PDQ IS A COMPREHENSIVE CANCER DATABASE AVAILABLE ON NCI'S WEB SITE. PDQ is the National Cancer Institute's (NCI's) comprehensive cancer information database. Most of the information contained in PDQ is available online at NCI's Web site. PDQ is provided as a service of the NCI. The NCI is part of the National Institutes of Health,the federal government's focal point for biomedical research. .
Changes to This Summary (03 / 04 / 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.
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
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Recurrent Bladder Cancer
Recurrent bladder cancer is cancer that has recurred (come back) after it has been treated. The cancer may come back in the bladder or in other parts of the body. ...
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This PDQ cancer information summary for health professionals provides comprehensive, peer-reviewed, evidence-based information on bladder cancer treatment.
Changes to This Summary (02 / 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. General Information About Bladder CancerUpdated statistics with estimated new cases and deaths for 2013 (cited American Cancer Society as reference 1).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.
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.
Stage 0 Bladder Cancer
Stage 0 bladder cancer is defined by the following TNM classifications:Ta, N0, M0Tis, N0, M0Patients 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 following initial resection was 80%. Patients at greatest risk of recurrent disease are those whose tumors are large, poorly differentiated, multiple, or associated with nuclear p53 overexpression. In addition, patients with carcinoma in situ (Tis) or dysplasia of grossly uninvolved bladder epithelium are at greater risk of recurrence and progression.[1,2,3]Transurethral resection (TUR) and fulguration are the most common and conservative forms of management. Careful surveillance of subsequent bladder tumor progression is important. One retrospective series addressed the value of performing a second TUR
Treatment Options for Recurrent Bladder Cancer
Treatment of recurrent bladder cancer depends on previous treatment and where the cancer has recurred. Treatment for recurrent bladder cancer may include the following: Surgery. Chemotherapy. Radiation therapy. A clinical trial of chemotherapy. This summary section refers to specific treatments under study in clinical trials,but it may not mention every new treatment being studied. ...