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    Bladder Cancer Health Center

    Medical Reference Related to Bladder Cancer

    1. Bladder Cancer Treatment (PDQ®): Treatment - Patient Information [NCI] - Stages of Bladder Cancer

      After bladder cancer has been diagnosed, tests are done to find out if cancer cells have spread within the bladder or to other parts of the body. The process used to find out if cancer has spread within the bladder lining and muscle or to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment. The following tests and procedures may be used in the staging process: CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to

    2. Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage 0 Bladder Cancer Treatment

      Standard Treatment Options for Stage 0 Bladder CancerPatients with stage 0 bladder tumors can be cured by a variety of treatments, even though the tendency for new tumor formation is high. In a series of patients with Ta or T1 tumors who were followed for a minimum of 20 years or until death, the risk of bladder cancer recurrence after initial resection was 80%.[1] Of greater concern than recurrence is the risk of progression to muscle-invasive, locally-advanced, or metastatic bladder cancer. While progression is rare for patients with low-grade tumors, it is common among patients with high-grade cancers. One series of 125 patients with TaG3 cancers followed for 15 to 20 years reported that 39% progressed to more advanced-stage disease while 26% died of urothelial cancer. In comparison, among 23 patients with TaG1 tumors, none died and only 5% progressed.[2] Risk factors for recurrence and progression are the following:[2,3,4,5,6]High-grade disease.Presence of

    3. Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Changes to This Summary (10 / 23 / 2014)

      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.This summary was comprehensively reviewed and reformatted.This summary is written and maintained by the PDQ Adult Treatment Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.

    4. Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Proximal Urethral Cancer

      Female Proximal Urethral CancerLesions of the proximal or entire length of the urethra are usually associated with invasion and a high incidence of pelvic nodal metastases. The prospects for cure are limited except in the case of small tumors. The best results have been achieved with exenterative surgery and urinary diversion with 5-year survival rates ranging from 10% to 20%. To increase the resectability rate of gross tumor and decrease local recurrence, in an effort to shrink tumor margins, it is reasonable to recommend adjunctive, preoperative, radiation therapy. Pelvic lymphadenectomy is performed concomitantly. Ipsilateral inguinal node dissection is indicated only if biopsy specimens of ipsilateral palpable adenopathy are positive on frozen section. For tumors that do not exceed 2 cm in greatest dimension, radiation alone, nonexenterative surgery alone, or a combination of the two may be sufficient to provide an excellent outcome.It is reasonable to consider removal of part of

    5. Bladder Cancer Treatment (PDQ®): Treatment - Patient 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

    6. Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview

      Information about the treatment of urethral cancer and the outcomes of therapy is derived from retrospective, single-center case series and represents a very low level of evidence of 3iiiDiv. The majority of this information comes from the small numbers of cases accumulated over many decades at major academic centers. Therefore, the treatment in these reports is usually not standardized and the treatment also spans eras of shifting supportive care practices. Because of the rarity of urethral cancer, its treatment may also reflect extrapolation from the management of other urothelial malignancies, such as bladder cancer in the case of transitional cancers, and anal cancer in the case of squamous cell carcinomas. Role of SurgerySurgery is the mainstay of therapy for urethral cancers in both women and men.[Level of evidence: 3iiiDiv] The surgical approach depends on tumor stage and anatomic location, and tumor grade plays a less important role in treatment decisions.[1,2] Although the

    7. Bladder 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.

    8. Urethral Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Cellular Classification of Bladder Cancer

      More than 90% of bladder carcinomas are transitional cell carcinomas derived from the uroepithelium. About 2% to 7% are squamous cell carcinomas, and 2% are adenocarcinomas.[1] Adenocarcinomas may be of urachal origin or nonurachal origin; the latter type is generally thought to arise from metaplasia of chronically irritated transitional epithelium. Small cell carcinomas also may develop in the bladder.[2,3] Sarcomas of the bladder are very rare. Pathologic grade of transitional cell carcinomas, which is based on cellular atypia, nuclear abnormalities, and the number of mitotic figures, is of great prognostic importance.References: Al-Ahmadie H, Lin O, Reuter VE: Pathology and cytology of tumors of the urinary tract. In: Scardino PT, Linehan WM, Zelefsky MJ, et al., eds.: Comprehensive Textbook of Genitourinary Oncology. 4th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2011, pp 295-316. Koay EJ, Teh BS, Paulino AC, et al.: A Surveillance, Epidemiology, and End Results analysis

    9. Bladder and Other Urothelial Cancers Screening (PDQ®): Screening - Health Professional Information [NCI] - Description of the Evidence

      Incidence and MortalityBladder cancer is the fourth most commonly diagnosed malignancy in men in the United States. It is estimated that 72,570 new cases of bladder cancer are expected to occur in the United States in 2013.[1]Bladder cancer is diagnosed almost twice as often in whites as in blacks of either sex. The incidence of bladder cancer among other ethnic and racial groups in the United States falls between that of blacks and whites. The incidence of bladder cancer increases with age.[2]Since the 1950s, the incidence of bladder cancer has risen by approximately 50%. It is to be anticipated that, with the aging of the U.S. population, this trend will continue. There has been a decrease of approximately 33% in bladder cancer mortality during the same interval (National Cancer Institute's Surveillance, Epidemiology, and End Results program, 1973–1997). It is estimated that 15,210 Americans will die of bladder cancer in 2013.[1]The age-adjusted mortality from

    10. Bladder Cancer Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage I Bladder Cancer Treatment

      Standard Treatment Options for Stage I Bladder CancerPatients with stage I bladder tumors are unlikely to die from bladder cancer, but the tendency for new tumor formation is high. In a series of patients with Ta or T1 tumors who were followed for a minimum of 20 years or until death, the risk of bladder recurrence after initial resection was 80%.[1] Of greater concern than recurrence is the risk of progression to muscle-invasive, locally-advanced, or metastatic bladder cancer. While progression is rare for low-grade tumors, it is common among high-grade cancers. One series of 125 patients with TaG3 cancers followed for 15 to 20 years reported that 39% progressed to more advanced stage disease, while 26% died of urothelial cancer. In comparison, among 23 patients with TaG1 tumors, none died and only 5% progressed.[2] Risk factors for recurrence and progression include the following:[2,3,4,5,6]High-grade disease.Presence of carcinoma in situ.Tumor larger

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