How Long Can You Live With Untreated Bladder Cancer – Computer-aided segmentation and machine learning of integrated clinical and diffusion imaging parameters for predicting lymph node metastases in endometrial cancer
A Systematic Review and Meta-Analysis of the Vesical Imaging and Data Reporting System (VI-RADS) Interobserver Reliability: Added Value for Muscle Invasive Bladder Cancer Detection
How Long Can You Live With Untreated Bladder Cancer
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Causes Of Urinary Tract Infection In Babies And Its Symptoms
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Sexually Transmitted Infections: Symptoms, Diagnosis & Treatment
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Department of Abdominal Imaging, University of Texas Cancer Center, Anderson, 1515 Holcombe Blvd, Houston, TX 77030, USA
Bladder cancer is a complex disease, the sixth most common cancer and one of the most expensive types of cancer to treat. Over the past several decades, there has been a significant decrease in bladder cancer-related mortality, potentially related to decreased smoking prevalence, improvements in bladder cancer diagnosis, and advances in treatment. These advances in diagnostic tools and therapies, and a greater understanding of the disease, are helping to evolve how bladder cancer is treated. The aim of this article is to provide an overview of bladder cancer pathology, diagnosis, staging, radiological imaging and treatment, and to highlight the latest developments and research.
What Is Interstitial Cystitis(ic)/bladder Pain Syndrome?
Methods: Keyword searches of Medline, PubMed and Cochrane Library for manuscripts published in English and searches of references cited in selected articles to identify additional relevant papers. Abstracts sponsored by various associations were also searched, including the American Urological Association (AUA), the European Urological Association (EAU), and the European Society of Medical Oncology (ESMO). Background: Bladder cancer is the sixth most common cancer in the United States and one of the most expensive in terms of cancer treatment. The vast majority are urothelial carcinomas, more often non-invasive than muscle invasive. Bladder cancer is usually diagnosed after examination for hematuria. While the workup for gross hematuria remains CT urography and cystoscopy, the workup for microscopic hematuria was recently updated in 2020 by the American Urological Association with a multiple risk-based approach. Bladder cancer is confirmed and staged by transurethral resection of the bladder tumor. One of the main goals of staging is to determine the presence or absence of muscle invasion by tumor, which has broad implications for treatment and prognosis. CT urography is the main imaging technique in the treatment of bladder cancer. There is increasing interest in advanced imaging techniques, such as multiparametric MRI for local staging, as well as a standardized imaging and reporting system with the recently created Vesicle Data and Reporting System (VI-RADS). Bladder cancer therapies are developing rapidly with immune checkpoint inhibitors, particularly inhibitors of programmed death ligand 1 (PD-L1) and programmed cell death protein 1 (PD-1), as well as another class of immunotherapy called antibody-drug conjugates that consists of a cytotoxic drug conjugated to a monoclonal antibody against a specific target. Conclusion: Bladder cancer is a complex disease and its treatment is evolving. Advances in therapy, understanding of the disease, and advanced imaging have ushered in an era of rapid change in the care of patients with bladder cancer.
Bladder cancer is the sixth most common cancer with approximately 81,400 new cases and 4.5% of all new cancer cases in the United States in 2020 . In terms of cancer treatment costs, it is estimated to be one of the most expensive cancers prevalent in the United States .
In the last few decades, there has been a significant decrease in the mortality rate associated with bladder cancer, which is potentially related to the reduced prevalence of smoking, improvements in the diagnosis of bladder cancer, and advances in treatment . Improved understanding of the disease and new therapies have ushered in a period of rapid change in this field. In this review, we discuss the pathology, diagnosis, staging, radiologic imaging, and management of bladder cancer, highlighting recent advances and research.
What Is Fistula?
Urothelial carcinoma is the most common bladder cancer, occurring in 90% of cases. Urothelial carcinomas have a propensity for divergent differentiation resulting in different histological variants that are associated with high grade and locally advanced disease [4, 5]. In one study, urothelial carcinoma of mixed histology was observed in 25% of transurethral resection of bladder tumor (TURBT) specimens . Micropapillary, plasticityoid, and sarcomatoid variants have a higher risk of progression to muscle-invasive disease, which requires consideration of more aggressive treatment .
Pure squamous cell carcinoma is the next most common subtype accounting for 6–8%, although the rate can be as high as 50% in regions where schistosomiasis is endemic [ 8 , 9 ]. Pure adenocarcinomas are rare and represent less than 2% of bladder tumors, of which 2/3 are of urachal and 1/3 of urachal origin .
Bladder cancer is more common in men whose average age at diagnosis is 73. Risk factors include smoking, which causes about half of all bladder cancers. Other risk factors include environmental and occupational exposures such as arsenic in drinking water and analine dyes, pelvic radiation, alkylating agents such as cyclophosphamide, chronic bladder irritation/infections, congenital bladder abnormalities including urinary bladder remnants and exstrophy, and genetic mutations such as which are ) gene mutations, Cauden’s disease and Lynch syndrome .
Bladder Cancer Treatment (pdq®)
Bladder cancer is usually diagnosed after examination for hematuria. Patients with gross hematuria should undergo CT urography and cystoscopy. In 2020, the American Urological Association (AUA) updated its guidelines for microscopic hematuria from the 2012 guidelines, providing a new individualized risk-stratified approach based on age, smoking history, and quality and quantity of hematuria. The 2012 AUA guidelines recommend CT urography and cystoscopy for all patients older than 35 years with microscopic hematuria. In the 2020 guidelines, low-risk patients with microscopic hematuria should have shared decisions about repeat urinalysis in 6 months or cystoscopy with renal ultrasound. Cystoscopy and renal ultrasound are recommended for intermediate-risk patients. For high-risk patients, cystoscopy and CT urogram are recommended . Urine cytology or urine-based tumor markers should not be used in the initial evaluation of microscopic hematuria, but may be used in cases of persistent microscopic hematuria with a negative workup and symptoms of irritative micturition or risk factors for carcinoma in situ . Urine cytology may be considered in the initial workup when bladder cancer is suspected according to NCCN guidelines . Bladder cancer is confirmed by direct visualization with cystoscopy and transurethral resection of bladder tumors (TURBT).
Staging of bladder cancer requires a detailed understanding of bladder anatomy (Figure 1). The bladder consists of four layers, from inner to outer: (1) transitional epithelium, (2) submucosa/lamina propria, (3) muscularis, (4) serosa/adventitia. Transitional epithelium, also known as urothelium, is the deepest layer that lines the urinary tract in the renal pelvis, ureters, urinary bladder and proximal urethra. The second layer is the submucosa/lamina propria, which contains blood vessels and nerves. The third layer is the muscle layer consisting of a network of smooth muscles, also called the detrusor muscle. The outer layer of the upper bladder (dome of the bladder) is covered with serosa, which is part of the visceral peritoneum. The remaining areas without serosa have an outer layer of adventitia consisting of connective tissue. Outside the outer layer is the perivesicular fat.
Primary lymphatic drainage for bladder cancer includes the internal iliac, external iliac, obturator, and presacral nodes; and secondarily common iliac, para-aortic, aortocaval and paracaval nodes. It is rare for bladder cancer to bypass primary nodal drainage sites and metastasize to secondary nodes [11, 12].
Tracking Down Relief For A Urinary Tract Infection
Bladder cancer is usually staged using the American Joint Committee on Cancer (AJCC) TNM staging system (Table 1). T describes the primary tumor, N describes lymph node metastases, and M describes distant metastases. The stage of bladder cancer has prognostic significance. The 5-year relative survival rate for carcinoma in situ is 96%, for localized disease it is 70%, for regional disease it is 36%, and for distant disease it is 5% .
According to the NCCN guidelines for patients with suspected bladder cancer, a CT scan of the abdomen and pelvis without and with excretory phase contrast (CT urography) is recommended before TURBT to evaluate the bladder, lymph nodes, potential metastases, and any associated upper tract disease (Figure 2). ) .
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