Adrenal Cancer

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Symptoms & Prevention

Symptoms:

The primary symptom of bladder cancer is blood in the urine. Hematuria may be visible to the naked eye or visible only under a microscope (microscopic) and is usually painless. Other symptoms include frequent urination and pain upon urination.

Evaluation:

Office:

  • History and Physical Exam
  • Urine Analysis
    • Urine Culture and Sensitivity (rule out infection)
    • Urine for cytology
      • Examination of urine under a microscope to check for abnormal cells.
    • Tumor marker test
      • BTA and NMP22
        • checking a urine for proteins associated with bladder cancer
    • Fluorescence in situ hybridization (FISH).
      • Detect chromosomal abnormalities associated with bladder cancer
  • Cystoscopy
    • allows visualization of bladder to ascertain if there are growths on the bladder walls.
    • Biopsies maybe taken

Radiology:

  • CT scan (CAT scan) or MRI:
    • Detailed pictures of the upper urinary tract (Kidneys and ureter) and the bladder. A dye may be injected into a vein or swallowed to help with visualization of the organs.

Staging

Once the initial evaluation has been completed if bladder cancer is present the next step is to stage the disease. Staging the disease, will help determine the overall treatment profile for the patient.

Analysis:

  1. Size of tumor?
  2. Multifocal vs. Unifocal?
  3. Location of tumor?
  4. Spread of tumor? (lymph nodes or distant sites)
  5. Histopathology (analysis of biopsy)

Grading:

The grade is an estimate of the speed of tumor growth and ability to spread as suggested by cell features seen under a microscope. Most systems are based upon the degree of tumor cell anaplasia - that is, the loss of cellular "differentiation," the distinguishing characteristics of a cell.

  • Grade 1 (well-differentiated)
  • Grade 2 (moderately differentiated)
  • Grade 3 or Grade 4 (poorly differentiated)

TNM Classification of Urinary Bladder Cancer

T - Tumor N - Regional Lymph Nodes M - Distant Metastasis

TX - Primary tumor extent not evaluated

T0 - No primary tumor

Ta - Noninvasive papillary carcinoma

TIS - Carcinoma in situ ("noninvasive flat tumor")

T1 - Tumor invades connective tissue under the epithelium (surface layer)

T2 - Tumor invades muscle

  • T2a - Superficial muscle affected (inner half)
  • T2b - Deep muscle affected (outer half)

T3 - Tumor invades perivesical (around the bladder) fatty tissue

  • T3a - microscopically
  • T3b - macroscopically (e.g., visible tumor mass on the outer bladder tissue)

T4 - Tumor invades any of the following: prostate, uterus, vagina, pelvic wall, abdominal wall NX - Regional lymph nodes not evaluated

N0 - No regional lymph node metastasis

N1 - Metastasis in a single lymph node < 2 cm in size

N2 - Metastasis in a single lymph node > 2 cm, but < 5 cm in size, or Multiple lymph nodes < 5 cm in size

N3 - Metastasis in a lymph node > 5 cm in size

MX - Distant metastasis not evaluated

M0 - No distant metastasis

M1 - Distant metastasis

Prevention

The best way to lower the risk is not to smoke. Studies have shown that drinking plenty of fluids daily also lowers the risk for bladder cancer; this theoretically decreases the time compounds in the patients urine is exposed to the bladder wall.