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Actos Bladder Cancer : Despite prompt and appropriate medical treatment if you have mus­cle-invasive TCC, there is about a 50 percent chance that your cancer will metastasize (spread), either to another organ in the body or with­in the bladder area itself. The most common sites of “distant metastasis” (not in the imme­diate area of the bladder) are the para-aortic lymph nodes and the liver, lungs, and bone. Occasionally, bladder cancer can send deposits through the bloodstream to the brain, but usually this happens only after prolonged and repeated treatment. Most recurrences, both dis­tant and local, occur within the first two years after treatment.

One point worth emphasizing is that cancer cells in a distant metastasis still have the characteristics of the bladder cancer (i.e., they behave in the pattern of those bladder-cancer cells and don’t really constitute ” bone cancer”or “liver cancer”as such).Thus the drugs that may work against bladder-cancer cells also have a chance of working against these metastases located at other sites in the body.

As you might expect, the metastasis of your cancer is a dangerous situation that reduces your chance of a permanent cure. That doesn’t mean that cure is impossible or that you no longer have options. Some established chemotherapy approaches can sometimes achieve cure if the metastases are not too extensive. In addition, new and promising therapies, including novel chemotherapy drugs, are under­going clinical trials as this book goes to print, and many of those may well be available to you.

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When metastasis occurs, the direction of your treatment shifts somewhat from a totally focused attempt to achieve cure. In this situ­ation/ while we attempt to cure the metastatic cancer if possible/ we also tty to palliate (reduce) the symptoms and we place a greater emphasis on comfort and pain control This type of treatment is called palliative care. At this point, not only you but your family and loved ones should be involved with your medical team in understanding the progression of your disease and making decisions about your care.

This is a very important point and it can be confusing. On the one hand, your medical team is still trying very actively to cure the cancer, if possible, and to prolong your life and improve its quality to the maximum extent. However, as the chance of cure is somewhat small­er, you and your medical team must also give thought to the benefits and drawbacks of treatment, to quality-of-Hfe issues, and to making the decisions that make the most sense. You and they will want to weigh the chance that treatment might be successful against the possible side effects, the time spent in treatment, and the possible limitations on your quality of life.Your doctor may discover the metastasis during a routine check­up, although sometimes a patient will experience symptoms.

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might be bone pain, abdominal discomfort severe headache, or tin­gling in the legs. (The latter may occur if a metastasis is pressing on nerves in the spine.) Perhaps weight has been lost without changing exercise or diet habits. One might develop a cough or abdominal pain, or experience hematuria (blood in the urine) or other symp­toms of bladder irritation. Any of these symptoms should send you to the phone to make an appointment with your doctors to figure out whether something sin­ister is beginning to occur. As you read this you might be thinking that if the cancer is so advanced – if it has spread to the lungs or bones what’s the point of treating symptoms like tingling in your legs or vague abdominal pain?

The point is that even though the cancer has advanced and metas­tasized, you are likely to live for an extensive period of time – months or years – and it makes good sense to make sure that you are able to live that time comfortably and as fully as possible. If you allow symp­toms to go untreated, your ability to participate in everyday life with your family and friends may be greatly diminished, and the time you have left with them may be cut short. On the other hand, occasionally a specialist may decide to watch and wait. For example, when a change is seen on an x-ray but there are no symptoms. Or when a patient is unwell from other medical problems or is just keen to avoid treatment at that time. In such situ­ations, sometimes the decision will be made to observe closely and start treatment when symptoms occur.

What kind of treatment can one expect if the cancer metastasizes? Surgery to remove the bladder is occasionally a possibility if the only site of recurrence is the bladder and surrounding tissues. It usually doesn’t make sense to operate if the cancer has spread to distant sites. Sometimes radiotherapy will be used to reduce the symptoms of recurrence in the bladder if the recurrence is too extensive to permit surgery or if distant metastases have also occurred.

Our use of the term or terms Actos Bladder Cancer is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Bladder Cancer : For those individuals whose bladder tumors are at high risk for recurrence or progression, instillation of agents directly into the bladder can be worthwhile. The forms of therapeutic agents come in two groups: chemotherapy or immunotherapy. It is fortunate the bladder is readily accessible to these agents, allowing for direct action with minimal systemic side effects.

Those individuals at high risk for recurrence and or progression should be considered for this therapy. Individuals with multiple or diffuse superficial tumors, large tumors, high grade tumors, superficially invasive tumors, those with recurrence within one year, or individuals with CIS all should be considered for this treatment. In addition, those with positive cytology after resection or patients with persistent superficial tumors which could not be removed should also be considered.

The agent is passed via a catheter into the bladder. The passage of the catheter generally takes just a few seconds in a woman, and perhaps ten seconds in a man. The urethral meatus (the outermost part of the urethra) is first cleansed with an antiseptic solution and then the catheter, which is made slippery with a sterile lubricant, is inserted up the urethra and into the bladder. On passage of the catheter, there is minor, short lived discomfort which may be reduced by an injection up the urethra with numbing medication. The various therapeutic agents are not painful during the infusion but may cause side effects afterwards. Depending on the agent instilled, the patient is asked not to void for a period of time afterwards to allow the agent to have its maximal effect on the bladder lining.

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BCG is a living but attenuated form of tuberculosis bacteria. Similar to other living vaccines, it is used to create a heightened immunity. There are a number of precautions which must be taken to make sure the BCG is infused safely. BCG should not be infused immediately or shortly after tumor resection. Several weeks should be allowed to pass so the BCG does not gain access into open blood vessels. In addition, BCG should not be infused if the individual has a urinary infection, has active bleeding, or if the catheterization is traumatic and causes bleeding. It should not be used in patients whose immune system is seriously compromised or for those on steroids, which can decrease the immune system.

The exact mechanism(s) of BCG is still not fully understood. It is known BCG actually attaches to and enters cancer cells. BCG is thought to trigger an increased immune reaction in the bladder, thereby killing off cancer cells.

BCG is held in the bladder for two hours. One should not hold it longer as adverse reactions are increased. The individual should then void into a toilet at home, preferably in a seated position to avoid splashing. After voiding, the toilet is disinfected with bleach. Since BCG can be shed from the urethra after treatment for several days, condoms should be used or one should abstain from sexual relations for at least 48 hours after treatment.

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Adverse reactions are side effects of treatment. Approximately 95% of individuals will tolerate treatments well. Adverse reactions may be mild. Common reactions include cystitis (inflammation of the bladder characterized by burning on urination), hematuria, mild fever, malaise, and nausea. These symptoms generally pass without any treatment. For bothersome symptoms, various medications may prove helpful. Your physician can prescribe medication for burning or urinary frequency. For those with persistent cystitis, antibiotics can be utilized. For individuals experiencing severe symptoms lasting more than 48 hours, isoniazid, an anti-tuberculous drug can be prescribed. A short course of 3 days, starting the day before the next dose of BCG can be used to prevent severe side effects. Fortunately severe reactions resulting in sepsis, a life threatening condition characterized by high fever, chills and drop in blood pressure, is exceedingly rare. Sepsis would be treated in a hospital with triple anti-tuberculous drugs, steroids, and broad spectrum antibiotics. There are other serious adverse reactions which may require dose reduction or discontinuation. These are all rare and include: inflammation of the prostate, persistent hematuria, hepatitis, inflammation of the testicles and or epididymis, bladder contraction, ureteral obstruction, joint pain or inflammation of the lungs.

Recurrence of bladder cancer after the initial induction course, or relapse after complete response, would indicate failure of therapy. When two or more courses result in recurrence or when recurrence develops during the first six to twelve months after induction and maintenance therapy, patients generally are felt to have disease which is at higher risk for progression. A high percentage of patients who are complete responders remain tumor free for up to five years. However, with the passage of more time, additional patients will have late recurrences. For those with late recurrences (two to three years after therapy), most will respond to repeat BCG therapy.

Our use of the term or terms Actos Bladder Cancer is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Bladder Cancer : The actual surgery to form the continent diversion may take several hours more to accomplish compared to an ilea) loop. This additional surgical time is not a problem as long as the individual is in good health, and the surgery has gone well. Not all urologists do continent diversions on a regular basis. If a urologist does not do this operation regularly, you will be better off finding a urologist that does, since complications related to this part of the surgery will be increased by inexperience. Because different techniques exist and the level of expertise and experience of each urologist is different, it is important to ask the urologist about the complications that may occur and the general frequency of occurrence he has seen in his patients. Complications unique to this diversion as compared to the ileal loop may occur, requiring reoperation in up to 20% of patients. If the complication rate is unacceptable, consider an ileal loop. The most common complications are:

Difficulty with catheterization: After the surgery the pouch may become increasingly difficult to empty. Surgical reconstruction is mandatory if a pouch cannot be readily emptied. Incontinence: During surgery, the continence mechanism is checked. However, at some time after surgery, incontinence may occur, necessitating the wearing of a collection device. In addition, the pouch may still need to be catheterized. Surgical reconstruction is required to reformat the continence mechanism. Pouch stones: Stones may form in the pouch. Removal may be accomplished with a scope either through the stoma or directly through the skin above the pouch.

Neobladder means new bladder. In this surgery, the urologist uses a combination of small bowel, large bowel, or a combination of both to create anew bladder pouch which is attached to the remaining urethra. The individual can void by increasing abdominal pressure which is accomplished by holding one’s breath and bearing down. There are many surgical techniques to accomplish the formation of a neobladder.

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There are a number of issues which need to be reviewed. Cancer recurrence in the urethra after the formation of a neobladder would likely require surgery to remove the urethra and a new form of urinary diversion. After cystectomy, urethral recurrence of cancer can be expected in approximately 10% of patients. Those with multi­focal disease and especially with disease near the bladder neck will likely have a higher recurrence rate in the urethra. For those with a neobladder, the urethra must be carefully followed for possible cancer recurrence. Monitoring is accomplished by washings of the urethra for cytology or by visual inspection with a scope. if there is a concern for an increased risk of urethral recurrence given the nature of the individual’s bladder cancer, the formation of a neobladder should be avoided.

Urinary incontinence may occur after the formation of the neobladder because of damage to the continence mechanism of the urethra. The nerves to the urethral sphincter travel deep in the pelvis and generally are not injured during surgery. However, meticulous care must be taken in handling the urethra and the sphincter muscle around it. Complications resulting in scar tissue may also jeopardize the continence mechanism leading to leakage. Marked scarring between the neobladder and the urethra may occur, but is readily handled via an incision or dilation of the blockage accomplished through a cystoscope. Even in those with an intact sphincter, especially in females, leakage often occurs at night, necessitating the wearing of a pad.

For some individuals, the neobladder is not adequately emptied with increased abdominal pressure. The solution is intermittent self catheterization through the native urethra. This can be uncomfortable, especially for male patients. For many individuals continence is preserved and catheterization is not required, making this an excellent form of diversion.

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Creating a neobladder is technically more difficult and will require several more hours of surgery as compared to the simpler ileal loop diversion. Many urologists do not create neobladders on a regular basis. If your urologist does not do this part of the operation frequently, you are better off finding a urologist who does neobladder surgery regularly or you will face the prospect of a higher complication rate. It is important to question your urologist regarding the various complications and the frequency of occurrence he has seen in his patients. Ideally, the individual with a neobladder will empty without the need for catheterization and will remain continent between emptying. It is important to understand what percentage of individuals can expect this ideal outcome. If the probability for incontinence or need to catheterize is too high a risk for you, choose a continent diversion or an ileal loop diversion instead.

Chemotherapy uses drugs to kill cancer. There are many different types of chemotherapy. Some drugs work better than others for specific cancers. Some are given orally as pills. Many are given intravenously. Susceptibility to chemotherapy varies depending on the specific cancer. Some, like testicular cancer, are extremely sensitive to chemotherapy while others, like kidney cancer, are not. Bladder cancer is felt to be moderately sensitive to chemotherapy.

Chemotherapy drugs work systemically, throughout the body. These drugs work via various mechanisms to damage and hopefully kill rapidly dividing cells. Since cancer cells are for the most part rapidly dividing, they are generally sensitive to chemotherapy. Other rapidly dividing cells in the body may also suffer injury during chemotherapy, which is why people often experience hair loss, anemia, and diarrhea as a result of therapy. Chemotherapy also can lower the blood cells that fight infection, leading to a diminished immune system and an increased susceptibility for acquiring a potentially serious infection.

Our use of the term or terms Actos Bladder Cancer is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Bladder Cancer : When an individual has gross hematuria or persistent microscopic hematuria, a complete assessment of the urinary tract is required. Although cystoscopy is the test of choice for examination of the bladder, imaging studies are required to make sure there is no disease in the upper tracts (kidneys and ureters). Bleeding can be caused from many different disorders including transitional cell carcinoma of the upper tracts, kidney or ureteral stones, or renal cell carcinoma (cancer of the parenchyma or fleshy part of the kidneys). Your urologist has a number of options to choose from. There are advantages and disadvantages of each.

Intravenous pyelogram (IVP) is accomplished by injecting a contrast agent into your vein and then obtaining X ray images. The contrast is excreted by your kidneys, subsequently filling the lumen of the kidneys, ureters and the bladder. The contrast allows one to see subtle filling defects within chambers of the urinary tract, possibly representing tumor, stone or blood clot. Tumors of the fleshy part of the kidneys can also be seen. The study also allows for an assessment of renal function. It is a sensitive test for renal obstruction, which can occur because of cancer. Disadvantages of the study include the possibility of an IV contrast agent allergy, which occasionally may be serious.

You will be asked whether you have a sea food allergy, a known allergy to iodine or to IV contrast. If this is the case, you may need to be premedicated prior to the exam to avoid a reaction. Although the study is quite useful at visualizing the upper tracts, it is not very good at picking up subtle tumors on the bladder surface. If your kidneys do not function well (you have renal insufficiency), the contrast may cause harm to your kidneys and the imaging will not be as good. For pregnant women, any X ray exam could be potentially damaging to the fetus and therefore, will not be performed.

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Ultrasonography can check for a kidney tumor, stone, or obstruction. Bladders filled with urine can be scanned. There is no contrast or X rays involved, and therefore the study can be accomplished in those with renal disease, contrast allergies or for women who are pregnant. Although larger tumors of the bladder are often visible, it is not a good study to rule out urothelial cancer (transitional cell cancer of the urinary tract lining) since smaller tumors or flat tumors in the lining are not visible. Also, other conditions such as enlarged folds in the bladder or enlarged prostates can be confused with bladder tumors. Ultrasound exams are generally fast, painless, and relatively inexpensive. An ultrasound combined with cystoscopy plus cytology (to rule out cancer cells) is a reasonable assessment for those with a low likelihood of having upper tract disease.

CT Scan or CAT (computerized axial tomography) provides a computerized cross sectional visualization of the abdomen and pelvis. X ray images are synthesized into exquisitely detailed images. The CT scan can be done with or without IV contrast, and therefore has the same limitations as IVP in those with allergies to contrast or renal insufficiency. These studies are excellent for finding renal cell cancers and stones within the kidneys and ureter, but not very good at delineating cancers of the lining. CT scan is often an important part of staging bladder cancer, determining whether the cancer has spread.

Magnetic Resonance Imaging (MRI) is a technology which uses strong magnets to provide detailed images of your internal organs. Like ultrasound, this study has no known harmful effects on the body. It does not require contrast injection like CT scan and can be done safely in patients with renal insufficiency. It is not generally used for initial screening. Many individuals find the test uncomfortable due to a loud noise heard throughout the test, in addition to the close quarters the machine requires, leading to feelings of claustrophobia. A mild sedative may be required if the test is necessary and the individual experiences these uncomfortable feelings.

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Initial treatment may eradicate an individual’s bladder cancer, however, for many, recurrent tumors may develop. Up to 70% of individuals will have recurrent bladder cancer after initial therapy. In approximately one third of patients, not only will tumors recur, but they will become more serious over time, developing a higher grade or stage. This chapter will review the importance of staging bladder cancer, the single most important predictor of future problems. In addition, we will review other important indicators that impact the prognosis.

After the diagnosis of cancer is made, it is critical to establish the stage of the cancer. Cancer stage quantifies the extent of cancer in the individual. The number of tumors, their size, whether or not they have grown into the wall of the organ or spread beyond, all fit into the various stages of a particular cancer. Most cancers can be found at an early, nonlethal stage. As they grow and worsen, they can invade the wall of the organ they lodge in, spread locally through the organ into surrounding tissue, or spread throughout the body via the lymphatic or blood system.

Our use of the term or terms Actos Bladder Cancer is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Bladder Cancer : The experienced urologist uses several techniques to improve his chances of removing tumors that are difficult to reach. He will often keep the bladder under filled. Although this may reduce visibility, it will allow the tumor to be closer to the resectoscope. Another technique is to place manual pressure on the bladder from above. This is done by an assistant or by the urologist himself. By pushing down from above, tumors at the dome are displaced downwards. An additional technique, for the male patient, is operating through a perineal urethrostomy. The urologist makes a surgical opening into the urethra between the scrotum and rectum, allowing the resectoscope to move further into the bladder, bypassing much of the urethra.

Another option would be to use a laser. Laser fibers are flexible and may be able to reach a difficult tumor. The tumor may be effectively destroyed with laser energy; a disadvantage is no specimen is obtained. Photodynamic therapy may afford additional results. With this novel technique, a chemical is instilled into the bladder, sensitizing the cancer cells to light energy. The entire bladder is then illuminated with laser light via a cystoscope. This treatment is not widely available at the present time and it is most effective for small tumors.

Bleeding is usually present, but rarely severe. Some tumors are more vascular than others and will bleed more. In addition, the resection will involve the bladder wall and vascularity varies here as well. Transfusions are not generally required unless an individual starts with a low blood count from previous bleeding or medical condition. Bleeding can be an on going concern until the bladder completely heals weeks later. Catheterization and irrigation may be required. Just a small amount of blood will change the color of urine red. Urine that is punch colored or the color of rosé wine generally is not serious and will clear on its own. When the urine has large amounts of blood in it, the appearance generally looks like tomato juice, indicating serious bleeding requiring medical attention.

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Bladder perforation may occur, especially with large tumors or those located on the lateral bladder walls. During resection of tumors on the lateral walls, the obturator nerve, which runs alongside the outside of the lateral bladder wall, may cause a strong muscle contraction. This contraction can abruptly move the bladder during a resection, resulting in a perforation. During resection of a large tumor with solid base, the urologist proceeds with deep resection of the tumor to remove the entire tumor and also determine whether or not it is a high stage tumor with muscle invasion. Bladder walls differ in size and integrity, and sometimes a perforation may occur. In addition, bladders which have previously been subject to some form of stress such as radiation or chemotherapy may have extremely poor integrity and are subject to pulling apart during a resection, resulting in a perforation. Bladder perforation is usually detected during the resection when the urologist sees fat (perivesical fat is located on the outside of the bladder). Sometimes, during a particularly bloody resection, the perforation may not be visible intraoperatively, but discovered when the lower abdomen becomes firm and distended (indicating that a large volume of fluid has passed into the abdomen). Small perforations are usually handled by stopping the procedure and maintaining a catheter for a week or more. Large perforations, especially those that communicate with the peritoneal cavity (the cavity that encases the bowels) generally require open surgical repair. Perforations can potentially spread cancer beyond the bladder.

Ureteral injury may occur when a tumor covers the ureter in the bladder. The ureter may be obscured by a bladder tumor, and the urologist may inadvertently resect it along with the tumor. In general, cutting current to remove a bladder tumor does not usually lead to long lasting problems as compared to cauterization, which is more likely to cause permanent blockage or obstruction of the ureter. If the urologist is working in the area of the ureter, he should avoid cauterization as much as possible. He may ask the anesthetist to inject an intravenous coloring agent which will turn the urine blue and allow visualization of the ureter. If he knows a ureter may be in jeopardy, he may insert a stent (a small plastic tube that traverses the ureter) for several weeks to allow the ureter to heal in an open fashion.

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Urethral injury is infrequent and is almost always in males. A stricture or narrowed area of the urethra may result from irritation or injury from the resectoscope pressing on the urethra. Individuals that develop strictures complain of difficulty urinating, experiencing a slow or split stream. Strictures are usually readily handled with a number of urologic procedures.

Bladder tumor “seeding” may occur during the procedure. As the tumors are resected, cancer cells are released into the irrigant which fills the bladder. These cells may implant in other areas of the bladder traumatized during the procedure. It should be understood that the bladder is generally filled with urine, and tumor cells can naturally implant at other locations even without surgery. Implantation can be lessened during surgery by avoiding injury to other bladder areas and by the use of adjuvant intravesical chemotherapy. There have been numerous studies over the past decade showing a number of chemotherapy agents can be effective in decreasing initial tumor recurrence, possibly by preventing seeding. Reduction in recurrence may however be short lived. Previously, it was common practice to obtain multiple random bladder biopsies at the time of initial tumor resection. This was recommended to rule out the possibility of hidden CIS. Understanding these biopsy sites may increase the possibilities of tumor recurrence by tumor seeding, biopsies are now often limited to areas adjacent to the tumors removed and suspicious appearing areas only. CIS can be ruled out by using cytology, or by obtaining biopsies during future cystoscopy after the tumor has already been removed. When dealing with low grade tumors, random biopsies of the bladder will rarely show cancer.

Our use of the term or terms Actos Bladder Cancer is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Bladder Cancer : Before visiting your bladder cancer specialist for the first time, you should gather all of your medical records. It is important to obtain copies of your biopsy and cytology reports, radiology studies, operative reports and any other test reports related to your diagnosis of bladder cancer. In addition to written reports, you should request your actual pathology slides for review by the urological pathologist who works with your urologist. It is also important to obtain actual copies of any radiological exams performed. Often, you can obtain a CD with your exams on it or actual films.

A biopsy is a small piece of tissue obtained during cystoscopy when a urologist looks inside of your bladder. This tissue sample is then sent to the laboratory and looked at under a microscope by a pathologist. Although there are standards that all pathologists follow, there can be small differences that can be seen by a trained eye. This is why it’s important to obtain actual slides and not just the report. In addition to biopsies, pathologists often look at urine specimens or bladder washings for the presence of abnormal cells. It’s important to bring this report to your first appointment as well.

Before your referral to a bladder cancer specialist, your primary care provider or urologist may order one of a few radiology exams to help evaluate the extent of cancer. We’ll briefly discuss those tests commonly ordered during the workup of someone with bladder cancer. These tests help determine someone’s cancer stage. Again, it is very important to obtain copies of your images (the actual films or CDs) along with reports.

An ultrasound is a noninvasive test used to evaluate the kidneys and bladder. Ultrasounds are painless and don’t have any associated side effects. Ultrasounds are performed by either a radiologist or radiology technician and take approximately 30 minutes to complete. An ultrasound allows doctors to image your kidneys to determine whether or not they are normal in size. An ultrasound can also determine if one of your lddneys is not draining properly, which can occur with bladder cancer. Although images of your bladder can be obtained, an ultrasound cannot rule out evidence of cancer. Ultrasound was a primary test used in the past to evaluate patients with bladder cancer; however, we now have better tests that allow us to image your entire urinary tract in greater detail. Ultrasound pros include its noninvasiveness and lack of radiation, whereas its cons remain its lack of fine details and the fact that some very small tumors can be missed.

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An intravenous pyelogram, or IVP, is a test used to define the anatomy of your urinary tract using intravenous dye and an x-ray machine. Doctors order this test to determine whether or not there are any blockages or tumors in the renal pelvis, ureter, or bladder. Often, patients are asked to have a light meal the night before an IVP and to skip breakfast the morning of the exam. You may be given instructions to perform a bowel prep using magnesium citrate, a laxative available in your local pharmacy or supermarket, This clears out your small intestine and colon as these may interfere with visualization of your urinary tract. If you have diabetes and are using Glucophage (metformin), you may need to stop these medications several days in advance. This should be coordinated by your urologist and primary care physician.

IVPs can take an hour to perform because images are taken of your abdomen at various time points. You may feel a warm sensation, become nauseated, or have a metallic taste in your mouth when the dye is injected. There are several reasons why you should not have an IVP performed, and these will be explained by your doctor. If you have an allergy to IV dye, you could have a potentially severe allergic reaction. In some cases, steroids are given to prevent this from occurring. Either way, this is something that must be discussed with your doctor before the exam. If you have abnormal kidney function, another test will most likely be performed instead of an IVP. This is because the IV dye can worsen your kidney function. If you are pregnant, another test will be performed because of the potentially small risk that the radiation from the x-ray machine poses to the developing fetus. If you have asthma, multiple myeloma, sickle cell disease, pheochromocytoma, or a tumor of your adrenal gland, your physician may order another test because you may also be at greater risk of complications from the exam.

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IVP pros include its ability to assess how well your kidneys are working and the images that it can obtain of your renal pelvis and ureter. Its cons include x-ray radiation exposure in addition to the risks of an allergic reaction to IV contrast and potential worsening of borderline kidney function. IVPs are still ordered to evaluate people with blood in their urine or a diagnosis of bladder cancer, but it is slowly being replaced by other, more accurate imaging modalities including CT scan and MRI.

A CT, or CAT scan, is a computed tomographic scan that obtains accurate, detailed images of the body and its contents. It allows radiologists to look at detailed images of all your internal organs, including your heart, lungs, liver, brain, kidneys, and bladder, in addition to soft tissues like lymph nodes. CT scans are performed in radiolog)’ departments by radiologists with the assistance of nurses and technicians. The actual exam may only last 15 minutes, but you may be in the radiolog)’ area for an hour. As with the preparation for an IVP, you wall be asked to eat a light dinner the night before, and some doctors prefer bowel preparation with a laxative the day before. You should not eat anything in the 8 hours before your scheduled appointment. Those with diabetes using Glucophage must stop taking these medications several days before die scan if IV dye will be used and will not be able to resume use of these medications for 48-72 hours after the scan. This is because of a potential harmful reaction from the medications and IV dye. Some physicians prefer that this exam be done after drinking a chalky oral dye to better differentiate your intestine from parts of your urinary tract. The pros of CT include the detailed images that it provides in addition to the relatively short amount of time it takes to perform the exam. Its cons are the risk of radiation exposure to the developing child in a pregnant woman and risk of an allergic reaction to IV dye.

Our use of the term or terms Actos Bladder Cancer is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Bladder Cancer :

The first T level refers to Ta or Tl tumors, which are superficial in nature. These noninvasive tumors can be papillary or carcinoma in situ (CIS), and have penetrated only the epithelium or intermediate cell layers of the bladder. This is an early, highly treatable stage of bladder cancer. The Ta tumor is the least invasive (or most superficial) variant, whereas theTl tumor shows the beginnings of invasion into the first layer of the bladder wall (before muscle is reached).

Tumors that are invasive and have moved into the muscle layer of the bladder are classified as T2. The lowercase letters a and b are used to describe how far into the muscle the tumor has spread. A T2a tumor has not penetrated as deeply into the muscle as a T2b tumor.

Tumors classified as T3, which can be further classified by the letters a and b, have penetrated beyond the bladder wall and into the fatty tissue surrounding the outside of the bladder. A T3a tumor is visible only with a microscope. A T3b tumor is visible in scans or to the naked eye during surgery.

AT4 tumor, the most serious and advanced of this local tumor grouping, has spread to other tissues or organs. A T4a tumor has inyaded the nearby uterus or vagina in a woman or the prostate in a man. A T4b tumor has spread through the pelvic or abdominal wall into the body.

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The letter N, followed by a numeral from one to three (1 to 3), tells your doctor whether your cancer has spread to lymph nodes near the bladder and how deeply the cancer has penetrated the nodes. The higher the number, the more lymph nodes are involved and the more enlarged the nodes are.

The letter Mfollowed by a one or a zero (1 or 0) indicates whether your cancer has spread to lymph nodes in other parts of the body (beyond the pelvis) or to other organs such as the lungs or liver. A zero indicates that the cancer has not spread to other organs; the number one means that it has.

Once your doctor and pathologist have determined your TNM values, the results will be combined and expressed as Roman numerals from zero to four (0 to IV). Stage IV, for example, is the most advanced and serious stage of cancer. The stages help predict rates of survival five years after treatment; they range from 98 percent survival in the Stage 0 category to about 15 percent in the Stage IV category. The stage of your cancer also helps doctors decide how aggressive to be in recommending treatment options,

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The terms Stage I or Stage IVare like medical shorthand, giving your physician a quick indication of overall prognosis and the general type of treatment that will be needed.

Grading tumors is another tool for your doctor. Instead of measuring how invasive the tumor is, grading indicates how abnormal the tumor cells appear under the microscope. The more abnormal, or undifferentiated, the tumor cells are, the more likely it is your cancer will spread aggressively.

Pathologists use the numerals one, two, or three (1, 2, or 3) or the words low, medium, or high to describe how abnormal the tumor cells appear. A tumor graded three (3) or higher is the most likely to spread aggressively. In some systems, grading is done on a scale of one to four.

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Actos Lawyer 12/21/2011: The urethra is a hollow tube lined with transitional cells at its beginning that connects the bladder to the outside world. The structure of the urethra is different in men and women. The urethra is short in women and is much longer in men due to the presence of the penis. The cells lining the urethra change along its length. The inner cells, closest to the bladder, are transitional cells, whereas the cells closest to the outside of the body are squamous cells resembling skin. Although the urethra has different lengths in men and women, it functions the same. In men, the urethra passes through the prostate gland near the bladder.

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Actos Bladder Cancer12/20/2011: This brief review undermines the uncertainty of receiving chemotherapy during an experimental protocol. If the individual needs chemotherapy, it is generally safer and wiser to receive the standard regimen already established as safe and possibly effective. If however, prior standard chemotherapy has proven to be ineffective, or if the patient cannot tolerate standard therapy and the patient’s health allows for additional chemo, enrollment in a chemotherapy trial may be appropriate if the individual qualifies. At times, there can be breakthroughs and new agents can be more effective in eradicating cancer than the established drugs.

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Actos Attorney 12/15/2011: If a urine dipstick is positive for blood, it is recommended to check the urine under a microscope. The urine is first spun down to separate out the sediment and is then examined under the high power lens. If there are more than 3 red blood cells per high power field it is felt to be significant. If there are no other reasons for the presence of blood such as a urinary infection, the urine should be rechecked. If there is a persistent presence of significant microscopic hematuria, an assessment is recommended. When there is a large amount of microscopic hematuria, especially in older individuals with risk factors for bladder cancer, there is no need to repeat the urinalysis as a workup should be done.

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Our use of the Terms Actos Side Effects, Actos Bladder Cancer is not intended to imply or insinuate that there is any relationship or connection between Best Legal Source and the maker of Actos. Actos is a trademark of its manufacturer, Takeda Pharmaceutical Company Limited. Best Legal Source is not the maker of Actos nor do we have any connection with Takeda Pharmaceutical Company Limited.

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