uses cytotoxic drugs to destroy the cancer cells.
  • For gallbladder cancer, it may be used after surgery if the surgeon cannot remove all cancer.
  • It may also be used if surgery is not possible or if cancer has come back after surgery.
  • The chemotherapy drugs most commonly used are Gemzar and cisplatin.
  • Radiotherapy: This uses high-energy rays to destroy cancer cells.
  • It may be used to relieve symptoms if gallbladder cancer has spread.
  • Stents: If cancer is blocking the bile duct, this can often be treated with a flexible plastic or metal tube called a stent. The stent holds the duct open, so it is no longer blocked.
  • Acute Myeloid Leukemia 5

    Bladder cancer

    Leukemias develop from stem cells in the bone marrow, which differentiate into different blood-cell precursors and eventually blood cells. Leukemia occurs when blood cell development is halted and the cells become cancerous, explained Romundstad. Leukemias are classified according to the stage at which blood cells and precursors halt their development and become cancerous, Romundstad said.

    Acute myeloid leukemia refers to any cancer that develops in myeloid cells , which are blood precursor cells that have the potential to develop into red blood cells, some types of white blood cells, and platelets.

    In AML, rather than developing into these blood cell types, stem cells get stuck at an immature stage and are called “blast cells,” according toLeukemia and Lymphoma Society . There are no or very few blast cells in healthy blood. Having too many blast cells and too few healthy blood cells causes many symptoms of AML, including frequent infections, bruising, and bleeding easily.

    AML is more common in adults than in children, though it can occur at any age. For the most part, doctors don’t know what causes it, though smoking, previous chemotherapy or radiation treatments for other cancers, and exposure to the chemical benzene increase the risk of getting it. Treatment approaches may include chemotherapy, a stem cell transplant or targeted therapies. According to the NCI, AML is predicted to claim the lives of some 11,540 Americans in 2022.

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    Bladder Cancer Risk Factors

    Anything that increases your chance of getting bladder cancer is a risk factor. These include:

    Smoking tobacco: This is the greatest risk factor for bladder cancer that individuals can control. Smokers, including pipe and cigar smokers, are two- to three-times more likely than nonsmokers to get bladder cancer. Chemicals in tobacco smoke are absorbed into the blood, and then they pass through the kidneys and collect in the urine. These chemicals can damage the inside of the bladder and increase your chances of getting bladder cancer.

    Age: The chance of developing bladder cancer increases with age. It is uncommon in people under 40. Most diagnoses are in people age 65 or older.

    Race: Bladder cancer occurs twice as often in Caucasians as it does in African Americans and Hispanics. Asians have the lowest rate of developing the disease.

    Gender: Men are up to four times as likely as women to get bladder cancer.

    Personal history of bladder cancer: Bladder cancer has a 50% to 80% chance of returning after treatment, either as a recurrence of the first cancer or as a second individual disease.

    Exposure to chemicals: Historical studies have shown that people who work around certain chemicals are more likely to get bladder cancer. These include:

    • People who work in the rubber, chemical and leather industries

    Which Bladder Cancer Is Aggressive

    Small Cell Carcinoma of the Bladder This aggressive form of the disease begins in small nerve-like cells in the bladder called neuroendocrine cells. Small cell carcinoma makes up about 1 percent of bladder cancers. It is often detected at an advanced stage, after it has spread to other parts of the body.

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    Squamous Cell Carcinoma Of The Bladder

    Squamous cell carcinoma is the second most common type of bladder cancer. It accounts for about 5 percent of bladder cancers in North America and Europe. This cancer begins in the thin, flat squamous cells that may form in the bladder after chronic inflammation and infection. Squamous cell carcinoma is most often found in parts of the world where a parasitic infection called schistosomiasis is widespread, such as the Middle East.

    Prognosis And Survival For Bladder Cancer

    Bladder Cancer: The Basics | Johns Hopkins Greenberg Bladder Cancer Institute

    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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    Why Are Men More Likely To Get Bladder Cancer Than Women

    Men are more likely to develop bladder cancer than women are. Exposure to certain chemicals. Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, its thought that being around certain chemicals may increase the risk of bladder cancer.

    What Role Does Our Team Play From The Screening Process Through Cancer Remission

    Our radiologists and screening specialists want to make you feel comfortable while undergoing any regular screenings. We strive to have our service go beyond providing the standard of care to connect with our patients on a deeper level. We also have the latest technology available to develop the clearest and most precise scans.

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    Initial Treatment Of Prostate Cancer By Stage

    The stage of your cancer is one of the most important factors in choosing the best way to treat it. Prostate cancer is staged based on the extent of the cancer and the PSA level and Gleason score when it is first diagnosed.

    For prostate cancers that havenât spread , doctors also use risk groups to help determine treatment options. Risk groups range from very low risk to very high risk, with lower risk group cancers having a smaller chance of growing and spreading compared to those in higher risk groups.

    Other factors, such as your age, overall health, life expectancy, and personal preferences are also taken into account when looking at treatment options. In fact, many doctors determine a mans possible treatment options based not just on the stage, but on the risk of cancer coming back after the initial treatment and on the mans life expectancy.

    You might want to ask your doctor what factors he or she is considering when discussing your treatment options. Some doctors might recommend options that are different from those listed here.

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    What Is The Most Aggressive Cancer

    Bladder Cancer Types

    Here is a list of the most aggressive sorts of cancer. 10 Lung Cancer. It is a cruel lung tumor typified by unrestrained cell growth in tissues of the lung. If still untreated, this growth can increase beyond the lung by process of metastasis into near tissue or other parts of the body. Most cancers that begin in the lung,

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    Permission To Use This Summary

    PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as NCIs PDQ cancer information summary about breast cancer prevention states the risks in the following way: .

    The best way to cite this PDQ summary is:

    PDQ® Adult Treatment Editorial Board. PDQ Bladder Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated < MM/DD/YYYY> . Available at: . Accessed < MM/DD/YYYY> .

    Images in this summary are used with permission of the author, artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in Visuals Online. Visuals Online is a collection of more than 3,000 scientific images.

    Are Most Bladder Cancers Curable

    Most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. But even early-stage bladder cancers can come back after successful treatment. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs.

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    Is Bladder Cancer Treatable

    Many types of therapy are used to treat bladder cancer. In general, the treatment pathway chosen depends on the type and stage of bladder cancer present and a patients overall health and individual preferences. Common treatment options include:

    • Surgery: to remove tumor cells and surrounding tissue. The type of surgery used depends on factors such as the size and progression of the tumor.
    • Chemotherapy: which refers to the use of drugs to destroy cancer cells. Chemotherapy may be local or systemic .
    • Immunotherapy: which uses naturally occurring or man-made substances to improve or bolster the bodys immune system function. Like with chemotherapy, immunotherapy may be delivered locally or systemically.
    • Radiation therapy: which uses x-rays or other high-energy waves or particles to kill cancer cells.

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    Who Is At Risk Of Prostate Carcinoma

    Bladder Cancer, Causes, Signs and Symptoms, Diagnosis and Treatment.

    Scientists havent found the exact cause for prostate malignancy. But, like any other carcinoma, prostate cancer can develop in individuals with a family history of the disease or constant exposure to dangerous chemicals.

    Whatever is causing the problem will trigger a cell mutation. This mutation is the one that causes the disease. Although prostate carcinoma can happen in any man, certain risk factors can make them more susceptible to the disease. These factors are:

    For example, African Americans are found to have the highest risk of this particular illness. Also, those who are obese can become more vulnerable to the disease. Thats where understanding the risk factors could prove useful. It may help lessen the risk, particularly in older adults.

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    Radiotherapy With A Radiosensitiser

    Radiotherapy is given by a machine that beams the radiation at the bladder . Sessions are usually given on a daily basis for 5 days a week over the course of 4 to 7 weeks. Each session lasts for about 10 to 15 minutes.

    A medicine called a radiosensitiser should also be given alongside radiotherapy for muscle-invasive bladder cancer. This medicine affects the cells of a tumour, to enhance the effect of radiotherapy. It has a much smaller effect on normal tissue.

    As well as destroying cancerous cells, radiotherapy can also damage healthy cells, which means it can cause a number of side effects. These include:

    • difficulty passing urine

    Most of these side effects should pass a few weeks after your treatment finishes, although theres a small chance theyll be permanent.

    Having radiotherapy directed at your pelvis usually means youll be infertile .

    After having radiotherapy for bladder cancer, you should be offered follow-up appointments every 3 months for the first 2 years, then every 6 months for the next 2 years, and every year after that. At these appointments, your bladder will be checked using a cystoscopy.

    You may also be offered CT scans of your chest, abdomen and pelvis after 6 months, 1 year and 2 years. A CT scan of your urinary tract may be offered every year for 5 years.

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    Side Effects Of Treatment For Bladder Cancer

    All cancer treatments can have side effects. Your treatment team will discuss these with you before you start treatment. Talk to your doctor or nurse about any side effects you are experiencing. Some side effects can be upsetting and difficult, but there is help if you need it.

    or email to speak with a caring cancer nurse for support.

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    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.

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