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Actos Bladder Cancer Headlines

By admin | Published January 27, 2012

Actos Bladder Cancer : Keep your doctor informed if you are experiencing any of the above side effects. There are drugs that can help minimize these con”ditions and make your treatment more comfortable. Luckily, these side effects tend to disappear once you are no longer receiving chemotherapy, and you will gradually feel stronger and become less vulnerable to bleeding or infections.

For invasive bladder cancer, chemotherapy is sometimes given before you have a cystectomy. Sometimes it’s given afterwards. Sometimes it’s not given at all. It depends entirely on the type of tumor you have, where it may have spread, and whether you have another medical condition that might make it difficult for you to tol”erate chemotherapy. Very advanced age can also be a factor in decid”ing whether chemotherapy is appropriate.

The choice of drugs used to treat invasive bladder cancer is similar to the choice in advanced or metastatic disease. If you have invasive transitional cell carcinoma you will probably undergo chemotherapy, as this type of cancer is responsive to either radiotherapy or surgery with chemotherapy, and many stud”ies have examined this type of cancer treatment.

If you have been diagnosed with squamous cell cancer or adeno”carcinoma, the track record for chemotherapy is not so clearly defined. Most physicians don’t recommend chemotherapy as standard treatment in conjunction with cystectomy for these types of cancer. It is, however, quite reasonable for your team to suggest that you look into a clinical trial (for example, one that is exploring the use of chemotherapy) if you have been diagnosed with squamous cell or adenocarcinoma.

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Most of the reported trials indicate that the use of single chemother”apy drugs does not have an extensive beneficial effect, but that the use of combinations of three or four chemotherapy drugs can shrink the bladder cancer in around 70 percent of cases and can also improve the cure rate and length of survival. For you as a patient, the information gleaned from these clinical trials means that if you have TCC, your doctors are likely to recom”mend treatment that includes a “cocktail” of several carefully targeted chemotherapy drugs as well as cystectomy or radiotherapy.

In some cancers, such as breast cancer, it is pretty standard practice to give several doses of chemotherapy after surgery, especially for tumors with high-risk pathological features, such as lymph-node involvement. We know of six studies that have looked at this question in bladder cancer, but the results are somewhat inconclusive as to whether chemotherapy is most effective given before or after surgery.

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When radiation is used alone or with chemotherapy there is an increased likelihood that your other organs, such as the prostate and uterus, will remain functional, as does your ability to void urine normally and have sex. The intention when chemotherapy and radio”therapy are given is usually to improve the chances of curing the cancer while preserving the bladder and avoiding the need to remove it surgically. This area is still somewhat controversial; while some physicians believe that this approach is nearly as effective as surgical removal of the bladder, others feel that cystectomy is the best treat”ment The decision depends in part upon the physical fitness of the patient as well as upon the patient’s personal preferences.

The use of radiotherapy doesn’t mean that it is without side effects. There can be scarring of the bladder tissue, and that can reduce the amount of urine your bladder can hold. The result would be an increase in the number of times you have to urinate, which can be irritating, especially at night. You also may experience an increase in bouts of cystitis.

There has been much discussion about whether the results achieved by radiotherapy are the same as those from cystectomy with, respect to achieving cure. We think that when one considers all types of bladder cancer, in the hands of a highly experienced urologist who specializes in this operation, cystectomy gives better results than radiotherapy. However, there are some patients, particularly those with other significant medical conditions, who will benefit from radiotherapy despite the possibility of a lower chance of permanent cure. In some centers, such as Massachusetts General Hospital, where the techniques of chemoradiotherapy and bladder preservation have been piloted, a urologist wall perform a cystoscopy about halfway through the planned course of radiotherapy. If the tumor is shrinking well, radiotherapy will be completed. However, if it appears that the cancer is not responding to radiotherapy, the plan wall be abandoned and replaced with a radical cystectomy.

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

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Actos Bladder Cancer Info

By admin | Published January 27, 2012

Actos and Bladder Cancer: Radical cystectomy is the gold standard treatment for muscle-invasive bladder cancer and is also the procedure of choice for individuals with high-grade recurrent bladder tumors. Radical cystectomy has proven to provide excellent long-term cancer-free survival in individuals whose bladder cancer has not spread beyond their bladders or into their lymph nodes. Radical cystectomy is the therapy by which all other treatments are compared and judged.

Technically speaking, radical cystectomy for men involves removal of the bladder and prostate and also includes removal of the pelvic lymph nodes. In women, the bladder and typically the uterus, ovaries, fallopian tubes, and por”tions of the vagina are removed, although more recently surgeons have been moving toward preservation of some of these structures to improve quality of life. Because the main function of the bladder is to store urine that is made by the kidneys, a mechanism for diversion of urine outside of the body or storage of urine in a newly created reservoir must be performed in the same setting. Various types of urinary diversion are discussed below.

 

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By and large, you can expect to go home the same day that this procedure is performed. Depending on the extent and depth of resection, your urologist may decide to send you home with a Foley catheter in place for a few days to allow time for your bladder to heal. Generally, this procedure is well tolerated, but it is not uncommon to see blood in the urine for several days after the procedure. Many patients also experience lower urinary tract symptoms, including painful urination, frequency, and urgency for up to several weeks following the procedure.

 

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Our use of the term or terms Actos and 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

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Cell Phone Privacy Lawsuit Information

By admin | Published January 26, 2012

Cell Phone Privacy Lawsuit News- 1/25/2012: Increasingly, cell phone calls and computer communications, whether over personal computer, laptop, or handheld device with multiple functionality, are being transmitted over the Internet in a wireless form, giving users greater mobility and allowing them to work, socialize, and interact with others anyplace where there is wireless service available. Work is no longer confined to the office, playing games can take place alone or with anonymous participants in cyberspace, and daily life can incorporate multiple functions from different locations. For many, the typical nine-to-five workday is becoming a distant memory, and the types of activities formerly associated with “home,” “work,” and “leisure” are no longer clearly separated. There is some irony in thinking that using cell phones and the Internet gives us more flexibility about where we go and how we control our time, but at the same time, many people report that they feel more stress in their lives, rather than less. Could these two technologies be contributing to more stress, rather than simplifying or facilitating our lives?

Everyone has a strong opinion about cell phones. Many people complain that the cell phone is an annoyance, but then claim they couldn’t live without one. The cell phone is not just a more portable version of our traditional wired telephone. It is a small, portable technology that allows us to make phone calls and participate in a wide range of media interactions anywhere, anytime (as long as we’re in range of a cell tower). It is actually remarkable that in a period of about ten years, cell phones have become a “must-have” technology for many, despite the often-poor reception quality or unreliability of cell phones, the need to remember to charge them, and their extra cost. In the United States, where 92.9 percent of the population already has access to a telephone,1 the growth of the less reliable and more expensive cell phone is nothing short of a phenomenon.

The Internet became a viable form of communication as early as the 1960s, but the commercial explosion of home-based Internet use started in the early 1990s. Like many technologies that seem to become second nature to a segment of the population, the Internet has developed to provide a host ofservices that may have been already available to people in other ways before they found their way to the online world. Many people, particularly the younger members of our society, spend hours each day negotiating the world of the Internet—time they are not spending with other forms of media or with other people. Google’s acquisition of the popular Internet site YouTube, on which anyone can post video clips, made headlines in October 2006 because of the $1.65 billion (in stock) purchase price. Within two months, Verizon, Fox, CBS, and NBC announced that they, too, were collaborating on offering an Internet alternative to YouTube.5 The television and film industries know that they’ve got to court the Internet crowd or lose valuable viewers of traditional media content.

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Personal habits also condition people to use communication technologies in particular ways. Checking cell phone messages or answering e-mail first thing in the morning is now as much of a routine for many as having a cup of coffee or brushing your teeth. Getting news or music over the Internet is convenient and can be done while sending e-mail, reading the latest celebrity gossip, or working from home, all over the Internet. Who your “friends” are can be listed in an available directory on a cell phone or on any number of personal social networking sites on the Internet. When a cell phone is programmed to block calls from anyone who hasn’t been entered into an “approved” call list, or someone removes your name from their roster of “friends,” the number of interactions on either technology are limited. There is no surprise that many people claim that the more we have access to communication technologies, the less we really communicate.

Sometimes cell phones and the Internet are the catalysts for social change, and sometimes they reflect social change: either way, these technologies are contributing to subtle changes in American values and to how different groups (based on age, gender, class, and race) use those changes to define individual and group identities. This book is about the changes that cell phones and the Internet—the dynamic duo—are bringing to American life, where the technologies always seem to be “on.” As a cultural history, this book examines how these two technologies—separately and together—are contributing to a change in American attitudes, behaviors, and cultural values.

It is probably human nature to want to believe that all technologies make our lives easier, better, or more efficient. After all, commercials for these products and services promise us better control over the chaos of our lives. When we first start using a new technology, we experience a learning curve. For those who learn quickly, expectations for what the technology can do for us can be wonderful. Those who struggle to learn how to use the technology may experience greater stress or anxiety. Some people try something, only to realize that they don’t really like or need it. But those who do master the technology tend not to notice how they begin to rely on it. The instantaneous nature of communicating with cell phones and the Internet leads us to transmit and receive information faster and with less consideration for how it might affect our lives. Our ability to connect immediately, anywhere, anytime, to someone conditions us to think of all activities in full operation twenty-four hours a day, seven days a week. That hum we feel in the air may be constant, invisible potential for immediacy—or it may well be anxiety, particularly for those who allow these technologies to infiltrate so many aspects of daily life. Or, it may accompany the unspoken reality that our daily activities, both private and public, are changing our culture in ways that we don’t yet truly understand, and for that reason, we feel uncomfortable.

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Earlier technologies give us a clue to understanding social change. The telegraph and telephone changed American culture; they united east and west coasts with a distribution form that delivered communication and messages to people and changed the way they lived, worked, and played. The wired model of communi­cation became the backbone for telephony and the Internet, and even though we increasingly use these technologies in wireless form, the institutions, practices, and social attitudes about communication remain rooted in the structures that intro­duced wired communications to American culture in the late nineteenth century and all of the twentieth.

Our use of the term or terms Cell Phone Privacy Lawsuit: 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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Cell Phone Privacy Lawsuit

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Mesothelioma Cancer Data

By admin | Published January 26, 2012

Mesothelioma Cancer : The doctor may also request an MRI (magnetic reso­nance image). An MRI uses radio waves and strong magnets along with a computer to form detailed images of the body. The MRI can occasionally give the doctor information about whether the diaphragm or chest wall have become involved and if the tumor has invaded through it. Not all mesothelioma specialists use MRIs in their workup. A PET scan (positron emission tomography scan) is a relatively new type of scan that shows how the body takes up and uses glucose (sugar). Tumors, cancer cells, and areas that are inflamed or infected use glucose at a higher rate than normal tissues do. Since a radioactive tracer is attached to the glucose injected into your body, the areas which use glucose at a higher rate (i.e. tumors) will hold onto the radioactive tracer longer than normal cells. Areas on PET scans that “light up” as bright spots are abnormal. It is important to know, however, that abnormal areas on PET scans are not necessarily cancerous; they can also be the result of inflammation. The PET scan can also give the doctor information as to whether the cancer has spread outside the original area to other parts of the body, and it may pick up areas of spread that are completely unexpected. Mesothelioma Cancer

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There have not been enough large studies that prove the usefulness of this scan in mesothelioma, and therefore it has not been approved by most insurance companies as a standard test for mesothelioma, as it has been for lung cancer. However, there are mechanisms that can help pay for PET scans that doctors who do them (nuclear medicine physicians) can help you with. Ask them about these programs. A patient with a large, unexplained fluid accumulation in the chest or abdomen and who has a small or moder­ate amount of thickening of the pleura should have a biopsy performed, using semi-invasive techniques (tech­niques that require only local anesthesia and that do not involve cutting into the chest or abdomen). For exam­ple, the biopsy might involve an initial thoracentesis (drainage of fluid in the chest) or paracentesis (drainage of fluid in the abdomen) and a pleural biopsy. These are relatively safe procedures that can be performed by a pulmonologist (lung physician), a radiologist, or a sur­geon. A local anesthetic (a numbing medicine such as lidocaine) is given to temporarily reduce the feeling in the area before the needle is inserted. Mesothelioma Cancer

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A pleural biopsy with a special needle may help in get­ting a diagnosis of mesothelioma, and it is generally performed by a pulmonologist. Since mesothelioma is usually diffuse (widely scattered) in the chest, a ran­dom sample of the pleura may give tissue with mesothelioma cells in it. A thoracentesis can be performed after the pleural biopsy is completed. The doctor inserts a needle into the pocket of fluid in the chest or abdomen to draw off some of the fluid. Many times, the needle is simply used to insert a flexible catheter (a tube the size of thin spaghetti) which is then used to draw off the fluid. After the fluid is drawn out through this catheter, the catheter is removed.

Our use of the term or terms Mesothelioma 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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Mesothelioma Cancer

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Carrier IQ Lawsuit Breaking News

By admin | Published January 26, 2012

Carrier IQ Lawsuit News – 1/25/2012 : In many countries, governments have discussed and proposed laws to regulate privacy protection and mechanisms to punish people and organizations that break the rules. Until privacy laws are really enforced, however, companies will find few incentives to protect and respect user privacy, mainly because most users don’t even realize that their privacy can be violated. A central problem is that behavior on the Web can’t be controlled. To regulate the Web, governments would have to regulate code writing or how Web applications (browsers, Java, e-mail systems, and so on ) function (Lessig, 1999). Also it is difficult to reach international consensus on Web privacy because the privacy concept is heavily dependent on widely variable cultural and political issues.

Later on U.S. government asked the Commerce Department to work with the Federal Trade Commission (FTC) to encourage organizations to implement self-regulatory practices. An FTC report in 2000, however concluded that U.S. self-regulatory approaches were ineffective in safeguarding consumer information, marketing techniques employed to profile customers were increasingly intrusive, and congressional legislative action was warranted to protect consumer privacy online (Electronic Privacy Information Center. The self-regulatory approach adopted by the U.S. is in direct contrast with the government-mandated approach adopted by the European Union (EU). Under the EU’s 1995, and subsequent 1997, Directive on Data Privacy, the burden is placed on companies and organizations—not individuals—to seek permission before using personal information for any purpose (Consumer International, 2003).

In July 2000, however, the United States negotiated a safe harbor agreement with the EU commission, wherein U.S. companies can voluntarily self-certify to adhere to a set of privacy principles loosely based on the fair information practices developed by the commerce department and the EU Commission. The primary difference under safe harbor is the ability of U.S. companies to administer self-enforcement by the European Commissioner or other agencies for compliance with the explicit rules of the EU directive (Consumer International, 2003). Although the United States recently passed new online privacy legislation, including the Childerns Online Privacy Protection Act (COPPA), Provisions in the Gramm-Leach-Bliley Financial Modernization Act (GLB) and the Health Insurance Portability and Accountability Act (HIPAA), these laws are applicable to relatively narrow types of information and particular industry sectors (Turner & Dasgupta, 2003).

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The issue of who has control over personal data and how this data is used needs to be addressed at a global level in order for the Internet to develop into a trusted, widely acceptable international marketplace for the exchange of goods and services. The primary technology for collecting information on an individual’s activities over the Internet has been the Web “Cookie.” Cookies are digital information sent from a Web server and stored on the hard drive of an individual’s computer by the browser software or network application. Cookies were designed to address the problem of statelessness inherent in the Hypertext Transfer Protocol (HTTP) (Kristol, 2002). Because a browser does not stay connected to a server, but instead makes a connec­tion, sends its request, downloads the response, and makes a new connection to send another request, it severely limited the functionality ofWeb services and complicated application development. Web cookies provide a solution to this statelessness by allowing for continuity in the interaction between the browser and the Web server. The cookie has proven to be the most reliable, robust, and network friendly means to provide needed state functionality on the Web, although this functionality can also be provided by embedding state information in URLs, using hidden fields in HTML forms, or using the client’s IP address (Kristol, 2002).

Web bugs are hidden images that can be covertly added to any Web page; e-mail, or Microsoft Word, Excel, or PowerPoint file and used to collect information about user bahaviour. Web bugs send messages back to a server indicating its location, including the IP address of the computer, the URL of the page, the time the Web page or document was viewed, the type of browser used, and the previously set cookie value. Web bugs can also be used to determine if and when a Web page, e-mail message, or document is opened, the IP address of the recipient, and how often and to whom information is forwarded and opened (Harding, 2001).

Web bugs can also be used to associate a Web browser cookie to a particular e-mail address and read previously set cookie values. Thus, a source server with a very small or invisible window could be added to any Web site or Web-enabled file and used serendipitously for a variety of tracking, surveillance, and monitoring activities (Berghel, 2001). Monitoring browsing activities in and of itself is not considered by most Web users to be privacy invasive; however it is the ability to then link these activities back to an individual that has most consumers and privacy advocates alarmed (Turner & Dasgupta, 2003).

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One of the first technologies available for protecting privacy on the Internet was the anonymizer. Anonymizers provide the ability to sanitize packet headers passed from the client to the server. Early versions consisted of software that would act like a proxy server, intercepting all communication between the browser and the server and removing all information about the requester. Current versions use Se­cure Socket Layers (SSL) technology for sending URL requests, establishing an encrypted communications tunnel between the user and the anonymizer proxy, and routing traffic through a number of proxy servers (Electronic Privacy Information Center, 1999).

This firewall- like technology disguises a user’s IP address, similar to most Internet service providers, and supplies with dynamic IP addresses every time they log on. Software tools are also available that provide a pseudonym proxy for logging on the Web sites, giving users consistent access to registration based systems without revealing personal data (Gabber, 1999). Web users can also install a filter, such as the one offered by Anonymizer. Filters are software programs that block cookies, banner advertisements and Web bugs. The disadvantage of filters is that they fail to consider consent; they block all cookies and thus users lose access to all personalized services, even those from the most trustworthy of sites. Also filters make privacy invasion difficult, but not impossible. A site can still identify users by IP address, interaction time, and geographical loca­tion, for example.

Given this users might need additional levels of privacy protection (Ishitani, 2003). These tool provide a means to protect the network identity of the computer; however, there are also negative performance and reliability consequen- ses. In addition, some specialized proxy servers can be used to intercept and alter information between client and server (Berghel, 2002). There are other technology-based solutions available for protecting privacy, includ­ing tools for filtering HTML allowing users to block certain URLs, anonymous re-mailers for sending and receiving e-mail messages, and software for managing Web cookies (Electronic Privacy Information Center, 1999).

Our use of the term or terms Carrier IQ Lawsuit: 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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Carrier IQ Lawsuit

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Mesothelioma Lawyers Information

By admin | Published January 26, 2012

Mesothelioma Lawyers : The fluid and the tissue from the pleural biopsy will be sent to a pathologist and/or cytologist who will look under the microscope at the cells and determine whether mesothelioma is present. In the past, a diag­nosis of mesothelioma from fluid alone was possible only a third of the time because of the difficulty of distinguishing between reactive or noncancerous cells and tumor cells. By staining the fluid with a special substance, pathologists can now make a diagnosis more easily. Your doctor will refer to these stains as “immunos,” short for immunohistochemistry. You should make sure that any material used in the biopsy has been studied using these immuno stains. A chest x-ray is always performed after these procedures to make sure there were no complications from the biopsies, such as an accumulation of air in the chest (pneumothorax). The chest x-ray is also very important to see whether the majority of the fluid has been removed and if the lung is now able to expand with air and fill the chest cavity as it normally should. Mesothelioma Lawyers

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More-invasive testing may be needed if the initial results of the semi-invasive tests do not provide ade­quate information or if the CT scan indicates that it would be difficult to do the semi-invasive tests. The latter situation would occur if the fluid is not free flow­ing but is hidden in pockets that are difficult to reach. In such cases, it is better to inspect the chest directly to find out where to do the biopsy. A thoracoscopy (the use of a lighted scope, with or without a camera, to look into the chest) is performed in patients who are at risk for mesothelioma and who develop a large fluid accumulation, with or without associated solid tumor masses in the chest. In patients who are at risk for mesothelioma but whose thoracentesis does not reveal cancer cells, or who experience a recurrence of fluid after the initial thoracentesis is performed, a thora­coscopy should probably be performed. This procedure involves using a special lighted instrument called a thoracoscope to look inside the chest cavity. The scope is placed into the chest between two ribs after a small (1-inch) cut is made through the chest wall. If the doctor finds any tissue that looks abnormal, he or she will cut out a piece, or biopsy a piece, of it to have it looked at under the microscope. This tissue will then be examined for cancer cells. Mesothelioma Lawyers

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Lastly, if the radiologic tests indicate that there is more solid tumor than fluid, or if there is no longer a space where fluid can accumulate because of previous attempts to control the fluid, an “open” biopsy may be indicated. The incision does not have to be large if the pleura is thickened, but the procedure should be per­formed by a thoracic surgeon who understands the principles of mesothelioma treatment. This surgeon will usually suggest a 3- or 4-inch incision on the side of the chest, overlying an area of pleura that is thickened. The surgeon may or may not remove a small piece of rib at this site to allow a direct view of the thickened pleura. Many times, a good-sized piece of pleura (1 to 1 1/2 inches in diameter) can be removed at this site. Getting a quick freeze of the tis­sue in the operating room, with the pathologist look­ing at the biopsy, will ensure that there’s enough tissue to perform all the required testing and to make a diagnosis. Surgeons performing these biopsies should pick the right place for the biopsy, and the cut (inci­sion) for this biopsy should be in line with the longer incision that would be used later if the patient is a surgical candidate. That way, this shorter incision can be removed.

Our use of the term or terms Mesothelioma Lawyers 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 Side Effects Scoop

By admin | Published January 25, 2012

Actos Side Effects :

WHAT IS THE FUNCTION OF THE BLADDER?

A bladder stores urine and expels it at a convenient time. The bladder is a very useful organ, (tissues working together to accomplish a function), but an individual can live a normal life without one, if required, by surgical creation of a substitute.

 

ARE THERE DIFFERENT TYPES OF BLADDER CANCER?

More than 90% of bladder cancers arise from the lining bladder cells called transitional cells. Bladder cancer is almost always transitional cell cancer. These cells are also present in the urethra (the body tube which drains the bladder), as well as the renal pelvis (inner lining of the kidneys), and the ureters (the body tube draining the kidneys).

Bladder cancer can vary from the non serious, low grade superficial type (approximately 70%), to the invasive, aggressive type that can spread and prove to be fatal (approximately 30%).

5% of bladder cancer is accounted for by squamous cell carcinoma. This cancer is usually secondary to long term inflammation or infection of the bladder. Even rarer is adenocarcinoma, which accounts for less than 2% of all bladder cancers.

HOW COMMON IS BLADDER CANCER?

The American Cancer Society estimates that in 2006,61,420 new cases of bladder cancer were diagnosed in the United States with approximately 73% of those occurring in men. In the same year, this cancer caused approximately 13,060 deaths with approximately two out of three of those being in men. The disease is more common in whites than blacks. The incidence of bladder cancer increases with age in both sexes. When bladder cancer occurs in young people, it tends to grow slower and not be as serious. In men, it is the fourth most common cancer. However, because of the rate of recurrences and long term survival, it is the second most prevalent cancer in middle aged and elderly men. In women, it is the eighth most common cancer. The average age at diagnosis is 65. Over the past decade, there has been both an increased incidence, but also an increased rate of survival for bladder cancer [1]

WHAT CAUSED MY CANCER?

A mutation is a disruption in the DNA of a cell, leading to a loss of regulated cell growth. Mutations can occur spontaneously as we age. It is truly amazing that all of us don’t develop cancer as we are composed of trillions of cells dividing regularly over decades. Fortunately, our cells have repair mechanisms which can often fix damaged cells before cancer arises. In addition, the immune system can destroy cancer cells before they have a chance to grow into tumors.

Mutations and cancer can also be triggered by environmental factors. Certain chemicals have been identified to be particularly effective at inducing mutations in our DNA and subsequent cancer. These chemicals are called carcinogens. Smoking is the most common culprit! Cigarette smoking has a strong link with bladder cancer. Studies have shown approximately 50% of bladder cancer is secondary to tobacco smoke. Smoking releases dozens of carcinogens into the lungs and then into the blood stream. Many of these carcinogens are excreted by the kidneys.

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IT IS TOO DIFFICULT TO QUIT SMOKING; IS THERE ANY SURE FIRE WAY TO QUIT?

Tobacco smoke contains nicotine, an extremely addictive chemical. Men overall find it easier to quit smoking than women. When facing the prospects of losing your bladder to cancer or possibly your life, most individuals will become convinced and many simply stop smoking “cold turkey.” Unfortunately, many choose not to quit until their cancer repeatedly recurs or becomes invasive, needlessly placing their health at risk. For those who need assistance in quitting, nicotine patches, gum, and lozenges are all available over the counter. These products allow the smoker to quit without experiencing the discomfort of withdrawal from nicotine. Many smokers also find hypnosis or support groups useful. In addition, prescription medication is available.

ARE THERE ANY OTHER KNOWN CAUSES?

Occupational exposure may account for up to 20% of bladder cancers. Those exposed to aniline dyes (used to color fabrics), aldehydes (used in chemical dyes and in the rubber and textile industries) and those using organic chemicals (used in a wide range of occupations) are all at increased risk. Individuals previously treated with radiation to the pelvis or having received cyclophosphamide (a type of chemotherapy) are at markedly increased risk for developing bladder cancer. If your well water is high in arsenic, your risk may also be increased. Studies have also correlated obesity and a high fat diet, especially with increased cholesterol, as a possible contributing factor.

CAN I HELP TO PREVENT BLADDER CANCER BY DRINKING MORE FLUIDS?

Surprisingly, the answer may be yes. In a recent study, the relationship of diet to cancer was analyzed in a group of47,000 health professionals.[1] In the case of bladder cancer, those who drank the most fluid (greater than 10 cups/day) had half the risk as those who drank the least (less than 5 cups/day). The type of nonalcoholic beverage was less important than the total amount.

WILL MY CHILDREN BE AT HIGHER RISK OF DEVELOPING BLADDER CANCER?

Although there have been clusters of bladder cancer reported, most researchers believe these may be secondary to risk factors such as smoking and exposure to carcinogens. At this time, there is no convincing evidence bladder cancer risk is hereditary. If an environmental factor caused your cancer and your children are exposed as well, their risk of cancer may be increased.

WHAT IS CANCER?

The basic building block of the body is the cell. Cells are specialized to perform a particular function. Skin cells are distinctly different from liver cells which are different from bladder cells. An organ is composed of various cells working in unison to carry out a body function. Cells eventually get old and die. New cells are created by cell division. When cells are behaving normally, they only generate enough new cells to replace the old dying ones. Occasionally, cell growth becomes unchecked. As the cells continue to divide, a tumor (abnormal growth of cells) may form. Such tumors may be benign (no ability to spread beyond their organ of origin) or cancerous (a malignant tumor with the ability to spread beyond their organ of origin and cause harm and possibly death).

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HOW CAN I TELL IF MY BLADDER CANCER IS LIKELY TO SPREAD?

Larger tumors are more likely to spread than smaller tumors. Another critical concern is the grade of the tumor. Normal cells are specialized, differentiated to perform specific function, and have a typical structural arrangement with surrounding cells. As cancers worsen, the cells become less specialized, less differentiated, and lose their normal structural arrangement, resulting in a higher pathologic grade.

In the case of bladder cancer, pathologists classify them into 3 grades based on a number of criteria:

Grade 1: low grade, well differentiated Grade 2: intermediate grade, moderately differentiated Grade 3: high grade, poorly differentiated The higher grade tumors have a greater propensity to metastasize- spread throughout the body.

For bladder cancer, another key indicator for likelihood to spread is the depth of penetration into the bladder wall. The bladder wall is composed of an inner lining called the urothelium (made up of transitional cells) which rests on a membrane layer called the basement membrane, below which is the connective tissue layer (support tissues) called the lamina propria. Within the lamina propria lies a small amount of muscle called the muscularis mucosa. Deep to the lamina propria is the deep muscle of the bladder arranged in three layers. This layer is called the muscularis propria. Tumors located in the inside, superficial layers of the bladder wall are unlikely to spread. Tumors that grow into the deeper layers (down into the muscle of the bladder wall) are much more likely to spread. Furthermore, there is a definite link between the grade of the tumor and its likelihood of invasion. Low grade tumors are almost always noninvasive, while high grade tumors are usually invasive. In general, papillary tumors, which are delicate and frond like in appearance are usually low grade and superficial. This is to be contrasted to sessile tumors which appear solid, are often high grade and invasive. Depth of invasion is critical in establishing prognosis. The tumor which invades into the lamina propria is a far more serious tumor than the superficial tumor which demonstrates no invasion. It has a much higher propensity to progress to the muscle invasive tumor, a much more dangerous cancer, with a high risk for spreading beyond the bladder. For further information see Chapter 6.

 

 

Our use of the term or terms Actos Side Effects 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 and Bladder Cancer Scoop

By admin | Published January 25, 2012

Actos and Bladder Cancer: For the practicing urologist it is often difficult to inform the patient on muscle invasive bladder cancer and the often need for radical surgery and some kind of urinary diversion to follow; however, it is even more elaborate to do so in case of a nonmuscle invasive tumor where the evidence calls for radical treatment. In Chap. 15, Waalkes, Merseburger, and Kuczyk present pathologies where a radical treat­ment is strongly advised.In Chapters 16-18 focus various aspects of cystectomy. In Chap. 16, radical surgery of the bladder is discussed by Dr. Gschwend. The improvement in surgical techniques had led this formerly challenging procedure into a more standardized one. Chapter 17 includes urinary diversion by Drs. Richard and Stefan Hautmann. The ileal neobladder has become one of the worldwide chosen procedures for con­tinent orthotopic urinary diversion. Chapter 18, laparoscopic cystectomy by Dr. John, is the latest evolvement in bladder surgery and covers innovative tech­niques as well as the well-established surgical routines in radical treatment of invasive bladder cancer.

 

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In 2010, only 5% of all urologists are performing neoadjuvant chemotherapy in patients with muscle invasive bladder cancer, hence the 5% survival benefit in5 years and possible down staging of the tumor. Dr. Sherif guides us along the current literature and discusses the pros and cons of the neoadjuvant chemotherapy. Diagnosis and treatment of upper tract tumors is challenging and Chap. 20 by Dr. Remzi discusses the basics as well as recent advances in this field. In Chap. 21, De Santis and Bachner focus on the development and optimal use of new regimens for systemic agents as well as standard treatment options for the treatment of meta­static urinary carcinoma in the areas of targeted drugs. Options for “unfit” patients and elderly as well as in second-line setting are discussed. In Chap. 22 non-TCC tumors: Diagnosis and treatment is discussed by Dr. Abol-Enein. He focuses mainly on the squamous cell and adenocarcinoma of the bladder.

We hope that this brief synopsis of the topics covered in each chapter will encourage the readers to use this book for a general read on bladder cancer and as a reference guide for specific molecular and clinical aspects of bladder cancer. We again thank the authors for contributing to this project. We thank our Mr. Michael Koy, production editor at Springer and Spi Editorial Department, India for helping us in the publication of this book. We would like to thank Brian Halm of Springer for helping us with the publication of this book.

 

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Abstract Bladder cancer (BC) is a worldwide health problem. In 2006 in Europe, there were an estimated 104,400 incident cases of BC diagnosed (82,800 in men and 21,600 in women) that represent a 6.6% of the total cancers in men and 2.1% in women.Tobacco use is a major preventable cause of death, and especially involved with BC carcinogenesis. Tobacco smoking is the most well-established risk factor for BC, causing around 50%-65% of male cases and 20%-30% of female cases.

Occupational exposure has been considered the second most important risk factor for BC. Work related cases account for a 20%-25% of all BC cases in several series.

In addition, chronic urinary tract infection had been related to BC, particularly, with invasive squamous cell carcinoma. Bladder schistosomiasis has particularly- been considered by the international agency for research on cancer (IARC) as a definitive cause or urinary BC with an associated fivefold risk.

 

Our use of the term or terms Actos and 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 Warning News Flash

By admin | Published January 25, 2012

Actos Warning : Recently, a metaanalysis of observational studies on cigarette smoking and cancer from 1961 to 2003 has been published. The authors extracted data from 254 reports published during that period of time and included them in the 2004 IARC Monograph on Tobacco Smoke and Involuntary Smoking. The analyses were arried out on 216 studies with reported estimates for current and/or former smokers. The pooled risk estimates for BC demonstrated significant association for both current and former smokers. In an analysis of 21 studies, the overall rela­tive risk calculated for current smokers was 2.77 [95% confidence interval (CI) 2.17, 3.54]; while from the analyses of 15 studies, the overall relative risk calcu­lated for former smokers was 1.72 (95% CI 1.46, 2.04) (Gandini et al. 2008).

 

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In a pooled analysis of 11 case-control studies regarding cigarette smoking and BC, the following three variables were analyzed: duration of smoking, average number of cigarettes smoked per day, and time since quitting smoking. The popula­tion consisted of 2600 cases and 5524 controls. An increasing risk of BC was observed with increasing duration of smoking, which appeared to be linear. The relative increase was approximately 100% after 20 years smoking and reaches to 400% after 50 years smoking. In addition, a relationship was observed between the number of cigarettes smoked per day and BC.

The OR increased to nearly threefold for those who smoked between 15 and 20 cigarettes per day, after which a plateau in the risk graph was observed. They concluded that the duration of smoking habit and not the amount of cigarettes smoked per day was the main determining factor for BC. An immediate decrease in risk of BC was observed for those who quit smoking. This reduction was about 40% within 1-4 years of quitting smoking and reaches 60% after 25 years of cessation. However, the risk does not reach the level of nonsmokers even after 25 years. This suggests that tobacco has a late effect in the carcinogenesis of BC, but the fact that this risk does not reach the levels of nonsmokers until 25 years after quitting smoking suggests that tobacco may also be involved in an early irreversible stage in the carcinogenesis process (Brennan et al. 2000).

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Other issues as type of tobacco could be taken into account. Six studies have published a significant higher risk of BC for the blacks who are cigarette smokers compared to smokers of otherraces. Also, case-control studies suggest a strong evidence of a carcinogenic effect of cigars and pipe, which is comparable to that of cigarettes (Boffetta 2008). The mode of inhalation of tobacco smoke has been related to BC risk, as well. In a case-control study of smoking and BC from Spain that included 1219 cases and 1271 controls, they concluded that the former and current smokers experienced risks of BC three to seven times higher than nonsmok­ers, respectively.

In addition, they found that the risk was higher for subjects who inhaled into the throat or chest [OR 4.8 (95% CI 2.3-9.9)] compared with those who inhaled only into the mouth [OR 10.0 (95% CI 6.7-15.0)], at each level of duration (Samanic et al. 2006).

Taking into account that current smokers have higher risk of BC than nonsmokers, and that this risk decreases by 40% after 1-4 years of quitting smoking, the promotion of cessation of smoking would allow reducing the incidence of BC in men and women.

Internationally, there is a general agreement on the broad strategy needed to successfully combat the tobacco epidemic.

 

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Actos Bladder Cancer News Flash

By admin | Published January 25, 2012

Actos Bladder Cancer : 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.

After your procedure, depending on the level of anesthesia and the extent of surgery, you will be brought either to the recovery room or back to the area where you were first prepared for your procedure. You will be released to home only when you have fully recovered from you anesthetic and are doing well. The recurrence rate for superficial bladder cancer can be as high as 60-90%. Recurrences can cause bleeding and other difficulties and are best handled sooner rather than later. In addition, depending on the initial tumor grade and stage, progression to a more serious form of bladder cancer is an ongoing concern. Surveillance cystoscopy is therefore recommended. Cystoscopy is still the best means to check for recurrent disease. It is however, an invasive procedure and should be accomplished only as often as required. For solitary, low grade, non invasive disease, follow up cystoscopy can be accomplished with the flexible cystoscope if available. If negative at three months, further cystoscopic exams can be done yearly and eventually lengthened even further. For those with multiple tumors, large tumors, high grade tumors or those who also have CIS, frequent cystoscopies, initially every three months are called for. As long as there are no recurrences, the time between cystoscopies can be lengthened. Cytology can also be utilized to reduce the number of cystoscopies. If recurrence or progression does occur, heightened scrutiny is again called for.

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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.

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Invasive bladder cancer is often recognizable to the urologist by its appearance during cystoscopy. These cancers are generally large, sometimes multi-focal, and solid in appearance as compared to the fine papillary appearance of superficial bladder cancers. During the transurethral resection of the tumor, the urologist can generally tell the tumor is invading into the deeper portions of the bladder wall.

The pathologist’s report will then indicate the grade of the cancer and the depth of invasion. If the tumor invades into muscle, it is an invasive tumor. Further staging would then include a CT Scan or MRI to assess local contiguous spread, lymph node spread, or more distant spread of the cancer. A chest X ray is also routine. If there are any suspicious areas, a CT Scan of the chest is ordered. A bone scan is generally not required unless the individual has had a new onset of bony pain that is not explained by injury or arthritis.

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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