Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
Bladder cancer is most frequently diagnosed on investigating the cause of
bleeding in the urine that a patient has noticed. The following are
investigations or tests that come in handy in such circumstances:
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. It is usually one of the first tests that is asked for by a physician.
It does not confirm that a person has bladder cancer but can help the physician
in short listing the potential causes of bleeding.
Urine cytology: This test
is performed on a urine sample which is centrifuged and the sediment is examined
under the microscope by a pathologist. The idea is to detect malformed cancerous
cells that may be shed into the urine by a cancer. A positive test is quite
specific for cancer (for example, it provides a high degree of certainty that cancer is
present in the urinary system). However, many early bladder cancers may be missed
by this test so a negative or inconclusive test doesn't effectively rule out the
presence of bladder cancer.
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. It can also
detect other causes of bleeding, such as stones in the urinary system or prostate
enlargement, which may be the cause of the symptoms or may coexist with a
bladder tumor.
CT scan/MRI: A CT scan or MRI provides greater visual detail
than can be afforded by an ultrasound exam and may detect smaller tumors in the
kidneys or bladder than can be detected by an ultrasound. It can also detect
other causes of bleeding more effectively than ultrasound especially when
intravenous contrast is used.
Cystoscopy and biopsy: This is probably the
single most important investigation for bladder cancer. Since there is always a
chance to miss bladder tumors on imaging investigations (ultrasound/CT/MRI) and
urine cytology, it is recommended that all patients with bleeding in the urine,
without an obvious cause, should have a cystoscopy performed by a urologist as a
part of the initial evaluation. This entails the use of a thin tube-like optical
instrument connected to a camera and a light source (cystoscope). It is passed
through the urinary passage into the bladder and the inner surface of the
bladder is visualized on a video monitor. Small or flat tumors which may not be
visible on other investigations can be seen by this method and a piece of this
tissue can be taken as a biopsy for examination under the microscope. The
presence and type of bladder cancer can be diagnosed most effectively by this
method.
Newer biomarkers like NMP 22 and
fluorescent in-situ hybridization
(FISH) are currently in use to detect bladder cancer cells by a simple urine
test. However, they have not yet achieved the level of accuracy to replace
cystoscopy and cytology in the diagnosis and follow-up of bladder cancer.
Lymph nodes help the body's immune system fight infections. Causes of swollen lymph nodes (glands) may include infection (viral, bacterial, fungal, parasites). Symptoms of swollen lymph nodes vary greatly. They can sometimes be tender, painful or disfiguring. The treatment of swollen lymph nodes depends upon the cause.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Hydronephrosis is a condition in which the kidney swells, due to a backup of urine. Hydronephrosis generally occurs with another disease.Symptoms of hydronephrosis include nausea, vomiting, urinary tract infection, fever, painful urination, increased urinary frequency and urgency, flank pain, and swelling of the abdomen. Treatment of hydronephrosis depends on the cause.
Smoking is an addiction. More than 430,000 deaths occur each year in the U.S. from smoking related illnesses. Secondhand smoke or "passive smoke" also harm family members, coworkers, and others around smokers. There are a number of techniques available to assist people who want to quit smoking.
Though it's difficult to say why some people develop cancer while others don't, research shows that certain risk factors increase a person's odds of developing cancer. These risk factors include growing older, family history of cancer, diet, alcohol and tobacco use, and exposure to sunlight, ionizing radiation, certain chemicals, and some viruses and bacteria.
Arsenic comes in two forms, inorganic and organic. Organic arsenic poisoning is usually not poisonous to humans; however, inorganic arsenic in large enough amounts can lead to shock and death. Symptoms of arsenic poisoning include nausea, abdominal pain, diarrhea, dehydration, dark urine, vertigo, delirium, shock, and death. Treatment for arsenic poisoning includes Hemodialysis and a variety of drugs.
Schistosomiasis (snail fever), a disease caused by parasites, causes a variety of symptoms and signs, such as cough, rash and bloody diarrhea. Praziquantel is used in the treatment of schistosomiasis.
Tumor grade is a system used to classify cancer cells in how likely the tumor is to grow, and how abnormal they look under a microscope. Tumor grade is not the same as tumor stage. A biopsy is taken to determine if the tumor is benign (non cancerous) or malignant (cancerous).
Urethral cancer is a rare form of cancer that primarily affects white females, people over 60 years of age, and those who have stds or who experience frequent urinary tract infections. Symptoms and signs of urethral cancer include blood in the urine, interrupted urine flow and discharge from the urethra. Treatment involves surgery, radiation therapy, and chemotherapy.
Smokeless tobacco can have negative health effects such as cancers, poor oral health (gum disease and tooth decay), infertility, pregnancy complications, and nicotine addiction.
Most often, caregivers take care of other adults who are ill or disabled. Less often, caregivers are grandparents raising their grandchildren. The majority of caregivers are middle-aged women. Caregiving can be very stressful, so it's important to recognize when it's putting to much strain on you and to take steps to prevent/relieve stress.
Disease prevention in men includes routine screening tests that are part of basic prevention medicine. Take an active role in your own health care and discuss screening tests with your doctor early in life. Age of screening and timing of screening depends upon the condition being assessed.
Disease prevention in women includes screening tests that are a basic part of prevention medicine. All screening tests
are commonly available through your general doctor. Some specialized tests may be available elsewhere.
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