Bladder Cancer (cont.)

The best way to prevent bladder cancer is to avoid exposure to agents that cause the disease. People who don't smoke are three to four times less likely to get bladder cancer as compared to smokers. Continuing to smoke after the diagnosis of bladder cancer portends a poorer outcome and increases the chance of the disease coming back after treatment. Avoidance of occupational exposure to cancer-causing chemicals such as aniline dyes may also be important. Despite research in this area no medication or dietary supplement has been conclusively demonstrated to decrease the risk of bladder cancer in normal individuals.

A number of online resources are available for bladder cancer patients to gain more insight into this disease and its management. Bladder Cancer Advocacy Network (http://www.bcan.org) is one such resource which provides a downloadable patient information handbook and links to patient support groups.

The National Cancer Institute (http://www.cancer.gov/cancertopics/
types/bladder) also provides bladder cancer information.

The European Organisation for Research and Treatment of Cancer (http://www.eortc.be/tools/
bladdercalculator) features a calculator which predicts the chances of recurrence and progression of superficial bladder cancer after initial treatment on the basis of certain tumor characteristics.

Bladder cancer is a topic of intense scientific research currently. Basic science research is focused on finding and studying the genetic alterations (or changes in the human DNA) that predispose to bladder cancer in the hopes to discover new medications and treatments for curing the disease. Other areas of research include the following:

• Newer molecular diagnostic tests to detect bladder cancer thereby avoiding the need for invasive tests like frequent cystoscopy examination
  
  
• Targeted therapy acts on genetic pathways responsible for bladder cancer as the next generation of chemotherapy for the disease.



• Newer surgical techniques, such as robotics, have been incorporated to improve precision and accelerate patient recovery after bladder cancer surgery.



• Stem cell research for creation of urinary diversion during radical cystectomy without the need for intestinal segments.

This field is likely to see significant advances in the years to come and hopefully would provide effective treatment strategies and hope for the millions of bladder cancer patients worldwide.

• Bladder cancer is one of the common cancers affecting men and women.
• The most common symptom is bleeding in the urine (hematuria).
• Cigarette smoking is the most significant risk factor with smokers three to four times more likely to get the disease than nonsmokers.
• Bladder cancer can be subdivided into superficial and muscle invasive, with the former having much better treatment outcomes than the latter.
• The initial treatment for bladder cancer is transurethral resection (TURBT), which removes the tumor from the bladder and provides information regarding stage and grade of the tumor.
• Low-grade superficial tumors (Ta) are treated with TURBT followed by an optional instillation of a single dose of a chemotherapy medication in the bladder to reduce recurrence rates. These tumors have high recurrence rates but a very low chance of progression to higher stages.
• High-grade T1 tumors have high chances of recurrence and progression and may need additional treatment in the form on BCG or chemotherapy instillation in the bladder. Patients unresponsive to these may be best treated by radical cystectomy.
• Radical cystectomy provides the best chances of cure in patients with muscle invasive disease.
• Cisplatin-based chemotherapy is used in patients with metastatic disease at presentation or those in which bladder cancer cells are present outside the bladder wall or in lymph nodes during radical cystectomy.

REFERENCE:

Wein, A.J., L.R. Kavoussi, A.C. Novick, A.W. Partin, and C.A. Peters. Campbell-Walsh Urology, 9th Edition. Philadelphia, PA: Saunders Elsevier, 2007.

Last Editorial Review: 2/7/2011

Source: MedicineNet.com
http://www.medicinenet.com/bladder_cancer/article.htm