Sunday 27 October 2013

Bladder Cancer

The bladder is a hollow elastic organ in the center of the lower abdomen that collects urine from the kidneys and excreted them through the urethra.
Bladder cancer is most common type of cancer that effect men twice as frequently as it effects women. Usually it starts from the lining the bladder caused by several types of malignant growths of the urinary bladder cells.

Types of Bladder cancer
A. There are three types of bladder cancer beginning in cells in the lining of the bladder, classified due to their origination.
1. Transitional cell carcinoma
In early stage of bladder cancer, normal cells become cancerous in the innermost tissue layer of the bladder which can change shape and stretch without breaking apart as they are able to stretch when the bladder is full and shrink when it is emptied. More than 90 percent of bladder cancers begin in the transitional cells
2. Squamous cell carcinoma
Cancer begins in squamous cells in the found in the tissues of the surface of the bladder, due to long-term infection or irritation. About 8 percent of people with bladder cancers begin squamous cells
3. Adenocarcinoma
Cancer begins originates in glandular tissue of the bladder, including the surface layer of skin, glands and a variety of other tissue, due to long-term irritation and inflammation. Only 2 percent of people with the condition have a third bladder cancer type.

B. Types of bladder cancer classified due to their proliferation
1. Superficial types of bladder cancer
This type of bladder cancers have a characteristic of often recurrence but usually non invasive. It can be controlled or removed by regular cystoscopy.
2. Invasive types of bladder cancer
Invasive types of bladder cancer tend to spread after beginning in cells in the lining of the bladder. It often requires surgery by removing part or whole bladder.

Stages of bladder cancer
Bladder cancer can be classified in difference stage depending to the location, size, and spread of the cancer.
Stage 0: Cancer cells are found only on the inner lining of the bladder
Stage I: Cancer cells have spread to the layer beyond the inner lining of the bladder but not to the muscles.
Stage II: Cancer cells have spread to the muscles in the bladder wall but not to the fatty tissue that surrounds the bladder.
Stage III: Cancer cells have spread to the fatty tissue surrounding the urinary bladder and nearby organs, but not to the lymph nodes or other organs.
Stage IV: Cancer cells have spread to the lymph nodes, and/or other organs, etc.
Recurrent: Cancer has recurred in the bladder and/or another nearby organs after treatments.

Symptoms
1. Bladder spasms
2. Blood in urine
3. Frequent urination
4. Pain or burning sensation during urination
5. Pain in lower back and/or abdomen
6. Inability to urinate
7. Urinary urgency
8. Reduced bladder capacity
9. Difficult in urination
10. Loss of appetite and weight
11. Etc.

Causes
1. Smoking
Everybody knows that cigarette smoking is a major cause of lung cancer, but not many people understand that it also can lead to bladder cancer. Study of a group of people with the available smoking information, included duration of smoking habit, number of cigarettes smoked per day and time since cessation of smoking habit for ex-smokers, showed cigarette smoking increases the risk of bladder cancer with 1.96 after 20 years of smoking to 5.57 after 60 years, with an immediate decrease in risk of bladder cancer was observed for those who gave up smoking by over 30%. In fact, cigarette contains certain harmful chemicals which can also lead to bladder cancer due to prolong period of exposure in the limning of bladder walls.

2. Chemicals exposure
Reseachers investigated the risk of bladder cancer in association with exposure to over 12 000 occupational chemical agents, complex mixtures, and other substances, showed that increased risk of bladder cancer was detected for ever exposure to 635 chemical agents, and 341 chemical agents exhibited a significantly increasing dose-response relationship.

3. Diet high in fried meats and fat
Study showed that risk of bladder cancer increased by 37% with a high fat intake, by 40% with low fruit consumption and by 16% with diets low in vegetables.

4. Aging
The acceptance of that aging is one the greatest single risk factor for developing bladder cancer due to weakened immune system, increased free radicals frequent attacked, genetic and epigenetic changes, environmental influences, etc.

5. Infection caused by a certain parasite
A parasite worm, Schistosoma which can lead to Schistosomiasis, is a chronic disease that can damage a person internal organs and the urinary form of schistosomiasis may cause bladder cancer in adults. Schistosomiasis can also lead to inflammation of bladder lining leading to the transitional cell carcinoma, the predominant type of bladder cancer.

6. Etc.

Diagnosis
Diagnosis are always important for people who have had the symptoms mentioned above. If bladder cancer is diagnosed early, most of the times it can be cured.
Beside checking the patient personal health history and smoking habit, rectal examination for men and pelvic examination, others exams include
1. Urine test
Urine test is one of the first test which your doctor may order to rule out conditions of infection or inflammation causes of similar symptoms and detect the presence of certain antibodies and other markers may indicate bladder cancer.

2. Urinalysis:
Any abnormality found in urine test will be sent for urinalysis such as blood, protein, and sugar.

3. Cystoscopy
If you urine test came back positive, your doctor may want to take a look inside your bladder for abnormalities such as tumors by inserting a very narrow tube with a light and a camera on the end through the urethra. The camera transmits pictures to a video monitor for a direct viewing of the inside of the bladder wall.

4. Intravenous Pyelography (IVP)
The test is performed by taking a series of x-ray films of your bladder after injecting a drug solution with a catheter through the urethra to highlight and mark any abnormality inside your bladder easier. You are asked not to pass urine for a few hour after injection.

5. CT scan
CT scan can dive your doctor a three-dimensional view of your bladder and the rest of your urinary tract to look for masses and other abnormalities such as tumor.

6. Biopsy
This test usually is done under local anesthesia. If the lump is found in the bladder wall or area which is suspicious to be tumor, a tiny samples of your bladder wall are removed usually during cystoscopy and examined by a pathologist. Small tumors can also be removed during the biopsy process.

7. Etc.

Treatments
1. Surgery
a. Removal of superficial tumors
Normally if the tumor is the superficial type, general anesthesia is sometimes used for operative cystoscopic which is endoscopy of the urinary bladder via the urethra.

b. Total cystectomy
When cancer invades the muscle of the bladder wall, it is usually necessary to remove the entire bladder surgically, but for women patients, researchers advice that total cystectomy could manage invasive bladder cancer in women patients but night continence is not as good as that in men patients.

c. Partial cystectomy
Sometime by preserving the bladder, partial or segmental cystectomy is involved to remove only part of bladder tumor and surrounding bladder wall but researchers found that only 5.8-18.9% of patients with muscle-invasive bladder cancer are suitable candidates for partial cystectomy.

2. Radiotherapy
After the invasive cancer tumor is removed, if cancer cells are found on the edge of the removal tumor, your specialist may suggest radiotherapy to kill and prevent the cancer cells from spreading or if you want to try to keep your bladder, or try to keep your potency. Radiotherapy is the use of high energy rays to kill cancer cells. Treatments are usually 3 times a week, for up to 6 weeks or longer.

3. Chemotherapy
Chemotherapy is a method of treating cancer by using single drugs or combination of drugs to kill cancerous cells, especially for spreading quickly cancer cells or cancer cells have spread to other parts of body. In some case, chemotherapy may be recommended before surgery and/or radiotherapy.

4. Phototherapy
Phototherapy is treatment of a disease by exposing to light, especially by variously concentrated light rays or specific wavelengths. In one study, researchers found that the best results of treating bladder cancer by phototherapy were noted in tumors less than six mm. in diameter when treated with 15 mg./kg dihematoporphyrin ether (DHE) and exposed to 100 to 180 minutes of visible light.(Source)

Read more at http://www.wrongdiagnosis.com/treat/phototherapy.htm?ktrack=kcplinkPorphyrin-sensitized photoradiation therapy (PSPT) is a promising treatment for a variety of malignant tumors. Researchers found that phototherapy have a potential for a new modality in treating recurrent and resistant bladder cancer. Information gained form the basic studies will provide a better understanding for mechanisms of porphyrin uptake, retention and photosensitization in tumor cells, thus providing a basis for improving the treatment by increasing the efficacy and reducing the side effects. The development and the information can also be useful in the treatment of other tumors by PSPT.
5. Intravesical or instillation
Bladder instillations are treatments of putting drugs directly into the bladder by inserting a catheter through the urethra, normally without using general anesthesia. You are asked not to urine for a few hours. The treatment sometimes cause temporary bleeding and bladder irritation.

6. Etc.

Nutritional Supplements
If you have read my previous article, Anti-Aging - How to Live Longer & Healthier:Antioxidants, Free Radicals, Cancers, Diseases, You might already know that vitamins and minerals play an important in preventing and treating DNA mutation in cells division and replication. In fact, they are vital for people with bladder cancer
1. Vitamin B6
Study found that Vitamin B6 in several clinical trials in bladder cancer, may benefit patients with bladder cancer by improving immune function fighting against the forming of free radical and irregular cells growth causes of bladder cancer.

2. Vitamin D
Vitamin D is best known for its function in nehance the absorption of calcium in preventing osteoporosis, but in bladder cancer, studies found that exposure to ultraviolet B (UVB) activates photosynthesis of vitamin D3 in elevated levels in the body, lowering the risk of bladder cancers.

3. Vitamin E
Regular use of vitamin E supplement for longer than 10 years was associated with a reduced risk of bladder cancer mortality , but regular use of shorter duration was not.

4. Selenium
‘The lower the levels of selenium, the higher the risk of developing bladder cancer,’ said lead researcher Nuria Malats, M.D., Ph.D., leader of the Genetic and Molecular Epidemiology Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre, but the researchers noted a significant protective effect of selenium, mainly among women, which they believe may result from gender-specific differences in the mineral’s accumulation and excretion in women.

5. Carotenoids
Researchers from UT M.D. Anderson Cancer Center, Houston, TX, UT Health Science Center School of Public Health, Houston, TX, Baylor College of Medicine and Methodist Hospital, Houston, TX found that further evidence for a chemopreventive role for carotenoids by demonstrating that high carotenoid intake is associated with an overall decrease in BC risk and provided a reduction in risk for smokers and among individuals susceptible to DNA damage. These data may have important implications for cancer prevention, especially for individuals susceptible to DNA damage.

6. Combination of carotenoids, vitamin D , thiamin, niacin, and vitamin E
researchers found that in older individuals, the highest average intakes of the above were all associated with a reduced bladder cancer risk. In smokers, they also found that the highest intakes of vitamin E, carotenoids and niacin, were associated with a 42, 38, and 34 per cent reduction in bladder cancer risk in heavy smokers.

7. phosphorus
Some study found that phosphorus intakes also reduce the risk in bladder cancer.
Diet
1. calciferous vegetables
Studies found that increased intake of calciferous vegetables may slash the risk of bladder cancer by 36 per cent, says new research that attributes the benefits to the isothiocyanate content.
The Roswell Park researchers collected dietary data from 275 hospital-based bladder cancer patients and 825 cancer-free people, and found that those who consumed the highest consumption of raw cruciferous vegetables was associated with a 36 per cent reduction ibladder cancer risk


Furthermore, stronger protective effects were observed among current and heavy smokers with an intake of three or more servings of raw cruciferous vegetables per month associated with a 54 and 40 per cent reduction, respectively.

2. Soybeans
Reseachers found that genistein, soy phytochemical concentrate, and soy protein isolate have the ability to inhibit the growth of transplantable murine bladder cancer in vivo. Genistein, dietary soy phytochemical concentrate, and dietary soy protein isolate reduced tumor size by 40%, 48%, and 37%, respectively, as compared with controls.

3. Garlic
Chinese garlic-lovers are not the only ones to benefit from garlic's cancer-fighting abilities, including bladder cancer. John Milner, Ph.d., from Pennsylvania State University, points out in a review article tracking the anti-cancer effects of garlic that "the potential benefits of garlic appear not to be limited to a specific region of the world ..." when researchers noticed that a certain region of this country had both an extraordinarily high garlic intake and a surprisingly low rate of stomach cancer.

4. Green tea
Green tea is made from unfermented leaves and reportedly contains the highest concentration of powerful antioxidants called polyphenols the free radical scavengers that limit the damaging of DNA alternation resulting in lessening the risk of cancer, including bladder cancer. Green tea also has cancer-fighting properties and may cut off blood vessels that feed cancerous tumors.

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