 |
|
 |
|
|
Informations: New researches about the surgical therapy of bladder cancer
Posted by : Admin on Monday, May 21, 2007 - 08:26 PM
|
|
|
| |
1532 Reads
(AUA 2007, Anaheim, CA, May 20, 2007) – A podium session moderated from Robert R. Bahnson and Michael A O’Donnell discussed new studies about the surgical therapy of urothelian carcinomas. one highlight of this session was the studies about the laparoscopic and robotic radical cystectomy of the bladder. Some videos in this article are available.
Video is available here
Aaron Lentz, from Chapel Hill, NC, reported in their study that in patients undergoing cystectomy for bladder cancer, married individuals appear to have improved pre-operative laboratory variables, shorter hospitalization, and improved pathological outcomes vs. unmarried patients in our case series. These findings may support the evidence (observed in other tumor types and other disease states) that married persons present earlier than unmarried individuals, and this may help explain the improved survival outcomes that have been observed in married patients with bladder cancer.
Video is available here
A nonrandomized inter-institutional comparison from Bern, Switzerland and Cleveland, OH, reported that the extended pelvic lymphnode dissection is associated with lower recurrence rates in patients after radical cystectomy. Nivedita Dhar explained that the compare and evaluate the rates of recurrence (local and/or systemic) for patients with stage pT2pN0-2 and pT3pN0-2 urothelial carcinoma of the bladder with limited pelvic lymph node dissection (PLND) at Cleveland Clinic (CCF) or with an extended PLND at University of Bern (Bern). Recognizing the inherent limitations of a retrospective two institution comparison, the results suggest that the more extended the PLND, the more likely positive nodes are found and if so, a meticulous extended PLND may reduce the probability of local and/or distant recurrence when compared to a limited PLND.
Video is available here
The researcher group of Ulm, Germany, reported from Georg Bartsch, visualized a study about prostate cancer in cystectomy speciments of patients with bladder cancer. The results of this study explained that in 23 cases the patients had a definite PCA therapy before radical cystectomy, while in 244 cases PCA was diagnosed incidentally in the cystectomy specimen. In these concurrent PCA-cases the median and medium serum-PSA level was 2.3 ng/ml and 4.6 ng/ml (Range 0.3 -77.4 ng/ml), while in those patients who had no PCA, the median and medium serum-PSA level was 1.3 ng/ml and 2.0 ng/ml (range 0.1 - 51.7 ng/ml). The detection rate of PCA increased by optimizing the histopathologic work-up from 7.7% to 33.4%. The rate of PCA with Gleason-score >6 decreased from 15.6 % to 10.4 %, while the rate of locally advanced PCA decreased from 31.3 % to 11.8 %. The rate of significant PCA changed from 40.6 % to 31.6 %. The incidence of PCA in the early series was: < 50y: 2%, 50-59y: 4%, 60-69y: 7%, 70y+: 18%. These incidences increased in the current series: <50y: 8%, 50-59y: 28%, 60-69y: 34%, 70y+: 41%. The rate of postoperative PSA-progression in the complete series was only 1%. only one patient died from progressing PCA (Gleason-Score 10). Even with intensified histopathologic work-up, the incidence of prostate cancer remains lower than expected from the literature. In contrast to radical prostatectomy the cure rate of prostate cancer by radical cystoprostatectomy is extremely high. This raises the question, whether the definition of a ,,signficant“ PCA should be limited to cases with non organ-confined or Gleason 8-10 tumors.
Video is available here
Clayton S Lau, Duarte, CA, talk about their study of the laparoscopic and robotic assisted laparoscopic cystectomy and urinary diversion: the City of Hope experience. They retrospectively reviewed the charts of 111 patients that have undergone either laparoscopic or robotic assisted laparoscopic cystectomy and urinary diversion at our institution and examine multiple clinical and pathologic variables. Between 5/2001 and 10/2006 111 total cases were done, 51 laparoscopically and 60 robotic assisted laparoscopic. Eighteen of these were salvage cystectomies. The charts of these patients were retrospectively reviewed. Preoperative characteristics including gender, clinical stage, and indications for surgery were analyzed. Postoperatively EBL, conversion rate, number of lymph nodes removed, pathologic stage, positive margin rate, port site metastasis rate, and complication rates were evaluated. Ninety men and twenty one women underwent radical cystectomy via laparoscopic or robot assisted laparoscopic approach. The most common indication was high grade urothelial bladder cancer (n=98, 88,3%). Average EBL for the laparoscopic approach was 556,6ml (100-2000ml), while it was 375 (100-1500ml) in the robotic assisted laparoscopic group. The average lymph nodes removed in the laparoscopic and robotic assisted laparoscopic group was 16,1 (2-42) and 20,7 (2-47) respectively. There were positive margins in 6 (5,4%) patients. Urinary diversions were done via a mini-laparotomy. Average hospitalization was 15,1 and 12,9 days respectively in the laparoscopic and robotic assisted laparoscopic groups. Complication rates were 31,3% and 33,3% in the laparoscopic and robotic assisted laparoscopic group respectively. No port site metastasis reported. This is the largest single institional series of laparoscopic and robotic assisted laparoscopic cystectomies. It can be done safely, while postoperative recovery and oncologic outcomes appear to be similar to open surgery. An extended lymph node dissection can be accomplished via both minimally invasive approaches. However, controlled clinical trials and comparisons from high volume centers are needed.
Video is available here
Gerald J Wang from New York, NY, reported about their study of the prospective comparison of perioperative and early pathologic outcomes of the robotic versus open radical cystectomy. Their initialexperience with robotic-assisted RC suggests potential advantages compared to the standard open approach. Although operative duration was greater in the robotic group, blood loss, transfusion requirement, time to regular diet, and hospital stay were all decreased compared to the open cohort. The robotic method also demonstrated comparable early pathologic outcomes, with no difference in margin status or total number of lymph nodes removed. Long-term functional and oncologic outcomes are needed to better define the role of robotic-assisted RC in the surgical management of bladder cancer.
959 More words
|
|
|
|
|
|
|
|
|
|
|
Informations: New Markers for Detecting Bladder Cancer
Posted by : Admin on Monday, May 21, 2007 - 06:47 PM
|
|
|
| |
1308 Reads
(Anaheim, CA, May 20, 2007) – At an AUA – podium session physicans, researcher and urologists discussed new studies about marker for detecting bladder cancer.
One of these studies was a long term follow-up study of the prognostic utility of the BTA stat test from the University of Finland. The Finland researchers found out that BTA stat test is not only diagnostic, but seems also to have prognostic importance. Therefore in patients with negative test results, especially in those with low grade tumours, the interval between follow-up cystoscopies could be safely prolonged.
The researcher group around Hung-yi Chiou, Taipei, Taiwan, found out that cigarette smoking and alcohol drinking were significantly associated with the risk of urethelial cancer. Subjects with the hOGG1 Ser/Cys genotype have a significant increased urethelial cancer risk (OR 1.6; 95% CI: 1.5-4.5). No significant association was observed between the polymorphism XPD Lys751Gln and the risk of urethelial cancer. However, ever smokers with the XPD Lys/Lys genotype have a significant increased urethelial cancer risk (OR 2.0; 95% CI: 1.3-3.2). The highest significant urethelial cancer risk (OR 2.7; 95% CI: 1.4-5.3) was found in ever smokers with the hOGG1 Ser/Cys and Cys/Cys genotypes.
Lioudmila Sitnikov from Worcester, MA, reported about there study of the RNA-binding protein IMP3 – a novel molecular marker predicts progression of superficial (Ta and T1) urothelial carcinomas of bladder. The researchers of this group found out, that IMP3 is an independent prognostic marker that can be used at the time of initial diagnosis of superficial urothelial carcinomas to identify a group of patients with a high potential to develop progression and metastasis, and who might benefit from early therapy.
Another study from Los Angeles, CA, reported about the diagnostic, prognostic and therapeutic molecular marker of Carbonic Anhydrase IX (CAIX) in Bladder Cancer. Their conclusions are that CAIX is differentially expressed in non-invasive vs. invasive transitional cell carcinoma, low grade vs. high grade TCC, and primary tumor vs. metastasis. CAIX is an important predictor for TCC recurrence, progression, and survival. Since CAIX expression is absent in normal urothelial cells and it is highly expressed in non-invasive low grade TCC, evaluation of CAIX in urinary sediment may be a useful adjunct to diagnostic cytology, and intravesical CAIX targeted therapy might be effective in these high CAIX-expressing tumors. Likewise, since metastatic tumors express high CAIX, evaluation of systemic CAIX targeted therapy as a therapeutic approach is warranted.
Kerstin Junker from the german group of researchers around Prof. Schubert, Jena, visualized their study about a new tumour marker for diagnosis of bladder cancer in urine – oncofetal Fibronectin. They found out that FFN is a highly sensitive and specific quantitative biomarker and shows a higher sensitivity than cytology, BTAstat and NMP22. All invasive tumours were detected. In conclusion, their results have shown that oncofetal Fibronectin represents a new promising marker for the detection of bladder cancer in urine.
481 More words
|
|
|
|
|
|
|
|
|
|
|
Bladder C. Risks: Firefighters at increased Risk for Bladder Cancer
Posted by : Admin on Sunday, May 20, 2007 - 01:45 AM
|
|
|
| |
1413 Reads
(Anaheim, CA, May 19) Firefighters are among the most prominent occupational groups at increases risk for bladder cancer. Firefighters and other individuals at risk for bladder cancer are being tested for bladder cancer with the NMP22® BladderChek® Test, an easy to use CLIA waived, point-of-care urine test.
Studies have shown that people who have environmental and occupational exposure to certain chemicals, burning material, and soot have a higher risk for bladder cancer. Prolonged exposure to benzene compounds found in burning debris is associated with bladder cancer risk.
Screening of firefighters with the NMP22 BladderChek Test is ongoing and has occurred in a number of communities throughout the country. Legislation providing annual screening for firefighters is being considered in Rhode Island, Florida, New York and Massachusetts.
Matritech Inc. said today that the City of San Francisco is using one of its products to screen firefighters for bladder cancer and the San Francisco Firefighters Cancer Prevention Foundation is Scheduled to release information about the bladder screening program with the NMP22 BladderChek Test.
San Francisco Firefighters Cancer Prevention Foundation Spearheads Campaign Calling for Action to Address Firefighters Increased Risk for Cancer
Bladder Cancer Screening is the First Program Underway
San Francisco, CA (April 24, 2007) – With hundreds of pairs of empty firefighter’s boots, helmets, and tri-folded American flags lining the steps of San Francisco’s city hall as a backdrop, about 300 active and retired firefighters honoured their fallen members who lost their lives to cancer and called for action to increase awareness of the silent death of firefighters from job related cancers.
The firefighters gathered to announce the establishment of the San Francisco Firefighters Cancer Prevention Foundation, a non-profit organization that is leading a campaign to bring awareness to the increased risk that firefighters have of getting cancer. The Foundation is dedicated to educating San Francisco firefighters, whether active or retired, about the prevention and early detection of cancer. Firefighters Union Local 798 provided a $100.000 contribution to the Foundation.
The founder and Chairman of the Board of the Foundation, Captain Tony Stefani a retired San Francisco firefighter and cancer survivor said,” We don’t have an organization dedicated to solving the increased incidence of cancer and the impact it’s taking on the lives of our retired firefighters, and those still on the job. one of our immediate goals is early detection and making sure that those who are diagnosid with cancer get the quality care and the support they have earned through their service to their community.”
Captain (Ret.) Stefani added,”In a partnership with UCSF Medical Center and funding from the city, the SFFD has begun providing free bladder cancer screening to all the current and retired firefighters. It’s a voluntary program at this time, but we’ve already had about 1.000 people lining up to take the NMP22 BladderChek urine test – and we’re just beginning. We hope that we can build on the success of this program and launch screening programs for other cancers for which we are at-risk.”
Tom O’Conner, President of the Foundation and a Lieutenant in the SFFD said,” As firefighters we risk our lives each day as part of our job. Now there is research that reports we have a higher risk than most people to get cancer. We need to know the potential health hazards of simply reporting for duty so we can be able to do something about it.”
Major Gavin Newsome stood with the firefighters and spoke of the commitment by his administration to provide the funding for bladder cancer screening for all firefighters and retirees. The Mayor also recognized the efforts of everyone involved.
The bladder cancer screening program is the result of the efforts of Captain (Ret.) Stefani, Dr. Marshall Stoller, professor and Vice Chairman, Department of Urology, University of California, San Francisco (UCSF) School of Medicine and urologist at the UCSF Medical Center and his colleague Dr. Kirsten Greene. For the last year and a half, they worked with the SFFD administration with the approval of Chief Heyes-White, Deputy Chief Gary Massetani directs the bladder cancer screening program for the SFFD and secured city funding for the project.
Dr. Stoller and Dr. Greene are retriving the bladder cancer screening results from the NMP22 BladderChek Test and providing follow-up and further evaluation for any firefighter who may have a positive test result. As part of a long-term study, they have also administred cancer questionnaires to the firefighters to determine the incidence of other job related cancers among the San Francisco firefighters. More than 1.000 questionnaires have been completed by those an active duty and retirees.
Dr. Stoller explained,” We began screening for bladder cancer because it was apparent that there were a number of our local firefighters diagnosed with the disease – I have treated many of them. Firefighters are likely at a higher risk for bladder cancer than most people. And the tests that we could use in our initial screening, a dipstick test to assess for microscopic blood in the urine and the NMP22 test for bladder cancer are easy and inexpensive. The NMP22 test for bladder cancer is an urine test and results are available on the spot.”
Dr. Green added,” Our long term goal is to evaluate how many of our firefighters are getting cancer and what type of cancer. The research is important to assess the health hazards these people face in the line of duty, so we can do more to eliminate their risk.”
A poignant moment drivinghome the message for the firefighters assembled, was the remembrance of their comrade, Larry Murray who dies of bladder cancer. He was the driver of Engine 3 the busiest engine company in the city. Larry stood at the pump panel many hours throughout his career inhaling diesel furnes while pumping water to firefighters. one of the pairs of empty boots was for Larry who didn’t die a heroic death in a fire, but silently – and as a hero dedicated to saving others.
997 More words
|
|
|
|
|
|
|
|
|
|
|
Informations: AUA – 2007 is now starting in Anaheim, Ca
Posted by : Admin on Sunday, May 20, 2007 - 01:23 AM
|
|
|
| |
1215 Reads
(Anaheim, CA, May 19) The greatest urological congress in the world, the 102nd Annual Meeting & Exhibts of the American Urological Association (AUA) is running today. Thousands of physicans and urologists worldwide discusses from May 19 to 24 about new treatment and diagnosis in urological medicine.
Founded in 1902 and headquartered near Baltimore, Maryland, the American Urological Association is the pre-eminent professional organization for urologists, with more than 15,000 members throughout the world. An educational nonprofit organization, the AUA pursues its mission of fostering the highest standards of urologic care by carrying out a wide variety of programs members and their patients, including UrologyHealth.org, an award-winning on-line patient education resource, and the American Urological Association Foundation, Inc.
To honor sound reporting and outstanding news coverage of urologic disease topics, the American Urological Association has announced the establishment of its Annual Excellence in Urology Health Reporting Award. Presentation of the awards will take place during a special press reception on Saturday, May 19, 2007 in Anaheim in conjunction with the AUA Annual Scientific Meeting.
The award is designed to honor journalists in both trade and consumer media outlets for responsible, informative reporting on health topics in urology. Awards will be given annually in the following categories: Consumer Print Publications, Consumer Electronic Publications and Trade Publications. Applicants may submit their own work, or be nominated. Awardees will receive a stipend and award.
“Over the past decade, media interest in urologic topics has increased significantly, and there is an abundance of information available to the public as a result,” said Ira D. Sharlip, M.D., chair of the AUA Public Media Committee. “We feel that it is very important to honor journalists who have excelled in presenting urology in a thorough, balanced and effective manner.”
296 More words
|
|
|
|
|
|
|
|
|
|
|
Informations: Bladder Cancer Awareness Week
Posted by : Admin on Tuesday, October 24, 2006 - 11:35 AM
|
|
|
| |
1721 Reads
Bladder Cancer Awareness Week
November 13 - 17, 2006 The Bladder Cancer Support Team reminds you that November 13th - 17th is Bladder Cancer Awareness Week. If you are visiting M. D. Anderson Cancer Center on November 16th, please stop by our booth between 10:00 a.m. and 1:00 p.m., located on the Rotary House crosswalk, next to the Great American Smokeout exhibit. Download the Flier (pdf) Tobacco use is a major risk factor for bladder cancer. Cigarette smokers are two to three times more likely than nonsmokers to develop bladder cancer and both pipe and cigarette smokers are at increased risk. In conjunction with the Great American Smokeout on November 16th, the Support Team invites you to attend the following seminar: "Take Your Health in a New Direction: M. D. Anderson's Tobacco Treatment Program"
Danielle Devine, PhD
Research Psychologist
Department of Behavioral Science Thursday, November 16, 2006, 12:00 p.m. - 1:00 p.m.
Place...of wellness
Ambulatory Clinic Building, ACB2.1041
1220 Holcombe Blvd., Houston TX 77030 Download the Flier (pdf)
Autor:
The University of Texas M. D. Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX 77030
For more informations about the bladder cancer support team please visit:
http://www.mdanderson.org/departments/bladdercansup/
212 More words
|
|
|
|
|
|
|
|
|
|
|
disease stories: Sylvia Ramsey – 10 year Bladder Cancer Survivor
Posted by : Admin on Saturday, June 03, 2006 - 08:26 AM
|
|
|
| |
2758 Reads
Spearheading Campaign Calling for Greater National Awareness of this Forgotten Cancer AUGUSTA, GA (May 9 2006) – “The prevalence of bladder cancer in the United States is higher than lung cancer; and its prevalence in women is similar to the number of women with cervical and ovarian cancers. More than a half million people have had or are living with bladder cancer today,” said Sylvia Ramsey, Georgia Military Community College (GMC) professor, poet, and national bladder cancer patient advocate. “Unfortunately, without a celebrity spokesperson championing public health messages, bladder cancer has become the forgotten cancer.”
Concurring with Professor Ramsey, noted urologist, clinical investigator and author Mark Soloway M.D., Chairman, Department of Urology at the University of Miami School of Medicine said, “Bladder cancer is the second most common urologic malignancy in the U.S. after prostate cancer. We have made dramatic changes with the use of PSA, an early detection program, and tremendous public awareness. Unfortunately, we have not done the same with bladder cancer.”
“There is a lot of work to be done to continue to keep bladder cancer research funding and physician and patient awareness in the forefront,” said Ramsey. Since her book of poetry, Pulse Points of a Woman’s World, was released in 2004, Ramsey has been a crusading for bladder cancer awareness. She created the BC Sisterhood, a web-based group for bladder cancer support and even has apparel and other wearable items to help raise awareness. Most recently she has mentored students at GMC as they have joined the cause.
Ten years ago, Ramsey experienced a life-changing bladder infection. The blood that was noticed in her urine didn’t go away. The antibiotics didn’t solve the problem. Eventually she saw an urologist and underwent medical tests that showed she had bladder cancer, an invasive type that penetrated the muscle wall of her bladder. A surgery to remove her bladder included a radical hysterectomy and was followed by reconstruction to rebuild a bladder using a section of her colon and is referred to as an Indiana pouch. A section of her small intestine was used to connect to the umbilical site. It makes for an excellent cosmetic result and is easier to catheterize.
“I have been very lucky, I haven’t experienced follow-up infections, but I have been thrown into early menopause and body image concerns,” says Ramsey. “Writing this book forced me to look as what is really important – Living life, not necessarily the weighty things that distract us.”
As a ten-year bladder cancer survivor Ramsey is sharing a message of hope with the many people she meets at book signings, community events and through the BC Sisterhood.
“Life is as frail as thread and as strong as rope,” says Ramsey. It’s Ramsey’s belief that life is about-facing ones fears, considering alternatives and choosing to persevere in spite of the risk.
“I thought I had a urinary tract infection,” recalls Ramsey. “That’s what I was initially treated for,” but upon further evaluation, Sylvia’s cancer was already invasive and engulfed the entire left side of her bladder.
Once she was diagnosed, she began researching this cancer and treatments. Back then, she found very little information that was positive or oriented to women. Traditionally, bladder cancer is associated with older men, especially smokers. Sylvia’s positive attitude amidst glooming outcomes spurred her to communicate with her urologist to understand the next steps. He told her it would involve a radical hysterectomy, removal of the bladder and depending on if the cancer had spread anywhere else, they would decide what to do at that point.
She researched the web and found information on an Indiana Pouch that she presented to her urologist, and they discussed the possibilities. He said that if the cancer had not spread to other parts of the body we could take that route. Because of her attitude and her determination to get on with her life, he came up with an idea for the "stoma" that was not in the usual location. Sylvia’s positive attitude and active lifestyle made her a good candidate for the Indiana Pouch. Using a short section of her small intestine with two sphincter valves and ran it up to the natural opening in her navel. That is where she uses the catheter.
While Sylvia waited for surgery and after, she listened only to music that was uplifting, watched only positive things on television and wrote poetry. Her surgery was a success. In the eight years since the surgery she has never had an infection.
“Since I was diagnosed with bladder cancer, I have interacted with many women and men who also had the same thing,” says Ramsey. “The more I interact with people in all walks of life, the more I realize how little people know about this type of cancer.”
Ramsey has become an avid speaker about importance of knowing the symptoms and risk factors for bladder cancer. Blood in the urine and urine frequency are symptoms that should not be ignored. Urologists have tests to pinpoint the cause of the symptoms.
Bladder cancer has the highest recurrence rate of all cancers. Ramsey also says that individuals with a history smoking or exposure to chemical dyes are all at risk for bladder cancer. Medical studies have shown that firefighters, hairstylists working with permanent dyes, leather and textiles workers are among the occupations linked to bladder cancer.
As part of her follow-up care, Ramsey gets tested to monitor for any recurrence of the disease. Part of follow-up care includes the NMP22® BladderChek® Test, -- a simple urine test done in the physician’s office to help diagnose and monitor the recurrence of bladder cancer. The test detects elevated levels of the NMP22 protein marker in a single urine sample. Most healthy individuals have very small amounts of the NMP22 protein marker in their urine, but bladder cancer patients commonly have elevated NMP22 protein marker levels, even at early stages of the disease.
She feels her recovery was due to her doctor's care and his wisdom to make sure her "new equipment" was healed before it had to take over its new job.
Note: Since Sylvia Ramsey’s book of poems was published in 2004; she has taken to the road to speak about bladder cancer. She’s now an advocate for bladder cancer survivors and is working to generate national and local awareness of bladder cancer and women’s health issues. Sylvia is also designated a National Cancer Institute’s (NCI) bladder cancer patient advocate representative to the NCI Specialized Programs of Research Excellence (SPORE). Most recently she has be associated with the University of Texas M.D. Anderson cancer Center’s Bladder Cancer SPORE program.
For more information contact Sylvia Ramsey at sylvialramsey@sylvialramsey.com or call 706-951-7893.
1135 More words
|
|
|
|
|
|
|
|
|
|
|
Informations: German-based Federation of bladder cancer Patients driving home the message
Posted by : Admin on Tuesday, May 23, 2006 - 06:22 PM
|
|
|
| |
2523 Reads
Bladder Cancer Screening and Support Groups Are Needet Worldwide
(Atlanta, GA, May 22, 2006) The Federation of bladder cancer Patients (FbcP) at www.bladder-cancer.net based in Berlin, Germany is a global internet organization for patients with bladder cancer. The FbcP is also driving home its message for worldwide awareness of bladder cancer, literally via a "Bladder Cancermobile". Detlef Höwing, a German journalist, was diagnosed with bladder cancer in 2002. He now drives his Bladder Cancermobile throughout Germany to encourage education and the development of self-help groups for this cancer.
"Through the website, Bladder Cancermobile and other activities, we hope to encourage more support groups where cancer patients help cancer patients through the exchange of current health reports and therapeutic updates relevant to this disease," said Detlef Höwing, FbcP encourages the exchange of communication on a worldwide basis that includes patients and clinicians.
 Now Höwing is taking his message global to the more than 13.000 urologists attending the 2006 annual meeting of the American Urological Association, held in Atlanta, GA.
"As a reporter, I am interested in learning about worldwide bladder cancer research developments and treatments; as an advocate, I hope to encourage more awareness of bladder cancer education worldwide."
"After I was diagnosed with bladder cancer in 2002, I wanted to exchange views personally with other patients and search for self-help groups in Germany," said Höwing.
By 2004 Höwing had created the "online-journal human & cancer" at www.mensch-und-krebs.de , as a project of the Selbsthilfe Harnblasenkrebs e.V. (Support federation of bladder cancer), www.selbsthilfe-harnblasenkrebs.de in Germany. He published various articles in German and English about cancer. The idea for the www.bladder-cancer.net website and the organization originated at the 57th urologic cangress, held in Düsseldorf, Germany in September 2005.
 Höwing reports that more and more individuals are using the worldwide web for information. Visits to www.bladder-cancer.net (the offical site of FbcP) and the other sites of the organization and its projects total approximately 100.000 visits each mounth. "That's good news," says Höwing, "but there is much work to be done to drive home the message that more adults need to be aware of the bladder cancer risk factors, namely smoking and occupation exposure to chemical and dyes, and the key symptom, blood in the urine."
"My dream is that all people (bladder cancer patients) in the United States, United Kingdom, Germany, Sweden, Netherlands, and other Countries can have opportunity to publish articles about their experiences, activities and meetings, and would be able to receive and exchange information about the newest research in the field, both in English and their own language."
Bladder Cancer Statistics from Germany
- In Germany, 400.000 people sicken anually from cancer
- According to the newest values reported from the Robert Koch Institute, the number of newly diagnosed bladder cancer patients is on rise in Germany:
- 16.000 cases reported in 2000
- 24.700 cases reported in 2004
- The share of the invasive and palliative tumors remains unchanged during a 40-year period, 33 percent.
- Cancer-mortality can be reduced by up to 50% with provision-measures and can be reduced by up to 10% with early diagnosis-measures.
Comments about self-help groups in Germany
Althouth the innovative treatment of bladder cancer progresses, the work of cancer-support groups will increasingly gain importance in the next years.
"Without life-courage and psychological support and care, the best tumor-therapy cannot work successfully. The cancer-self-help madde itself to the task, to help, to provide courage, and to achieve practical help," said Ulla Schmidt, the federal minister for health of Germany. "The self-help is an essential part of our public health... the people in the support groups fulfill tasks, which supplement the proffessional offers of the medical supply in deverse and effective age, where people, which shar their experiences with others, commit here."
Mission of the FbcP
The Selbsthilfe Harnblasenkrebs e.V. faced the task along with the Federation of bladder cancer Patients (FbcP) through the enlightenment of the population and the support of meaningful early diagnosis measures, to lower the number of the people, with which an advanced bladder cancer is diagnosed and of the people, that will often die of this disease. For the concerned people, also their families, we offer a forum to share information and experiences. Furthermore, we take part in clinical research projects, where we work together with leding German clinics, like the Charite, Berlin.
The FbcP has supported initiatives, like those from Dr. Gerson Lüdecke, expert for urine-tumor marker studies from the University clinic in Giessen. Dr. Lüdecke spoke recently at the German cancer congress and EAU about the necessity of a provision for care of the bladder carcinoma, especially under consideration of inclusive screenings of risk groups of bladder cancer. Dr. Lüdecke said:
"We can improve the diagostics of the bladder carcinoma through a structure reorientation. Risk adapted screening is one of the most important points in the cancer provision surely in order to get costs and usefulness effectiveness."
For more information, contact:
FbcP c/o Detlef Höwing,
Quickborner Str.71,
13439 Berlin, GERMANY
email: info@bladder-cancer.net
www.bladder-cancer.net
891 More words
|
|
|
|
|
|
|
|
|
|
|
Diagnosis: UM Urology Chair presents at top Annual Urology Meeting and in National Medical Education Course on Bladder Cancer
Posted by : Admin on Tuesday, May 23, 2006 - 06:20 PM
|
|
|
| |
2305 Reads
Mark S. Soloway, M.D., chairman of the Department of Urology at the University of Miami Leonard M. Miller School of Medicine, provides the introduction on a continuing medical education course on bladder cancer being distributed to urologists around the country beginning this week. Soloway and his colleagues at the UM Miller School are also involved in several presentations at the 2006 annual meeting of the American Urological Association, May 20-25 in Atlanta.
On Monday, May 22, Soloway will present "Challenging Dilemmas in Bladder Cancer: A Case-based Interactive Discussion."
On Tuersday, May 23, he will present a research poster from 1 to 3 p.m. on the NMP22 BladderChek, a biological marker test to detect bladder cancer. Dr. Soloway also provides the introduction in an educational video on a new bladder cancer detection regimen. That video is being distributed to 13.000 urologists nationwide through leading urology journals and AUA conference materials. The course will educate urologists about the new NMP22 protein detection test which, when combinited with a traditional visual examination, increases detection of bladder cancer to 99 percent and helps identify which tumors are aggressive or have spread, This is all part of an effort by Soloway and his colleagues to increase awareness about this disease.
"If you have sudden pain in uour Chest you know it could be a heart attack and you call 9-1-1," explaines Soloway, who is also the physician leader of the Prostate, bladder, and Kidney Cancers site disease Group at UM/Sylvester comprehensive Cancer Center.
" Why don't you call 9-1-1 when you have blood in the urine? Most people, espesially women, assume it's an infection and they may take antibiotics and delay. If they have ever been a cigarette smoker they should be thinking, number one, this may be bladder cancer not a urinary tract infection."
Bladder cancer strikes about 63.000 people each year in the United States, according to the American Cancer society. It kills about 13.000 people a year and it is the fifth most common cancer in men, eighth most common in women. Most people don't realize that bladder cancer is largely correlated with cigarretes smoking.
"If someone is a smoker over 50 they should consider being tested," said Soloway.
Last year, Soloway chaired the International Consultation on Bladder Cancer, orginized by the World Health Organization and the Society Internationale d"Urologie. He is considered an international leader on bladder cancer detection, research and treatment. He has been a vocal advocate for improving the early detection of this disease, authoring papers for the British Journal of Urology, International and the journal Cancer calling for better education of the public and primary care physicians.
"With urine-based markers that are now on the scene and with public information and targeting those cigarette smokers that are at risk, older individual, and anyone with blood in the urine, I believe we now have an opportunity to make a major change for the earlier diagnosis of men and women with bladder cancer."
If detected early, bladder cancer is highly curable, with 94 percent of patients surviving five years or more. But about one in four patients is not diagnosed until the cancer is spread, cutting survival in half. Research has shown that use of a biological marker test like the NMP22 test can improve early detection and is especially valuable as a surviellance tool to detect a recurrence of the disease. Half-a-million Americans have a history of bladder cancer and half will suffer a recurrence of this disease within two years.
Soloway and others are working to educate the public and primary care physicans about the link between smoking and bladder cancer in hopes of increasing the number of people diagnosed early. The adcantage of a biological marker to both the patient and the physicians is the simplicity of the test, which detects a nuclear matrix protein secreted by bladder tumors into urine. A visual inspection requires threading a systoscope up the urethraa into the bladder, and cytology requires an invasive biopsy to retrieve a portion of tissue for a pathalogist. Bladder cancer patients undergo these tests as many as four times a year. The new test onlyrequires a sample of urine on a test strip, making it a much less invasive way to monitor high-risk patients.
705 More words
|
|
|
|
|
|
|
|
|
|
|
Informations: BCAN - New National Bladder Cancer Awareness Organization
Posted by : Admin on Tuesday, May 23, 2006 - 06:18 PM
|
|
|
| |
1922 Reads
Atlanta, May 22, 2006 - The Amarican Urological Association Foundation and the Bladder Cancer Advocacy Network (BCAN), www.bcan.org the first national patient-based organization for bladder cancer, announced today that they have formed a partnership to help promote awareness of bladder cancer, the 5th most prevalent cancer in the U.S.
As Part of the agreement, the two organizations will work together to help spread awareness among patients and the general public in USA. As a first step, the Foundation and BCAN plan to hold patient symposia across the country, with the first scheduled for the fall of this year. And in the future, BCAN and the AUA Foundation will work together with the global Orgaization: Federaion of bladder cancer Patients - FbcP, find at www.bladder-cancer.net .
"Given the importance of making people aware of this serious disiease, the AUA Foundation is pleased to join with BCAN in helping the public learn more about bladder cancer," said John Huber, executive director of the AUA Foundation. " We are proud to join BCAN in this mission to help educate people about the latest research, symptoms and treatments of this disease. Together we can help raise awareness and hopefully help save lives in the process."
In addition to the AUA Foundation, BCAN has received the support of the medical community. More than 20 prominent academic urologists, oncologists and radiologists, representing many of the major cancer centers in the United States, serve on BCAN's Scientific Advisory Board.
"Despite the fact that there are more than 63.000 new patients diagnosed with bladder cancer and 13.000 deaths annually, it has been treated like the "elephant in the room," the disease no one wants to talk about in public," said Diane Quale, president of BCAN. "With the help of the AUA Foundation and others, we hope to address the issue at all levels - so that bladder cancer is no longer the silent disease."
BCAN also recently announced that the actor Tate Donovan will join the organization as both a national spokesperson and member of the BCAN Board of Directors. Donovan will attend the AUA conference to express the importance of raising awareness about the disease.
Donovan and his family have been profoundly affected by bladder cancer. His father, Dr. Timothy Donovan, at the time a retired urologist, died of bladder cancer in 2000. His mother also was diagnosed with superficial bladder cancer in October 2005.
As spokesperson for BCAN, Donovan will appear in educational materials, as well as tell his family's story to the medical community and to the public to help spread awareness about the disease and its symptoms.
"We believe Tate can help us bring a national voice to bladder cancer in much the same way that Katie Couric increased public awareness of colorectal cancer," said Diane Quale. " His family's experience is a very real example that the need for awareness is mandatory - even among doctors - and that the disease can affect anyone at any time."
BCAN was founded by Diane Zipursky Quale and her husband, John Quale. John is a Bladder cancer survivor who was initially diagnosed in July 2000. Since they began dealing with the disease, they have discovered that there is little knowledge about bladder cancer and that there is only a limited amount of information avaiable to those suffering from it. Diane and John thought it was time to give a voice to bladder cancer and the hundreds of thousands of survivors of this disase.
Additional information about BCAN and bladder cancer can be found on the organization's web site:
www.bca.org
602 More words
|
|
|
|
|
|
|
|
|
|
|
Bladder C. Risks: Screening High Risk Patients for Bladder Cancer is Cost-effective
Posted by : Admin on Tuesday, May 23, 2006 - 06:15 PM
|
|
|
| |
1772 Reads
Yair Lotan, M.D., urologist at the University of Texas, Southwestern Medical Center at Dallas, presented new data regarding the cost-effectiveness and the lives saced from screening versus not screening for bladder cancer. This study was presented during a May 22 Bladder Cancer Detection and Screening podium presentation at the annual meeting of the American Urological Association held in Atlanta. Dr. Lotan and his colleagues also looked at the factors that limit the effectiveness of cancer screening, including survival benefit, disease prevalence, screening efficacy and costs.
The Marcov decision analysis model was created to estimate cumulative cancer-related costs and efficacy of screening (versus not screening) a high risk population for bladder cancer using a urine-based tumor marker (such as the NMP22 Bladder Chek Test) over a five-year period. High riask was designated as over 50 years of age with heavy smoking history or significantl occupational exposure to toxins and dyes.
"While the goal of cancer screening is to detect cancer early and save lives, it must be reasonably cost-effective if it is to be instituted widely," said Dr. Lotan. The researchers at the University of Texas developed a bladder cancer screening model that projected a gain of three life years and $101.000 saved per 1000 people screened based on a poputation with 4% incidence of bladder cancer. Researchers noted that adjusting for other causes of mortality did not vary the results significantly, and screening versus not screening is more cost-effective as long as the cancer incidence is greater than 1,6%.
Nationally, bladder cancer has the highest cost per patient of all cancers from diagnosis to death. This cancer has more than 63.000 new cases a year and is the 5th most common cancer among men and women in the United States. This year alone in the U.S. it's estimated that bladder cancer will cost $4 billion in direct costs.
"The best possibility for reducing bladder cancer mortality is early detection," said Dr. Lotan. " one out of four bladder malignancies are currently diagnosed at an advanced stage." Bladder tumors detected early at a non muscle invasive stage are very treatment, and the five-year survival rate is 95%. However once the tumors become more advanced the survival rate drops steadily from 50% to 10%.
This study goes beyond analyzing the cost of cancer detected. This study is about the cost per life saved and defines how effective a urine marker needs to be perform as a screening tool. once detected, bladder cancer has one of the highest rates of recurrence of all cancers. "From a surveillance standpoint, it may be advantageous to monitor bladder cancer using a cost-effective yet highly sensitive urine marker test," said Dr. Lotan. " With the FDA approval of the NMP22 Test for diagnosing high risk patients, the healthcare community has an initial test that can be assessed for efficacy in screening."
Compared to breast, prostate, and cervical cancer screening, bladder cancer screening is in its infancy. Dr. Lotan hopes this model will help healthcare professionals identify at risk populations that would benefit from bladder cancer Screening.
For more information contact Dr. Yair Lotan. At AUA call: 317-730-5349 or following AUA, Depatment of Urology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd. J8.112, Dallas, Texas 75390-9110, Ph: 214-648-0389/ Fax: 214-648-8786/ email: yair.lotan@Utsouthwestern.edu
549 More words
|
|
|
|
|
|
|
|
|
|
|
No smokers during the WM in the stadium
Posted by : Admin on Tuesday, May 09, 2006 - 09:51 AM
|
|
|
| |
1060 Reads
 | An initiative of UICC Global Smokefree Partnership
| |
German football stars announce Football World Cup 2006 should be smokefree
Geneva. World-class footballers Gerald Asamoah and Ebbe Sand want to kick tobacco out of the 2006 World Cup. The two teammates, who play for Schalke 04 – popularly known in Germany as the “Royal Blues” – are getting behind the Smokefree Football World Cup 2006 campaign. With just over a month to go to the kick-off in Berlin on June 9, it is not too late for the Fédération Internationale de Football Association (FIFA) and the national organising committee to declare the Cup smokefree, they say. “We are world class – the world class is smokefree,” says Gerald Asamoah. “That’s why we need smokefree stadiums at the World Cup.” Ebbe Sand agrees. “We should have smokefree stadiums because our guests expect that.” The smokefree campaign was launched because health organizations realized that although the last World Cup was free from tobacco smoke and the next World Cup will be too, smoking will be allowed in this year’s competition in stadiums across Germany. Michael Bamberg, the president of the German Cancer Society, welcomes the stand taken by Asamoah and Sand. “They demonstrate a high degree of social responsibility and prove themselves role models for young people in the best sense,” he says. “We hope other footballers and celebrities will follow their example and speak up for a smokefree World Cup”. The Smokefree Football World Cup 2006 campaign is the brainchild of a Global Smokefree partnership led by the International Union Against Cancer (UICC), a Geneva-based federation of national cancer societies, cancer research institutes and other bodies. “Only 100% smokefree policies can protect lives and promote health,” says Isabel Mortara, UICC’s executive director. “As the world prepares for the largest sporting event in the world, let’s make sure that fans around the globe will witness a celebration of sport, life and health. Tobacco has no place in this picture.”
|
876 More words
|
|
|
|
|
|
|
|
|
|
|
Significant Improvement in Bladder Cancer Detection - 99% of Malignancies Found
Posted by : Admin on Monday, January 23, 2006 - 04:35 PM
|
|
|
| |
1473 Reads
NEWTON, Mass.Jan. 17, 2006
JAMA Reports that the NMP22(R) BladderChek(R) Test is Better at Detecting Bladder Malignancies than Current Technologies
A simple point-of-care urine test, the NMP22 BladderChek Test, was found to significantly increase the detection of recurrent bladder cancer, finding 99% of the malignancies when used with cystoscopy, according to a report in the January 18 issue of the Journal of the American Medical Association (JAMA).
The lead author, H. Barton Grossman M.D. at the M. D. Anderson Cancer Center stated, "This study confirms the prior BladderChek investigation published in JAMA early last year-- NMP22 BladderChek combined with cystoscopy detects significantly more cancers than cystoscopy alone.
Because bladder cancer has a very high recurrence rate, we need to monitor patients vigilantly. Adding the NMP22 test to routine monitoring provides an extra measure of confidence. This test has important advantages over other methods: it provides results while the patient is at the doctor's office and as a molecular marker it can detect cancers that might be missed visually without requiring intact cells. No other test is FDA approved for both diagnosis and monitoring that can be used during a patient visit and costs less than cytology."
When used in combination with cystoscopy, a visual examination of the bladder, the NMP22 BladderChek test detected 99% of bladder malignancies compared to 91% for cystoscopy alone. The BladderChek test was positive for 8 of 9 cancers not seen by cystoscopy, including seven tumors that were aggressive or advanced.
The BladderChek test also detected four times as many cancers as the commonly used laboratory based urine cytology test. The authors of the study, who include clinical investigators at the University of Texas M. D. Anderson Cancer Center, the University of Miami School of Medicine, the University of Rochester Medical Center, Rhode Island Hospital, and community based clinicians, recommended using the NMP22 BladderChek(R) Test in the routine monitoring and management of bladder cancer patients.
They noted that it is an inexpensive and a cost-effective tool, proven to detect significantly more cancers than urine cytology, and at half the cost. When combined with cystoscopy the NMP22(R) test improves the detection of cancer. Unlike all cell-based urine tests it does not require laboratory time and facilities and expert analysis. This point-of-care test provides unambiguous results during a patient's visit.
"NMP22(R) BladderChek(R) Test is an important tool for doctors--early detection of bladder cancers, both initial and recurrent, improves treatment options and patient outcome," said Edward Messing M. D., Chairman of the Urology Department at the University of Rochester Medical Center. "Delay of diagnosis of an aggressive bladder cancer even by a few months can affect prognosis. The AUA guidelines for evaluation of patients with blood in the urine recommend using a urine test as back up to cystoscopy. We use the NMP22 test in our practice, and will include it in an upcoming National Cancer Institute (NCI) study for monitoring bladder cancer recurrence after treatment."
Bladder cancer has the highest rate of recurrence of any malignancy, with the cancer recurring in 50% to 90% of patients, depending on the aggressiveness and extent of the initial tumor. Patients are rigorously monitored throughout their lives for new malignancies.
A combination of methods is used to monitor patients since no single method is 100% accurate in detecting the cancer. The prevalence of bladder cancer in the United States is higher than lung cancer; and its prevalence in women is similar to the number of women with cervical and ovarian cancers. Currently there are 500,000 Americans with a history of bladder cancer. Developed and commercialized by Matritech (Amex: MZT), a leading developer of protein-based diagnostic products for the early detection of cancer, the NMP22 BladderChek Test is the only noninvasive point-of-care assay approved by the FDA as an aid in both the initial diagnosis and monitoring of bladder cancer. Using only four drops of urine, the test detects elevated levels of the nuclear matrix protein NMP22 and results are available during the patient visit.
"Bladder cancer is the second most common urologic malignancy in the U.S. after prostate cancer," notes investigator and author Mark Soloway M.D., Chairman, Department of Urology at the University of Miami School of Medicine. "We have made dramatic changes with the use of PSA, an early detection program, and tremendous public awareness. Unfortunately, we have not done the same with bladder cancer. one quarter of all bladder malignancies are still first diagnosed after they have become invasive, so treatment is more difficult and prognosis is worse. This hasn't changed in 20 years. The NMP22 BladderChek test is an important step forward. Not only has it been demonstrated in two large studies to improve detection of new and recurrent cancers, it provides an easy and inexpensive way for primary care doctors to screen patients we know are at higher risk for bladder cancer: people who smoke, are exposed to chemicals or have blood in their urine."
Because of the high recurrence rate of bladder cancer, patients who have had the disease are typically evaluated for new tumors every three months for the first two years after surgery, twice a year for the next two years, and yearly after that, until a recurrence is diagnosed, at which point monitoring resumes at three month intervals. Early detection is key to extending and providing quality of life for patients, and reducing treatment costs. The five year survival rate is 94% for patients diagnosed with early stage, or noninvasive cancer, while patients with metastatic or advanced stages of the disease have as low as a 6% chance of surviving five years.
931 More words
|
|
|
|
|
|
|
|
|
|
|
Informations: Bladder cancer, bladder carcinoma
Posted by : Admin on Saturday, October 29, 2005 - 05:45 PM
|
|
|
| |
2152 Reads
Bladder cancer, bladder carcinoma
Summary With 2-3 per cent of the cancer-diseases, the cancer (carcinoma) of the bladder is rather rare, but stands on place two in the smoker-conditional cancer-diseases after the lung-cancer, however.
The bladder-carcinoma stands as well over 24.000 new-diseases per year on place 5 of the frequency-scale of cancer-diseases in Germany. 230.000 people in Germany are circa or were affected by bladder-cancer once. Approximately 7.000 people die of the bladder-carcinoma per year in Germany. This is to big extent because the concerned go to late to the doctor although symptoms of the disease make themselves noticeable already in an early stage. It often is prevented a successful therapy and a complete cure by it. Men as frequently as women are well 3-once involved, although emerged in the last years, that also women more frequently sicken.
Concerned men therefore are more frequent than women and the disease-frequency rises with the 60.-year of life. Already often sicken member from risk-groups earlier, however. Risk factors are: The occupation-encumbrance had an influence on chemicals, tobacco-consumption, excessive alcohol-consumption, hair-stain, and in tropical regions the bilharziasis. Symptoms like bloody urine and pains only late rarely occur. With the lowest indications of problems at the urination or pains with it or in the lower abdomen, an urologist immediately should be consulted. The diagnosis becomes this, through sonography (ultrasound), the microscopic urine-examination (cytology), the urine-examination of the tumour marker NMP22 and the cystoscopy (bladder-reflection), executes. All excrescences in the bladder are cancer that subdivides itself into many stages. The successful therapy improves an early diagnosis and treatment considerably! For that reason, a preventive examination is after cancer, especially with risk-groups very important. - Below more of it.
A micro-hematuria (not with free eye visible blood in the urine) is determined at routine-examinations, should take place further examination.
The method of the election with existence of a bladder-carcinoma is the transurethral resection (TUR) with which the tumor is removed by means of an endoscope through the urethra and the withdrawal of tissue-tests to the histological examination.
Through the histological (microscopic) examination, the penetration-depth can and is determined the tumor-stage with it. Superficial tumors can be taken away over the urethra, so-called TUR. Whether the cancer encroached already on adjacent organs, is determined with CT or MRT. With advanced stages, there are two therapy-approaches: The radical operation with bladder-distance or a TUR (transurethral resection) with subsequent irradiation and chemotherapy. A follow-up treatment is meaningful in every case by means of an instillation-therapy with mitomycin or BCG, because bladder-cancer has a Reside - inclination of approximately 70 per cent. Definition The bladder is a concave-organ, in which the urine transports from the kidney over the ureters and is stored until the secretion. The bladder-cancer takes its origin of the so-called passage-epithelia (urothelium) of the bladder - this is the mucous membrane that lines the bladder.
One distinguishes two types from bladder-cancer: The superficial bladder-cancer: this form is more or less limited the mucous membrane and a relatively benign type. It represents 80 percent of the bladder-cancers.
The aggressive type, that grows into the bladder-wall and into the muscular system.
The first is marked in that it can perform again (relapse-inclination) after the therapy. The second, aggressive type frequently shows, if is not operated radically, a firm growth.
One understands a vicious tumor that is created in the bladder, by a bladder-carcinoma (bladder-cancer). This tumor is created in the urothelium. The urothelium is the lining of the bladder of interior, to some extent the inner-skin of the bladder.
Division (1)
Approximately 70 per cent of all bladder-tumors, so-called superficial tumors are at the time of the diagnosis-position that is called limited on the mucous membrane and the Lamina propria situated directly under it, the connective tissue-work period between mucous membrane and bladder-muscular system. The remaining is already in the deep work periods of the bladder (bladder-muscular system) as well as outgrown over it. one calls it locally advanced bladder-carcinomas. The symptoms are even still advanced if already metastases appeared. Consequently, one can subdivide the simpler survey the bladder-carcinoma half in three main-groups: the superficial carcinomas, the locally progressed carcinomas and the metastasis carcinomas. In accordance with leaves itself divide also the coarse direction of the therapy, namely into transurethral resection plus adjuvant therapy, radical cystectomy (bladder-distance) and systemic chemotherapy.
Division (2)
The division of the tumor-expansion happens after the TNM-System, with what T for tumor, N for lymph nodes ("node") and M for metastases stands. The expansion of the primarily-tumor with the corresponding uppercase letters becomes on that occasion plus addition and the Grading with the uppercase letter "G" and the figures 1 - 3 marked. The small senior letter of "p" then means that the stage was determined by the pathologist. All pTaG1-3 and pT1G1-3 tumors and the carcinoma in situ (Cis) belong to the superficial bladder-tumors.
Risk factorsNumerous elements are held responsible for the emergence of the bladder-cancer:
Occupational hazards
Altogether, over 50 differently chemical substances are known for an emergence of this disease. Among them also chemicals that are used in the rubber or magenta-industry, like the b-Naphthalin and diaminodiphenyl. Step with employed persons, with whom a more professionally chronic contact with these chemicals is proved, a bladder-carcinoma on, so this is recognized as occupation-disease.
Avoidable risks
The smoking is regarded as a risk factor for bladder-cancer, however not so influential for the lung-cancer or the vicious tumors in the oral cavity or the pharynx. However, bladder-cancer is the second-most frequent smoker-cancer after the bronchial-cancer. This is also the reason that the disease-numbers increase with the women since the share of the smokers increased strongly since the World War II in the population.
Newest studies showed, this also an excessive alcohol-consumption and here especially the periodic consumption of high-percent alcohol (schnapps) of the bladder-cancer can lead, since the urothelium (bladder-inner-wall) is attacked here.
Since newest, also content-materials are brought causally with the emergence of bladder-cancer in hair-stains in context what can also be proclaimed an increase of involved women.
Also more regularly frequent use of Phenacitin (an analgesic) can have to do causally with the emergence of a bladder-carcinoma.
Bilharziasis (schistosomiasis)
An infection is one of the most important risk factors world-wide with single-educational, the Schistosoma. These bacteria live in tropical countries in water-cochleae and penetrate through contact with the water in the human being one, in which these water-cochleae live. In some regions of Africa, all inhabitants virtually sickened because they swim in infested fluxions or seas, as well as use the infested water as drinking water. Approximately 300 million people are from this disease, the schistosomiasis as well as Bilharziasis involved. The bladder-carcinoma often is a rare late consequence if no therapy against these causes takes place. Since very poor countries, that an inclusive medical care, enlightenment and provision often lack, usually are about yielding a return at the concerned countries, no treatment often is carried out and the concerned find the red urine and blood normal in the chair.
Through the tourism in these countries, the schistosomiasis is one frequent also in Europe in the vacation of acquired disease. In failure-disease, bloody chair, red urine, pains and problems at the urination after a tropics-residence, one later should think also months and years of this disease.
Because of the completeness, viruses are called here, the human papilloma-viruses, that participation is also repeated with the emergence of vicious tumors in principle.
Symptoms and diagnostics As there are not any unequivocally specific trouble, that points out this disease with high likelihood, with most vicious tumors also with the bladder-carcinoma. For that reason, every abnormal symptoms should, like pains, bloody or unusually dark urine, undefinable woolly pieces in the urine (often with pains with the urination) excessive urine-urge problems at the urination, by a doctor is clarified. A low blood-addition in the urine (a red-coloring) already frequently exists early. However, this blood-addition (micro-hematuria) occurs in the bladders and kidney-system in almost all disease. First clearly bloody urine (macrohematuria) worries the patients. A farther progressed carcinoma however often consists of this case. Pains also very late originate first in far advanced stages or if an ureter (from the kidney to the bladder) or the urethra are transferred by the tumor. The pains can be in this case also in the edges or in the back, because of the congestion or inflammation in the concerned kidney. Symptoms can be also frequent or painful urination.
In principle, it is applicable to the urologist that every unclear micro-hematuria, that bloody urine is called, without fevers or clear urine-way-infection - until as evidence (from the German broad outlines to the bladder-carcinoma) the opposite on a bladder-carcinoma can remind.
A microscopic examination of the urine (urine-cytology) often is little helpful because the tumor-cells are to rarely be found in the urine. only with particular bladder-carcinomas (low differentiated), the marksmanship is higher. If no tumor-cells are therefore found in the urine, this is no evidence against the existence of a bladder-carcinoma.
For that reason, a Tumor-marker provision with NMP22 should take place additionally before the urine-cytology, that under consideration of the exclusion-criterions, a present bladder-cancer more certainly can prove.
The most important examination at the first visit with the urologist is the sonography (ultrasound-examination) of the bladder and the prostate gland where the first results can be put fast gentle for the patient on the existence of a bladder-carcinoma.
The additional examination is the reflection of the bladder (cystoscopy), that is performed in an urological clinic or with the urologist. Under local anaesthesia or anaesthesia, a flexible tube is put forward by the urethra into the bladder. Over optics, the inside of the bladder can be looked at. If the urologist sees a tumor in the bladder-wall, he can appraise which wall-work periods the tumor penetrates and also tests take, that then are examined microscopically. The doctor can see also the orifices of the two ureters and can recognize, whether blood comes from one of the two ureters. Over a cystoscopy, also a tumor-operation can take place if the tumor still is sufficiently small as well as is. The tumor with an electric loop is taken away on that occasion, shreds and later rinses, or by means of laser-ray becomes desolate. This operation is called (TUR) transurethral resection.
With the diagnostic action is a phase among other things - division of the bladder-carcinoma important, because the further therapy depends on the stage. Also here, the best examination is the cystoscopy and sampling (TUR).
A computerized tomography (CT) or magnet-resonance-tomography (MRT) are carried out with each patient afterwards. Regarding the stages - division however clearly was defeated the bladder-reflection (cystoscopy) she/it, because both examinations cannot represent the different work periods of the bladder-wall satisfactorily. From the participation the deceased work periods the bladder-wall is the stages namely - division decisively dependent. By the MRT and CT, a participation of adjacent organs (intestine, uterus, prostate gland, seminal vesicles, pelvic floor-muscular system or lymph nodes - attacks) can be determined. In this situation, however, already a far progressed carcinoma is metastases (daughter-lumps in liver or lung) before and with high likelihood. This participation of the adjacent organs is not recognized with a bladder-reflection. TherapyAll superficial bladder-carcinomas should with the basis-therapy, namely the transurethral resection is treated. An endoscope is introduced in it by the urethra in anaesthesia into the bladder and the tumor with an electro-loop is "planed" down there. The planed down tissue then is given to the pathological examination and the pathologist certain both the expansion-degree of the tumor (the stage) in the TNM-System and the size of the maliciousness (Grading).
The superficial bladder-carcinomas have a high relapse-quote that is called in up to 70 per cent of all cases appears tumor again sooner or later after the operation. For that reason, a so-called adjuvant therapy is recommended broadly today. This happens through in-flushes of medications into the bladder. After placing a disposable catheter, the medication is injected into the bladder. There, it can then effect the mucous membrane and the tumor-endangered areas. The therapy of the bladder-carcinoma depends however decisively on the stage, in which he/it was recognized.
The superficial bladder-carcinomas
Most bladder-carcinomas (approximately 80 per cent) are discovered in a very early phase (in the tumor-stage T1 or Tis). This means in this case that the tumor restricts itself to the most internal work periods of the bladder-wall and the muscular wall of the bladder doesn't involve. In these cases, a relatively small operation suffices over the bladder-reflection (cystoscopy and TUR). It becomes to this, how above described, executed a reflection of the bladder over the urethra. one can introduce operation-instruments additionally and can take away the tumor under view. The urologist even can partially take away the bladder over this way if that is necessary because of the expansion. It can be meaningful in certain situations, one, to execute therapy additionally. For example a local chemotherapy or local immune-therapy can be applied in that the corresponding medication is given into the bladder and works only in the bladder-inside.
After this therapy, however, a renewed bladder-carcinoma occurs in more than half of the cases (50-70 per cent) within 5 years. For that reason, a periodic control is necessary by means of the cystoscopy. In 60-70 per cent of the cases, the originally superficial bladder-carcinoma can be had command of by the repeated TUR long-term.
The deeply infiltrating bladder-carcinomas
Only approximately 20 per cent of the bladder-carcinomas is at the time of the first diagnosis of the advanced phase that is called with participation of the muscle-work period of the bladder-wall. These are named - deeply infiltrating bladder-carcinomas. In these cases, the above described TUR doesn't suffice. Several therapy-possibilities of the disposal stand:
The cystectomy
That is a complete operative distance of the bladder and the prostate gland, with subsequent or synchronized bladder-substitute. This is to be marked as the best method, with which achieving the highest absolute cure-chances is and that has the highest survival rate (approximately 70-80 per cent after 5 years) for the concerned. Often, one can a "Neo - bladder" from one piece of small bowel, that then takes over the function of the bladder, produces. If the urethra is not concerned, it can often be gotten also as natural urine-excretory-organ so that no artificial exit must be put what the quality of life influences positively in the future. With this operation, also parts of the lymph nodes of the surrounded area are taken. These become, how supplied also the other taken out tissue of a histological examination in order to finally be able to determine, whether metastases are likely, and a subsequent chemotherapy is advised.
A TUR (operative distance of the tumor over a bladder-reflection like above described) with subsequently irradiation and chemotherapy will only rarely be effective and comprises the danger of later metastases.
An exclusive one high-measured chemotherapy with several medications, possibly combined with an immune-therapy is executed only with patients, with whom a cystectomy is not possible from medical view.
One would recommend more final possibility however only when the tumor is available in the highest stage, if it therefore grew in adjacent organs and the likelihood of metastases is very high with it.
The TUR and radiotherapy
The exclusive radiotherapy is one in form shrink with the bladder-carcinoma through the danger of the side effect - bladder or a chronic bladder-inflammation restricts. For that reason, the radiotherapy is applied normally in combination with another law case. In principle, it can be appointed also before or after an operation. The most, an irradiation proved itself in combination with a relatively mild chemotherapy (Cisplatin) against a TUR. It becomes on that occasion, how above described, over a bladder-reflection the tumor or a part of the bladder removes. This should happen as in a way as possible that no microscopic tumor-remains are to be seen at the cut-fringes. The irradiation becomes subsequent over approximately daily 5-6 weeks executed. In the first and last week of the irradiation, chemotherapy takes place under stationary conditions.
The results regarding the cure and the 5-yearly-survival rate are at least just as good opposite the radical distance of the bladder. As advantage of this approach would be to be named that in 1st the bladder can be gotten. 2. In the case of a whereabouts of rest-tumor or a radical bladder-distance can still be carried out then a return of the carcinoma with good results.
Chemotherapy
The exclusive chemotherapy-approaches with several Chemo - medications is very side-effect-rich, therefore the usage-possibilities are left only younger patients for exception clauses because of their better constitution.
However, milder approaches stand by the relief with very far advanced stages to the disposal. Then, it becomes usually only one Chemo - medication started, or it is executed a local chemotherapy or immune-therapy. The medication is given directly into the bladder on that occasion.PrognosisMost bladder-carcinomas (approximately 80 per cent) are discovered in very early stages (in the tumor-stage T1 or an initial stage of T1 like the Tis or Ta).
After a TUR, therefore the operative tumor-distance between the bladder-reflection, steps in more than half of the cases (50-70 per cent) within 5 years a bladder-carcinoma renews on. For that reason, a periodic control is necessary by means of the cystoscopy. In 60-70 per cent, the originally superficial bladder-carcinoma can be had command of by the repeated TUR long-term.
With 20 per cent of these patients steps within 5 years a bladder-carcinoma renews, then however in a higher stage on. These patients then must be supplied equally a radical blister-distance or a combined radiation-chemotherapy like the patients, who had from start at a deeply infiltrating carcinoma, in the connection with a TUR. With both, the 5-yearly-survival rate is proceeding between 60 and 70 per cent.
If a radical distance of the bladder is carried out, the bladder must usually be replaced with turned off small bowel*-loops. In 80 per cent, this bladder-substitute works well. The patient is in 10 per cent durably incontinent (urine flows into the washing), the patient is incontinent in wider 20 per cent only at night. In 10-20 per cent, another operation must come after the bladder-substitute because of complications.
If radiotherapy is carried out after TUR, a long-term bladder-receipt can be achieved in 70-80 per cent. In approximately 10 per cent of the cases, the patients have side effects that impair the bladder-function. Low side effects would be a slight bladder, for example, - shrinkage with the consequence, frequent waters', to have to leave, (pollakiuria) respectively frequent nightly urine-urge (nycturia). Heavy side effects are chronic bloody bladder-inflammations or a massive shrinks - bladder that then leads to a cystectomy in the extreme-case, however. In approximately 10-15 per cent, a radical bladder-distance (cystectomy) must take place because of a renewed bladder-carcinoma within 5 years. In these unfavourable cases, one can still 5-yearly-survive, according to tumor-stage, between 30 and 60 per cent is reached.
With the existence of distant metastases (far away-housing projects, daughter-lumps), however, the forecast is bad. Distant metastases usually are found in the lung or in the liver. The medium survival-time then amounts usually less than one year.
Also the proof of lymph node-metastases, therefore daughter-lumps in the lymph nodes of the basin, is a sign bad prognostic because the likelihood of distant metastases is very high. This 5-yearly-survive-in the time of then lies with approximately altogether 20%. It must be roofed that the likelihood of a lymph node-affection rises in the basin with the stage of the tumor. As soon as a deeply infiltrating carcinoma is diagnosed, the likelihood of a lymph node-affection is between 10 and 20 per cent even if this cannot be diagnosed with the MRT or CT. As soon as adjacent organs are concerned, it even is up to 45 per cent; therefore almost half of all patients.
PreventionAs there is also this connection with the avoidable toxicants with the lung-cancer, with which the smoking is an avoidable risk factor, with the bladder-carcinoma.
With a professionally conditional contact with magenta or naphthalene over longer time, both urologist and patient should think of red discoloured urine at bladder-carcinoma at the appearance early.
The smoking and the uncritical use of analgesics should be avoided, as well the periodic consumption of a high-percent liquor and an excessive use of hair-stains. To this please read also the corresponding articles about these topics.
Another article occupies itself with newest examinations in the USA after Coffee-and tea-enjoyment decreases the bladder-cancer-risk.
In tropical and subtropical countries, swimming in seas and fluxions should be avoided. In many places, the bilharziasis is also pointed out publicly expressly to it. After a vacation-residence in these countries must think at the bilharziasis at the appearance of bloody urine or blood in the chair and a corresponding therapy is introduced.
In principle, it is applicable to the urologist that every unclear micro-hematuria, that bloody urine is called without fevers or clear urine-way-infection, until can remind the opposite on a bladder-carcinoma as evidence. In this case belong the cytology, the Tumor-marker - provision with NMP22, the sonography and bladder-reflection to the absolute routine of the diagnostics.
Author: Detlef Höwing - © 2005
On Basis of the German article 2002 in www.selbsthilfe-harnblasenkrebs.de
3524 More words
|
|
|
|
|
|
|
|
|
