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Is Transitional Cell Carcinoma Curable

Localized/early Transitional Cell Carcinomas Of Bladder

Transitional cell carcinoma – an Osmosis preview

Transitional cell carcinomas can be very difficult to treat. Treatment for localized stage transitional cell carcinomas is surgical resection of the tumor, but recurrence is common. Some patients are given mitomycin into the bladder either as a one-off dose in the immediate post-operative period or a few weeks after the surgery as a six dose regimen.

Localized/early transitional cell carcinomas can also be treated with infusions of into the bladder. These are given weekly for either 6 weeks or 3 weeks . Side effects include a small chance of developing systemic tuberculosis or the patient becoming sensitized to BCG, causing severe intolerance and a possible reduction in bladder volume due to scarring.

In patients with evidence of early muscular invasion, radical curative surgery in the form of a cysto-prostatectomy usually with lymph node sampling can also be performed. In such patients, a bowel loop is often used to create either a “neo-bladder” or an “ileal conduit” which act as a place for the storage of urine before it is evacuated from the body either via the urethra or a urostomy respectively.

Treatment Of Canine Transitional Cell Carcinoma

As with most tumors, the initial treatment for transitional cell carcinoma in dogs is wide surgical removal. However, the tumor is frequently found in an area that is difficult to excise or is more extensive than can be assessed clinically. Therefore, surgery rarely will cure dogs with TCC. A surgical debulking procedure may improve the survival time of dogs with TCC. This procedure will be explained with you if it is believed to be an option for your pet.

When wide surgical removal is not a viable option, radiation therapy can be used for local tumor control since we can often irradiate a larger area than a surgeon can remove. Radiation therapy has been used in humans for decades to control urinary tract tumors. At MedVet, we have frequently treated bladder and urethral tumors with radiation therapy when surgical removal is not possible. Both improvement in clinical symptoms and a decrease in tumor size are often observed in dogs treated with radiation therapy.

Nonsteroidal anti-inflammatory drugs have potential anti-cancer effects and have been shown to be beneficial for dogs with TCC. At this time, a combination of aggressive local control , chemotherapy, and NSAIDs is the recommended treatment for dogs with lower urinary tract tumors.

Are There Any Factors That Might Affect The Lab Results In Particular Does Your Patient Take Any Medications Otc Drugs Or Herbals That Might Affect The Lab Results

Evaluation of hematuria is the most important laboratory medicine test, and knowledge of its differential diagnosis is important. Pseudohematuria can by caused by food, such as beets, or food dyes. It may be caused by certain medications, such as phenytoin, rifampin, or pyridium. Pigments, such as porphyria, myoglobin, or hemoglobin, will also appear as hematuria. The latter usually results from intravascular hemolysis.

In the renal parenchyma, postinfectious glomerulonephritis, thin basement membrane disease, IgA nephropathy, membranoproliferative glomerulonephritis, focal glomerulosclerosis, and cresentic glomerulonephritis all represent primary glomerular causes of hematuria. Diabetes mellitus, lupus erythematosus, Goodpasture syndrome, polyarteritis nodosa, and endocarditis represent systemic causes of hematruia, as do hemolytic-uremic syndrome, throbotic thrombocytopenic purpura, Henoch-Schonlein purpura, malignant hypertension, polycystic kidney disease, hereditary nephritis, and Fabry disease.

Other causes of hematuria are acute pyelonephritis, nephrolithiasis, renal cyst, renal trauma, other renal neoplasms, low clotting factors, thrombocytopenia, acute interstitial nephritis, analgesic nephropathy, sickle cell trait or disease, medullary sponge kidney, malaria, papillary necrosis, and renal infarction.

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Prognosis & Survival Rate

The prognosis of the Urothelial Carcinoma depends upon the invasive nature of the malignancy and spreading of metastasizing. In the case of initial stage low-grade cancerous lesion provides a good prognosis, whereas poor prognosis is reported with the high grade cancerous lesion. The local invasion of the carcinoma can provide 5 years survival, whereas involvement of the lymph nodes can cause 0 to 30 percent 5 years survival1.

References

  • David F Jarrard. Urothelial Tumors of the Renal Pelvis and Ureters. Sep 18, 2016. Medscape. Online available at http://emedicine.medscape.com/article/452449-overview#a8
  • MARIANA DEACU, MDLINA BOOTEANU, MARIANA ACHIE, GABRIELA BLTESCU, V. SÃRBU, MARIANA BRDA Urothelial carcinoma of the renal pelvis associated with cystic disease of the kidney. Rom J Morphol Embryol. 2011 52:497-501. Online available at https://www.ncbi.nlm.nih.gov/pubmed/21424101
  • Rugvedita Parakh, Monika Roychowdhury, Bladder Urothelial carcinoma-invasive General. 18 July 2016. Online available at http://www.pathologyoutlines.com/topic/bladderurothelialinvasivegen.html
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    What Is Transitional Cell Carcinoma

    Bladder Transitional Cell Carcinoma, Light Micrograph ...

    4.6/5Transitional cell carcinomaurothelial carcinomacancercancercancerseen here

    Transitional cell carcinoma of the renal pelvis, accounting for only 7% of all kidney tumors, and transitional cell cancer of the ureter, accounting for only 1 of every 25 upper urinary tract tumors, are curable in more than 90% of patients if they are superficial and confined to the renal pelvis or ureter.

    Subsequently, question is, is transitional cell carcinoma malignant? Transitional cell cancer of the renal pelvis and ureter is a disease in which malignant cells form in the renal pelvis and ureter. The renal pelvis is the top part of the ureter. The ureter is a long tube that connects the kidney to the bladder.

    People also ask, what does transitional cell cancer mean?

    Transitional cell cancer is a rare type of kidney cancer. Transitional cells are able to change shape and stretch. They make up the lining of the renal pelvis, ureters, bladder and urethra. The lining of these organs needs cells that can stretch to expand when urine is stored in or flows through them.

    What causes transitional cell carcinoma?

    The causes of the disease haven’t been fully identified. However, genetic factors have been noted to cause the disease in some patients. Other potential risk factors for the development of this type of cancer include: abuse of phenacetin

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    Treating Bladder Cancer That Progresses Or Recurs

    If cancer continues to grow during treatment or comes back after treatment , treatment options will depend on where and how much the cancer has spread, what treatments have already been used, and the patient’s overall health and desire for more treatment. Its important to understand the goal of any further treatment if its to try to cure the cancer, to slow its growth, or to help relieve symptoms as well as the likely benefits and risks.

    For instance, non-invasive bladder cancer often comes back in the bladder. The new cancer may be found either in the same place as the original cancer or in other parts of the bladder. These tumors are often treated the same way as the first tumor. But if the cancer keeps coming back, a cystectomy may be needed. For some non-invasive tumors that keep growing even with BCG treatment, and where a cystectomy is not an option, immunotherapy with pembrolizumab might be recommended.

    Cancers that recur in distant parts of the body can be harder to remove with surgery, so other treatments, such as chemotherapy, immunotherapy, targeted therapy, or radiation therapy, might be needed. For more on dealing with a recurrence, see Understanding Recurrence.

    Risk Factors For Bladder Cancer

    Cigarette smoking predisposes people to bladder cancer. Smoking cigarettes increases a persons risk of developing bladder cancer approximately 5 fold. Industrial exposure to certain chemicals such as analine in the dye industry increases the risk. Other organic chemicals used in rubber and other manufacturing processes can also increase the risk. Exposure to the chemotherapy agent Cyclophosphamide is associated with a higher risk of developing bladder cancer. Chronic irritation of the bladder appears to provoke development of bladder cancer. The bladder can be irritated by reoccurring infections and bladder stones. In certain parts of Africa and in the Mediterranean area, a parasitic infection called schistosomiasis causes irritation of the lining of the bladder. The parasites that burrow into the bladder appear to stimulate the tumour.

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    Significance Of Hub Genes In The Prognosis Of Patients With Bladder Transitional Cell Carcinoma

    By screening the subnetworks, the MCODE score of each gene in the subnetworks was obtained. In order to further explore their ability in predicting prognosis, a total of 33 hub genes including the top 30 genes of MCODE score in Module 1 and seed genes in Module 2 and Module 3 were selected for subsequent analysis. In TCGA-BLCA data set, the median of gene expression in all tumor samples was used as the cutoff value for grouping. The results of KaplanMeier survival analysis exhibited that the OS rate and PFS rate of patients with high expression of Cyclin B1 and Actin Alpha Cardiac Muscle 1 were remarkably lower . Furthermore, patients with high expression of Assembly Factor for Spindle Microtubules had a dramatically lower PFS rate , but there was no significant difference in OS . Overall, the three hub genes including CCNB1, ASPM, and ACTC1 had good prognostic value in BTCC.

    Figure 4. Significance of hub genes in the prognosis of patients with bladder transitional cell carcinoma . Overall survival and progression-free survival analysis of patients based on high and low expression of CCNB1, respectively. OS and PFS analysis of patients based on high and low expression of ACTC1, respectively. OS and PFS analysis of patients based on high and low expression of ASPM, respectively. The red line represents high-expression group, and the blue line represents low-expression group.

    Urothelial Carcinoma The Most Common Form Of Bladder Cancer Linked To Smoking

    Transitional Cell Carcinoma in Dogs (TCC)

    Doru Paul, MD, is triple board-certified in medical oncology, hematology, and internal medicine. He is an associate professor of clinical medicine at Weill Cornell Medical College and attending physician in the Department of Hematology and Oncology at the New York Presbyterian Weill Cornell Medical Center.

    While bladder cancer may not be as frequently spotlighted as other types of cancer like melanoma, lung cancer, or breast cancer, it’s the fourth most common cancer in American men and the ninth most common in American women. According to data from the Centers for Disease Control and Prevention, over 55,000 men and 17,000 women get bladder cancer in the U.S. every year. Of these, nearly 16,000over one in fourwill die as a result of a malignancy.

    The most common type of bladder cancer is called transitional cell carcinoma . Also known as urothelial carcinoma , TCC arises from the inner lining of the urinary tract called, aptly, the transitional urothelium.

    TCC can develop in tissue from anywhere along the tract, including:

    • The renal sinus
    • The ureter
    • The innermost lining of the bladder
    • The urethra
    • The urachus

    TCC is considered the second most common cause of kidney cancer when involving the renal sinus.

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    Treating Stage Ii Bladder Cancer

    These cancers have invaded the muscle layer of the bladder wall , but no farther. Transurethral resection is typically the first treatment for these cancers, but it’s done to help determine the extent of the cancer rather than to try to cure it.

    When the cancer has invaded the muscle, radical cystectomy is the standard treatment. Lymph nodes near the bladder are often removed as well. If cancer is in only one part of the bladder, a partial cystectomy may be done instead. But this is possible in only a small number of patients.

    Radical cystectomy may be the only treatment for people who are not well enough to get chemo. But most doctors prefer to give chemo before surgery because it’s been shown to help patients live longer than surgery alone. When chemo is given first, surgery is delayed. This is not a problem if the chemo shrinks the bladder cancer, but it might be harmful if the tumor continues to grow during chemo.

    If cancer is found in nearby lymph nodes, radiation may be needed after surgery. Another option is chemo, but only if it wasn’t given before surgery.

    For people who have had surgery, but the features of the tumor show it is at high risk of coming back, the immunotherapy drug, nivolumab, might be offered. When given after surgery, nivolumab is given for up to one year.

    For patients who cant have surgery because of other serious health problems, TURBT, radiation, chemotherapy, or some combination of these may be options.

    Low Grade And High Grade

    Bladder cancer can also be described as either low grade or high grade.

    Low grade bladder cancer means that your cancer is less likely to grow, spread and come back after treatment. High grade means your cancer is more likely to grow spread and come back after treatment.

    For example, if you have early bladder cancer but the cells are high grade, youâre more likely to need further treatment after surgery. This is to reduce the risk of your cancer coming back.

    Low grade is the same as grade 1. High grade is the same as grade 3. Grade 2 can be split into either low or high grade. Carcinoma in situ tumours are high grade.

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    What Is Treatment For Bladder Cancer In Dogs

    Treating bladder cancer in dogs can consist of one or multiple treatment approaches. For small masses that are confined to the bladder, surgery may be advised. However, bladder tumors are often in locations that are not amenable to surgery. Chemotherapy is a common treatment for bladder cancer in dogs.

    Transitional Cell Carcinoma: Symptoms Diagnosis And Treatment

    LM of transitional cell carcinoma of bladder

    Transitional cell carcinoma is a cancerous tumor most commonly found in the urinary bladder and the urethra.

    It is most often seen in older small breed dogs such as Scottish terriers, West Highland white terriers, dachshunds, and Shetland sheepdogs and rarely identified in cats.

    There appears be a genetic component to the development of TCC, especially in Scottish terriers. Rare cases have been linked with the use of cyclophosphamide and chronic exposure to hydrocarbons. Many times a cause is not determined.

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    Signs And Symptoms Of Transitional Cell Cancer Of The Renal Pelvis And Ureter Include Blood In The Urine And Back Pain

    These and other signs and symptoms may be caused by transitional cell cancer of the renal pelvis and ureter or by other conditions. There may be no signs or symptoms in the early stages. Signs and symptoms may appear as the tumor grows. Check with your doctor if you have any of the following:

    • Blood in the urine.
    • A pain in the back that doesn’t go away.
    • Extreme tiredness.
    • Weight loss with no known reason.
    • Painful or frequent urination.

    Types Of Transitional Cell Carcinoma

    Also known as urothelial carcinoma, transitional cell carcinoma affects the renal pelvis and ureter. All bladder cancers have two subtypes of tumors that are classified based on how they grow. Papillary carcinomas are slim, finger-shaped tumors that originate in the bladders inner surface and grow deeper into the hollow portion of the bladder. Flat carcinomas have a similar appearance but do not grow into the bladders hollow center.

    Because both types of tumors can spread beyond the renal pelvis and ureter areas, specific cases of transitional cell carcinoma are referred to in numerous ways. These include:

    • Invasive urothelial or transitional cell carcinoma
    • Papillary urothelial neoplasm of low-malignant potential
    • Non-invasive flat carcinoma or flat carcinoma in situ
    • Primary transitional cell carcinoma of the prostate, colon, breast, or lung

    Your oncologist will explain the details of your diagnosis to ensure you feel comfortable in your treatment plan and understand what to expect.

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    Transitional Cell Cancer Of The Renal Pelvis And Ureter Is Also Described As Localized Regional Metastatic Or Recurrent:

    Localized

    The cancer is found only in the kidney.

    Regional

    The cancer has spread to tissues around the kidney and to nearby lymph nodes and blood vessels in the pelvis.

    Metastatic

    The cancer has spread to other parts of the body.

    Recurrent

    The cancer has recurred after it has been treated. The cancer may come back in the renal pelvis, ureter, or other parts of the body, such as the lung, liver, or bone.

    Sarcomatoid Carcinoma Of The Urinary Bladder

    Transitional Cell Carcinoma, Causes, Signs and Symptoms, Diagnosis and Treatment.

    The sarcomatoid areas may merge with foci of urothelial carcinoma , squamous cell carcinoma, adenocarcinoma or small-cell carcinoma, and most commonly resemble a high-grade sarcoma, not otherwise specified, or have a malignant fibrous histiocytoma histology. Heterologous differentiation may be present but has no definite prognostic significance . In decreasing order of frequency, areas of osteosarcoma, chondrosarcoma, rhabdomyosarcoma, liposarcoma, angiosarcoma or a mixture of sarcoma histologies may be seen. In the absence of an obvious invasive carcinoma , in a primarily malignant spindle cell tumor of the bladder, history of prior urothelial neoplasia, coexistence of in situ disease such as urothelial carcinoma in situ or strong and relatively diffuse cytokeratin immunoreactivity is helpful in making the diagnosis of sarcomatoid carcinoma over a primary sarcoma. Earlier treatment with radiation therapy and intravesical cyclophosphamide chemotherapy has been associated with sarcomatoid carcinoma, as also with external beam radiation for prostate cancer.

    Figure 9

    Sarcomatoid carcinoma of the urinary bladder. Urothelial carcinoma and high-grade spindle cell morphology of sarcomatoid component. Heterologous cartilaginous differentiation.

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    Question: What Causes Transitional Cell Carcinoma In Dogs

    The exact cause of TCC in an individual dog is usually not known. In general, canine TCC results from a combination of several factors including genetic predisposition and environmental factors. A genetic predisposition is strongly suspected because TCC is more common in specific breeds of dogs.

    There Are Three Ways That Cancer Spreads In The Body

    Cancer can spread through tissue, the lymph system, and the blood:

    • Tissue. The cancer spreads from where it began by growing into nearby areas.
    • Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
    • Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.

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