Bladder and Other Urothelial Cancers Screening (PDQ®): Screening - Health Professional Information [NCI] - Questions or Comments About This Summary
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Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage IV Bladder Cancer Treatment
Currently, only a small fraction of patients with stage IV bladder cancer can be cured and for many patients, the emphasis is on palliation of symptoms. The potential for cure is restricted to patients with stage IV disease with involvement of pelvic organs by direct extension or metastases to regional lymph nodes.Standard Treatment Options for Stage IV Bladder CancerStandard treatment options for patients with T4b, N0, M0 or any T, N1–N3, M0 diseaseTreatment options for patients with T4b, N0, M0 or any T, N1–N3, M0 disease include the following:Chemotherapy alone.Radical cystectomy.Radical cystectomy followed by chemotherapy.Radical cystectomy alone.External-beam radiation therapy (EBRT) with or without concomitant chemotherapy.Urinary diversion or cystectomy for palliation.Chemotherapy aloneCisplatin-based combination chemotherapy regimens are the standard of care for stage IV bladder cancer.[2,3,4,5,6] The only chemotherapy regimens that have been
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Urethral Cancer Associated With Invasive Bladder Cancer
Approximately 10% (range, 4%–17%) of patients who undergo cystectomy for bladder cancer can be expected to have or to later develop clinical neoplasm of the urethra distal to the urogenital diaphragm. Factors associated with the risk of urethral recurrence after cystectomy include:[1,2]Tumor multiplicity.Papillary pattern.Carcinoma in situ.Tumor location at the bladder neck.Prostatic urethral mucosal or stromal involvement.The benefits of urethrectomy at the time of cystectomy need to be weighed against the morbidity factors, which include added operating time, hemorrhage, and the potential for perineal hernia. Tumors found incidentally on pathologic examination are much more likely to be superficial or in situ in contrast to those that present with clinical symptoms at a later date when the likelihood of invasion within the corporal bodies is high. The former lesions are often curable, and the latter are only rarely so. Indications for urethrectomy in continuity with
Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - nci_ncicdr0000062908-nci-header
This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http://cancer.gov or call 1-800-4-CANCER.Bladder Cancer Treatment
Bladder Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Changes to This Summary (05 / 10 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above. Editorial changes were made to this summary.
Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Bladder Cancer
The clinical staging of carcinoma of the bladder is determined by the depth of invasion of the bladder wall by the tumor. This determination requires a cystoscopic examination that includes a biopsy and examination under anesthesia to assess the following:Size and mobility of palpable masses.Degree of induration of the bladder wall.Presence of extravesical extension or invasion of adjacent organs.Clinical staging, even when computed tomographic (CT) and/or magnetic resonance imaging (MRI) scans and other imaging modalities are used, often underestimates the extent of tumor, particularly in cancers that are less differentiated and more deeply invasive. CT imaging is the standard staging modality. A clinical benefit from obtaining MRI or positron emission tomography scans rather than CT imaging has not been demonstrated.[1,2]AJCC Stage Groupings and TNM DefinitionsThe American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define bladder
Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Distal Urethral Cancer
Female Distal Urethral CancerIf the malignancy is at or just within the meatus and superficial parameters (stage 0/Tis, Ta), open excision or electroresection and fulguration may be possible. Tumor destruction using Nd:YAG or CO2 laser vaporization-coagulation represents an alternative option. For large lesions and more invasive lesions (stage A and stage B, T1 and T2, respectively), brachytherapy or a combination of brachytherapy and external-beam radiation therapy are alternatives to surgical resection of the distal third of the urethra. Patients with T3 distal urethral lesions, or lesions that recur after treatment with local excision or radiation therapy, require anterior exenteration and urinary diversion. If inguinal nodes are palpable, frozen section confirmation of tumor should be obtained. If positive for malignancy, ipsilateral node dissection is indicated. If no inguinal adenopathy exists, node dissection is not generally performed, and the nodes are followed clinically.
Bladder and Other Urothelial Cancers Screening (PDQ®): Screening - Health Professional Information [NCI] - Changes to This Summary (08 / 08 / 2013)
The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.Description of EvidenceAdded text to state that a positive family history of bladder cancer has also been associated with an increased risk of bladder cancer (cited Burger et al. as reference 3).Added Gu et al., Engel et al., and Sanderson et al. as references 8, 10, and 14, respectively.Revised text to state that a variety of industrial exposures have also been implicated as risk factors for developing bladder cancer, primarily aromatic amines, such as 2-naphthylamine, beta-naphthylamine, or 4-chloro-o-toluidine, present in the production of dyes and benzidine and its derivatives; possibly chlorinated aliphatic hydrocarbons; chlorination by-products in treated water; aluminum production (polycyclic aromatic hydrocarbons, fluorides), and certain aldehydes.Revised text to state that
Bladder Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Get More Information From NCI
Call 1-800-4-CANCERFor more information, U.S. residents may call the National Cancer Institute's (NCI's) Cancer Information Service toll-free at 1-800-4-CANCER (1-800-422-6237) Monday through Friday from 8:00 a.m. to 8:00 p.m., Eastern Time. A trained Cancer Information Specialist is available to answer your questions.Chat online The NCI's LiveHelp® online chat service provides Internet users with the ability to chat online with an Information Specialist. The service is available from 8:00 a.m. to 11:00 p.m. Eastern time, Monday through Friday. Information Specialists can help Internet users find information on NCI Web sites and answer questions about cancer. Write to usFor more information from the NCI, please write to this address:NCI Public Inquiries Office9609 Medical Center Dr. Room 2E532 MSC 9760Bethesda, MD 20892-9760Search the NCI Web siteThe NCI Web site provides online access to information on cancer, clinical trials, and other Web sites and organizations that offer support
Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Recurrent Bladder Cancer Treatment
The prognosis for any patient with progressive or recurrent invasive bladder cancer is generally poor. Management of recurrence depends on previous therapy, sites of recurrence, and individual patient considerations. Treatment of new superficial or locally invasive tumors that develop in the setting of previous conservative therapy for superficial bladder neoplasia has been discussed earlier in this summary.Recurrent or progressive disease in distant sites or after definitive local therapy has an extremely poor prognosis, and clinical trials should be considered whenever possible. Patients who have not received previous chemotherapy for urothelial carcinoma should be considered for chemotherapy as described above for stage IV disease. Palliative radiation therapy should be considered for patients with symptomatic tumors.Standard Treatment Options for Recurrent Bladder CancerStandard treatment options for patients with recurrent bladder cancer include the following:Combination