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 staged using the tumor node metastases (TNM) system
developed by the International Union Against Cancer (UICC) in 1997.
The tumor or the T stage is accorded by a pathological examination of the
tumor specimen removed surgically. This refers to the depth of penetration of
the tumor from the innermost lining to the deeper layers of the bladder. The T
stages are as follows:
Tx - Primary tumor cannot be evaluated
T0 - No primary tumor
Ta -
Noninvasive papillary carcinoma (tumor limited to the innermost lining or the
epithelium)
Tis - Carcinoma in situ (flat tumor)
T1 - Tumor invades
connective tissue under the epithelium (surface layer)
T2 - Tumor invades
muscle of the bladder
T2a - Superficial muscle affected (inner half)
T2b -
Deep muscle affected (outer half)
T3 - Tumor invades perivesical (around the
bladder) fatty tissue
T3a - microscopically (visible only on examination under
the microscope)
T3b - macroscopically (for example, visible tumor mass on the outer
bladder tissue)
T4 - Tumor invades any of the following: prostate, uterus,
vagina, pelvic wall, or abdominal wall
The node or the N stage is determined by the presence and extent of
involvement of the lymph nodes in the pelvic region of the body near the urinary
bladder. The N stages are as follows:
Nx - Regional lymph nodes cannot be 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
The metastases or the M stage signifies the presence or absence of the spread
of bladder cancer to other organs of the body.
Mx - Distant metastasis cannot be evaluated
M0 - No distant metastasis
M1 - Distant metastasis
The proper staging of bladder cancer is an essential step which has
significant bearings on the management of this condition. The implications of
bladder stage are...
It helps select proper treatment for the patient. Superficial disease
(Ta/T1/Tis) can generally be managed with less aggressive treatment as compared
to invasive disease (T2/T3/T4).
Invasive tumors have a higher likelihood of
spread to lymph nodes and distant organs as compared to superficial tumors.
The
chances of cure and long-term survival progressively decrease as the bladder
cancer stage increases.
Staging allows proper classification of patients into
groups for research studies and study of newer treatments.
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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