Presentation
We discuss 2 patients with extension of carcinoma in situ into the seminal vesicles and replacement of the normally present cylindroid mucosal lining. Carcinoma in situ of the ureter, bladder and prostatic ducts also was present in both patients. [ncbi.nlm.nih.gov]
CLINICAL PRESENTATION While many bladder cancers (13-34%) present with gross hematuria (visible blood in the urine);[3,4] CIS is notorious for presenting with irritative voiding symptoms.[5] Upwards of 80% of patients with CIS will present with irritative [bradyurology.blogspot.com]
MUC5A, MUC2, CK20, and c-erbB2 were positive in all 25 cases of urothelial carcinoma in situ with glandular differentiation, and CDX-2 was present in 19 cases; MUC1, CK7, or 34βE12 was focally present in 21, 19, and 18 cases, respectively. [mayoclinic.pure.elsevier.com]
Primary squamous cell carcinoma of the bladder presenting as peritoneal carcinomatosis has not been reported in the literature. [hindawi.com]
Entire Body System
- Pathologist
The pathologists work together in a team, and there are often multiple pathologists assessing the tissue sample before the final diagnosis is made. [oncolex.org]
An algorithm integrating 3 IHC methods provided a sensitive and specific technique that may become a useful tool for pathologists and urologists to predict response to BCG in patients with carcinoma in situ of the bladder. [ncbi.nlm.nih.gov]
In our study, to overcome the inconsistence of pathological reports by several pathologists, the specimens were re-reviewed by an expert uro-pathologist in the blind fashion of clinical data and we are certain that our report has gone up in value. [academic.oup.com]
The sample will then be sent to a pathologist for examination under a microscope. If the biopsy confirms bladder cancer, other imaging tests may be used to determine if the cancer has spread. [healthline.com]
In some cases it may not be visible upon examination and only shows up when biopsy samples are examined by a pathologist. Bladder CIS is “high grade,” which means that the cells are very abnormal and are rapidly dividing. [bladdercancersupport.org]
- Constitutional Symptom
Patients with metastatic bladder cancer may present with constitutional symptoms including fatigue, unexplained fever, lack of appetite, weight loss, and night sweats. [cancertherapyadvisor.com]
Skin
- Photosensitivity
METHODS: Photofrin II was used as a photosensitizer (2 mg/kg) and in situ dosimetry to obtain the best possible central positioning of the light diffuser as well as to know exact dosimetry data (scattered plus nonscattered light). [ncbi.nlm.nih.gov]
The photosensitizer is injected into a vein, travels through the bloodstream and is picked up and incorporated into cancer cells. [news.cancerconnect.com]
Psychiatrical
- Fear
Fear of recurrence, financial impact of cancer treatment, employment issues and coping strategies are common emotional and practical issues experienced by bladder cancer survivors. [oncolink.org]
Urogenital
- Hematuria
As the most common presenting symptom of bladder carcinoma is painless hematuria, any disease process that causes hematuria can mimic the disease. [cancertherapyadvisor.com]
The incidences of fever greater than 103F, hematuria and bladder contracture were increased in patients receiving BCG following radiation therapy, although the cause of bladder contracture was probably multifactorial in our patient population. [ncbi.nlm.nih.gov]
Patients can be stratified into high and low risk.[4] High risk patients include those with visible hematuria or those with non-visible hematuria and risk factors.[4] A complete evaluation of the urinary tract is indicated for hematuria. [en.wikipedia.org]
Nearly all patients with SCC of the bladder present with hematuria. Our patient did not have gross hematuria, and microscopic hematuria was initially attributed to her underlying urinary tract infection. [hindawi.com]
- Nocturia
Patients may present with dysuria, nocturia, and urinary frequency and urgency with microscopic hematuria. Cystoscopic findings may range from unremarkable to erythema or edema. Urine cytology is an important diagnostic tool. [jnccn.org]
Dysuria refers to difficult urination.[1][2] Painful urination is also sometimes, but rarely, described as dysuria.[3] It is one of a constellation of irritative bladder symptoms (also sometimes referred to as lower urinary tract symptoms), which includes nocturia [en.wikipedia.org]
His age and high likelihood of concomitant symptoms of benign prostatic hyperplasia (BPH) make it very important to distinguish the classic obstructive symptoms of BPH (weak stream, hesitancy, intermittency, nocturia) from irritative voiding symptoms [cancertherapyadvisor.com]
Managing symptoms of locally advanced or metastatic cancer [ 10 ] Bladder symptoms: Palliative radiotherapy may benefit those with symptoms of haematuria, dysuria, urinary frequency or nocturia caused by advanced bladder cancer. [patient.info]
- Urinary Incontinence
incontinence or a burning pain when passing urine Back/lower abdomen pain — less common than above, but sometimes this pain has been known to occur with bladder cancer Important! [depend.com.au]
Orthotopic bladders have a risk of urinary incontinence. Prognosis The recurrence rate for superficial transitional cell cancer of the bladder is high (70% within five years). As many as 80% of patients have at least one recurrence. [patient.info]
- Bladder Neck Obstruction
Death is usually due to locoregional progression (oftentimes ureteral or bladder neck obstruction and subsequent renal failure), and distant metastases are rare. [hindawi.com]
Workup
C 18 Complete blood count, blood chemistry tests, liver function tests, chest radiography, and CT or magnetic resonance imaging of the abdomen and pelvis should be included in the metastatic workup for invasive bladder cancer. [aafp.org]
Diagnostic workup 6.1. Biopsy of the red velvet lesion The diagnosis of CIS can be challenging task due to the flat nature of the lesion, where the mucosa containing the lesion could be unremarkable or simply an erosion [21]. [intechopen.com]
All adult patients with new onset hematuria should undergo a standard diagnostic workup including office cystoscopy, urine cytology, urinalysis and culture, and contrast-enhanced abdominal and pelvic cross-sectional imaging studies (CT or MRI). [cancertherapyadvisor.com]
Treatment
[…] for CIS in intravesical BCG treatment Patients who do not respond to intravesical treatment should strongly consider cystectomy due to the high rates of progression to advanced disease. [bradyurology.blogspot.com]
No patient discontinued therapy due to treatment-related adverse effects. [ncbi.nlm.nih.gov]
Prognosis
If you have bladder cancer, you may have questions about your prognosis. A prognosis is the doctor’s best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. [cancer.ca]
Abstract To evaluate the clinical response to intravesical instillation therapy with bacillus Calmette-Guérin (BCG) Tokyo 172 strain for carcinoma in situ (CIS) of the bladder and subsequent patient prognosis, we reviewed data for 30 patients treated [ncbi.nlm.nih.gov]
Etiology
In adult females, the most common etiology is ovarian adenocarcinoma, although carcinomas of the gastrointestinal tract, lung, or breast, or primary peritoneal carcinoma can produce this clinical syndrome. [hindawi.com]
[…] system existence of different histologic types of bladder cancer: sqamous cell carcinoma, herein described transitional cell carcinoma adenocarcinoma, rare poorly differenciated carcinoma/small cell carcinoma, exceptional Disease cancer of the urothelium Etiology [atlasgeneticsoncology.org]
Microscopic hematuria has a prevalence of 2% to 31%, depending upon age, sex, and other factors.[3] Glomerular hematuria[edit] A glomerular etiology is suggested by dysmorphic red blood cells, protein, and cellular casts in the urine.[3] This requires [en.wikipedia.org]
One focal area of increased tracer activity in the anterior right sixth rib of indeterminate etiology. Recommends radiographs in followups. We discussed surgery options with the doctor. He recommends the bladder be removed and so far we agree. [my.clevelandclinic.org]
Advances in the etiology of urothelial cancer. Urol Clin North Am. 1984;11(4):557-566. 6. Burch JD, Rohan TE, Howe GR, et al. Risk of bladder cancer by source and type of tobacco exposure: a case-control study. Int J Cancer. 1989;44(4):622-628. 7. [aafp.org]
Epidemiology
[…] definition, no invasion into lamina propria Note: high grade non-invasive papillary lesions are NOT designated carcinoma in situ to avoid confusion Terminology Also known as high grade intraurothelial neoplasia (HG IUN), severe dysplasia (sometimes) Epidemiology [pathologyoutlines.com]
[…] transitional cell carcinoma of the urinary tract TCCs in other locations: transitional cell carcinoma of the renal pelvis transitional cell carcinoma of the ureter other histologies: squamous cell carcinoma of the bladder adenocarcinoma of the bladder Epidemiology [radiopaedia.org]
[…] carcinoma, exceptional Disease cancer of the urothelium Etiology most often secondary to bilharzial infection (schistosoma haematobium), may be associated with other types of long term irritations: chronic infections, calculi, treatment with cyclophosphamid Epidemiology [atlasgeneticsoncology.org]
AH Al-Zalabani et al., “Modifiable risk factors for the prevention of bladder cancer: a systematic review of meta-analyses”, European Journal of Epidemiology, vol. 31, no. 9, 2016, pp. 811–51. Download PDF Order FREE booklet [cancervic.org.au]
Malignant Tumors Objectives: After completing this tutorial the student will know the following about malignant tumors of the urothelium: which are the common and important tumors the epidemiological features and predisposing factors what is meant by [med-ed.virginia.edu]
Pathophysiology
Terence Friedlander reviews the basic biology and pathophysiology of bladder cancer, focusing on methods used to detect bladder cancer, treatment of early-stage disease with therapies administered into the bladder, the role of surgery or radiation therapy [youtube.com]
Porth pathophysiology: concepts of altered health states (1st Canadian ed.). Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 660. ISBN 978-1-60547-781-7. ^ Robbins S, Kumar V, Abbas A, Fausto N (2007). [en.wikipedia.org]
Pathophysiology Ta and Tis have distinct molecular pathways and clinical course. Two distinct molecular pathways of oncogenesis and tumor progression are recognized in urothelial carcinoma of the bladder (Ta). [cancertherapyadvisor.com]
Prevention
Abstract There are theoretical limits to the efficacy of intravesical instillation of anticancer agents as a method to prevent recurrence of superficial bladder cancer. [ncbi.nlm.nih.gov]
Reduce the foreskin of uncircumcised patients by returning it to its normal position over the glans, to prevent paraphimosis. Remove the drapes. To prevent causing a UTI, maintain strict sterile technique during the procedure. [msdmanuals.com]