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BLADDER CANCER

UNDERSTANDING THE PROBLEM

The bladder is a hollow organ in the lower part of the abdomen that stores urine until it is passed out of the body. It is shaped like a small balloon and has a muscular wall that allows it to get larger or smaller. The urine passes from the two kidneys into the bladder through two tubes called ureters. The bladder is emptied through another tube called the urethra.

Bladder cancer begins when cells in the urinary bladder start to grow uncontrollably. As more cancer cells develop, they can form a tumour and spread to other areas of the body.

There are three types of bladder cancer that begin in cells in the lining of the bladder: transitional cell carcinoma; squamous cell carcinoma; and adenocarcinoma.

Cancer that is confined to the lining of the bladder is called superficial bladder cancer. Cancer that begins in the transitional cells may spread through the lining of the bladder and invade the muscle wall of the bladder or spread to nearby organs and lymph nodes; this is called invasive bladder cancer.

UNDERSTANDING WHO SUFFERS

According to US statistics, bladder cancer is fairly common, compared to other cancers, affecting approximately 45,000 men and 17,000 women per year. In 2016, it is estimated that there will be 76,960 new cases of bladder cancer will almost 80% being treatable. The incidence of bladder cancer increases with age, with the median age at diagnosis being 65 years and is twice as high in white men as in black men in the United States; bladder cancer is rarely diagnosed before age 40 years and is about 3 times more common in men than women.

POTENTIAL SIGNS AND SYMPTOMS

The most common symptoms of bladder cancer include:

  • Blood or blood clots in the urine (hematuria). Hematuria occurs in 8 or 9 out of 10 people who have bladder cancer and is the most common symptom. Usually it isn't painful.
  • Pain during urination (dysuria).
  • Urinating small amounts frequently.
  • Frequent urinary tract infections (UTIs).

Symptoms that may indicate more advanced bladder cancer include:

  • Pain in the lower back around the kidneys (flank pain).
  • Swelling in the lower legs.
  • Blood in the urine or semen.
  • A growth in the pelvis near the bladder (pelvic mass).

Other symptoms that may develop when bladder cancer has spread include:

  • Weight loss.
  • Bone pain or pain in the rectal, anal, or pelvic area.
  • Anemia.
EXAMINATIONS USUALLY REQUIRED

A thorough physical exam (this may include a rectal exam, a prostate exam for men, or a pelvic exam for women) combined with a complete medical history (including smoking history, possible exposure to cancer-causing chemicals and family history of cancer) are needed to confirm bladder cancer.

Tests and procedures used to diagnose whether bladder cancer is apparent may include:

  • Urinalysis. A simple urine test that can confirm that there is bleeding in the urine and can also provide an idea about whether an infection is present or not.
  • Urine cytology. A sample of urine is analysed under a microscope to check for cancer or pre cancer cells.
  • Urine tumor marker tests
    Different urine tests look for specific substances released by bladder cancer cells. One or more of these tests may be used along with urine cytology to help determine if you have bladder cancer. These include the tests for NMP22 (BladderChek) and BTA (BTA stat), the Immunocyt test, and the UroVysion test.
    Ultrasound: An ultrasound examination of the bladder can detect bladder tumors. It can also detect the presence of swelling in the kidneys in case the bladder tumor is located at a spot where it can potentially block the flow of urine from the kidneys to the bladder
  • Cystoscopy. During cystoscopy, doctors insert a narrow tube (cystoscope) through the urethra. The cystoscopy has a lens and fiber-optic lighting system, allowing the doctors to see and examine the inside of the urethra and bladder. Usually a local anaesthetic is received during cystoscopy.
  • Fluorescence cystoscopy or blue light cystoscopy
    This may be done along with routine cystoscopy, where a light-activated contrast dye is put into the bladder during cystoscopy. When Fluorescent light is shone through the cystoscope, any cells containing the dye will by highlighted to help see abnormal areas that might have been missed by the white light normally used.
  • Biopsy. During cystoscopy, doctors may pass a special tool through the scope and into the bladder in order to collect a cell sample (biopsy) for testing. This procedure is sometimes called transurethral resection of bladder tumor (TURBT). TURBT can also be used to treat bladder cancer. TURBT is usually performed under general anesthesia.
  • Imaging tests. Imaging tests allow doctors to examine the structures of the urinary tract. Tests to highlight the urinary tract normally use a dye, which is injected into a vein before the procedure. An intravenous pyelogram is a type of X-ray imaging test that uses a dye to highlight the kidneys, ureters and bladder. A computerized tomography (CT) scan is a type of X-ray test that allows doctors to better see the urinary tract and the surrounding tissues.
  • Urine culture. This this test may be done to see if an infection (rather than cancer) is the cause. Urinary tract infections and bladder cancers can have similar symptoms.
PROPOSING TREATMENT AND WHY AIMIS

 

Treatment options depend on the stage of bladder cancer (Stage 0 to Stage 4). There are four standard treatment options for bladder cancer which include Surgery, Radiation, Chemotherapy and Biologic Therapy. It is important to discuss all treatments and surgical options with a doctor before deciding which is best for each individual situation.

Once a doctor confirms the diagnosis, surgery may be needed. A cystectomy is the removal of all or part of the bladder and possibly the removal of nearby lymph nodes and organs that may contain cancer. If the bladder is removed, the surgeon creates a new path for urine to be stored and to leave the body.

If surgery is required, AIMIS is an expert in Robotic Surgery (Cystectomy) involving the best American and International surgeons who are experts in the field.

AIMIS provides Robotic and Laparoscopic surgical options providing many benefits over typical open surgery. It performs the latest techniques in Robotic surgery to ensure the best surgical outcomes and owns the superior da Vinci Xi Robot, the latest in robotics technology.

As a result of da Vinci technology, da Vinci Cystectomy offers many potential benefits when compared to traditional open surgery, including:

  • Favourable Operative and pathologic (more precise removal of cancerous tissue ) outcomes
  • Precise and rapid bladder removal with minimal blood loss and need of transfusion
  • Enhanced ability to preserve the neurovascular bundles (dependent on patient)
  • More rapid return of Bowel function and quicker return to a normal diet.
  • Less pain
  • Minimal scarring
  • Lower risk of complications and significantly reduced risk of major complications
  • Shorter hospital stay
  • Less chance of hospital readmission or follow-up surgery
  • Less risk of deep vein thrombosis (life-threatening condition where a blood clot forms deep in the body)
  • Faster recovery and return to normal activities

To see the procedures we undertake with Robotic Xi Surgery, please click here

GETTING MORE INFORMATION BEFORE MOVING FORWARD
YOU MAY HAVE QUESTIONS LIKE:
  • Can I get more information before I commit to this?
  • Can I get a second opinion from you before I commit to this?
  • How can I find out the cost before I have any obligation?
WHAT AIMIS CAN DO:

AIMIS will provide a full review, diagnosis and potential surgical options for your condition, after receiving the relevant examinations and information from you. They will also provide an estimate for your surgical procedure before you decide.

AIMIS’ mission is to the provision of “true” healthcare for those who require it. It provides world leading surgeons using state of the art procedures to optimize potential surgical outcomes, whilst taking care of all arrangements so as to allow concentration on recovery.

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AFFORDABILITY

AIMIS provide competitive prices for state of the art procedures. We also work with a large range of Insurance companies where your policy allows you to have surgery abroad.

 

FURTHER INFORMATION ON THE PROBLEM:

About 3 times as many men as women develop bladder cancer. Smoking is the greatest single risk factor and seems to be one of the causes in at least half of all new cases. Certain chemicals that are used in industry can become concentrated in the urine and cause cancer, although exposure to these chemicals is decreasing. These chemicals include hydrocarbons, aniline dyes (such as naphthylamine used in the dye industry) and chemicals used in the rubber, electric, cable, paint, and textile industries. Long-term exposure to some drugs, especially cyclophosphamide, increases the risk of bladder cancer. The chronic irritation that occurs with a parasitic infection called schistosomiasis or with a bladder stone also predisposes people to bladder cancer, although irritation accounts for only a small proportion of all cases. Most bladder cancers are of a type called transitional cell, affecting the same kinds of cells (transitional cells) that are usually the cancerous cells responsible for renal pelvis and ureter cancers.

The most common grading systems use 2 main grades:

  • Low-grade tumors grow more slowly. Though they may come back (recur) after treatment, they rarely spread to the muscle of the bladder. They also don't often spread to other parts of the body. The cells of low-grade tumors have only minor differences from normal cells.
  • High-grade tumors grow more quickly. They often recur after treatment and are more likely to spread to other parts of the body. The cells are disorganized and look abnormal

When cancer cells spread, it's called staging.

The stages of bladder cancer are:

  • Stage I. Cancer at this stage occurs in the bladder's inner lining but hasn't invaded the muscular bladder wall.
  • Stage II. At this stage, cancer has invaded the bladder wall but is still confined to the bladder.
  • Stage III. The cancer cells have spread through the bladder wall to surrounding tissue.
  • Stage IV. By this stage, cancer cells may have spread to the lymph nodes and other organs.
FURTHER INFORMATION ON INCREASED RISK GROUPS

The following factors can increase the risk of developing bladder cancer:

  • Smoking: smoking causes half of all bladder cancers in men and women
  • Workplace exposures, certain medicines and herbal supplements can actually change the risk factors.
  • Race: Whites are more likely to develop bladder cancer as African Americans and Hispanics. Age: About 9-10 people with bladder cancer are older than 55.
  • Gender: It is much common in men than in women.
  • Genetics and Family history: People who have family members with bladder cancer have a higher risk of getting it themselves. Sometimes this may be because the family members are exposed to the same cancer-causing chemicals (such as those in tobacco smoke). They may also share changes in some genes (like GST and NAT) that make it hard for their bodies to break down certain toxins, which can make them more likely to get bladder cancer.
  • chronic bladder infections
  • low fluid consumption
  • High fat diet
  • having previous treatment with a chemotherapy drug called Cytoxan
  • having previous radiation therapy to treat cancer in the pelvic area
FURTHER EXAMINATION THAT MAYBE REQUIRED OR REQUESTED

Once bladder cancer is confirmed, doctors may order additional tests to determine the extent (stage) of the cancer (in addition to test outlined at the beginning of this page):

  • Computed tomography (CT) scan, to provide detailed information about the size, shape, and position of any tumors in the urinary tract, including the bladder.
  • Magnetic resonance imaging (MRI) scan, show detailed images of soft tissues in the body.
  • Bone scan
  • Chest X-ray
WHY AIMIS FOR THIS SURGERY

If surgery is required, AIMIS is an expert in Robotic Surgery (Cystectomy) involving the best American and International surgeons who are experts in the field.

AIMIS provides Robotic and Laparoscopic surgical options providing many benefits over typical open surgery. It performs the latest techniques in Robotic surgery to ensure the best surgical outcomes and owns the superior da Vinci Xi Robot, the latest in robotics technology.

As a result of da Vinci technology, da Vinci Cystectomy offers many potential benefits when compared to traditional open surgery, including:

  • Favourable Operative and pathologic (more precise removal of cancerous tissue ) outcomes
  • Precise and rapid bladder removal with minimal blood loss and need of transfusion
  • Enhanced ability to preserve the neurovascular bundles (dependent on patient)
  • More rapid return of Bowel function and quicker return to a normal diet.
  • Less pain
  • Minimal scarring
  • Lower risk of complications and significantly reduced risk of major complications
  • Shorter hospital stay
  • Less chance of hospital readmission or follow-up surgery
  • Less risk of deep vein thrombosis (life-threatening condition where a blood clot forms deep in the body)
  • Faster recovery and return to normal activities
OTHER SERVICES PROVIDED BY AIMIS

In addition to its Innovative Healthcare, AIMIS provides seamless service along the way. From the start of your journey you'll know the best flights to take, where you'll be staying, what paperwork you will need. You will have a personal assistant assigned; from your pick up at the airport, to your accommodation, continuous assistance at your pre-consultation, through surgery and in your postsurgical care. Our Patients have said that they feel they have become "part of our family" and some even asked to stay a little longer! AIMIS is here to assist you in an all you requirements, allowing you to focus on your health and recovery.

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