by Warren » Mar 19, 2002 @ 3:57am
Ok, here.
Cancer is the uncontrollable division of mutated body cells. A mutation is a defect in the cell’s DNA, like the changing of an A to a T. Usually a small mutation like that has no real noticeable phenotypic alteration, but in the right place, it can have a devastating effect. Sickle-cell disease is caused by the mutation of a single nucleotide pair. Cell division is part of the cell cycle, and is controlled by growth factors. These growth factors are coded in DNA just like everything else, but if these codes are altered, the cell may either make too many growth factors, or the growth factor proteins may be altered themselves, which can all cause uncontrollable cell division. Also, tumor-suppressor genes, which make proteins that further cell division regulation, can be modified, letting the cell divide without restraints. Irrepressible cell division of mutated cells is called cancer. The mass of deformed cells is called a tumor. Genes that, if modified, can cause cancer are called proto-oncogenes; proto-oncogenes that have been mutated into cancerous genes are called oncogenes. Mutations that cause cancer come from carcinogens. A carcinogen can be anything that promotes cancer, like tobacco or ultraviolet light. It usually takes around 4 mutations in the proto-oncogene to cause major effects on the cell, the more, the worse.
In the year 1999, 54,200 people were diagnosed with bladder cancer. Bladder cancer is more common in males than females (3:1), and is the 6th most common cancer. It is primarily caused by tobacco cigarette smoking. I’m not sure how smoking causes cancer way down there, and no one really knows, just that people that smoke are much more likely to develop it. The most common symptom of bladder cancer is hematuria, the presence of blood in the urine. Usually with bladder cancer, there is no pain associated with the hematuria. Hematuria is a symptom of many other diseases too, so the only way to know is to be examined by a doctor, usually by IVU X-rays (intravenous urogram, a type of X-ray for the kidneys, ureters, and bladder). Other symptoms include high frequency of the need to go to the bathroom, and sometimes a burning sensation in the bladder. If pain does occur with hematuria, then the cancer may have developed into a dangerous level. Though bladder cancer is predominantly caused by tobacco, frequent bladder infections can also promote cancer. It is unknown what genes are affected that causes the cancer.
There are many treatments for bladder cancer, but that doesn’t mean survival rate is good. For early detection, invasive surgery is usually used. For the invasive technique, there is no surgical cuts or general anesthetics, doctors use a long thin tube and, well, shove it up there, through the urethra. At the end of the tube is a small camera and cutting tools to cut away the tumor. After the horrifying trauma, called cytoscopy, radiation or laser therapy can be used to make sure all the cancer is gone. Most bladder cancers are called superficial bladder cancers, and the tumors look like little sea anemones growing in the inside layer of the bladder. Unfortunately, tumors can, and usually, reappear between 6-12 months of the removal, and need to be removed again. If the tumor is too large, and has spread to too much of the bladder, doctors may resort to cystectomy, the complete removal of the bladder. The operation doesn’t only remove the bladder, in females, it removes the urethra, most of the ureters (tubes that connect the kidneys to the bladder), the front wall of the vagina, the entire womb (hysterectomy), the fallopian tubes, and the ovaries. In males, the bladder, the prostate gland, most of the ureters, and sometimes the urethra are all removed. In both males and females, sexual abilities may be lost, but can sometimes by recovered with additional surgery. In some cases, nerves in the pelvis may be damaged during surgery, resulting in the loss of feeling in that area. Now, what do you do without a bladder?! Well, there are two options. The first, doctors use a small section of the bowel, attach it to the side of the abdomen, attach the ureters to it, and have the urine drain into a bag on the outside of the abdomen. The second choice, if possible, is to make a duplicate bladder out of some of the bowel, connect the ureters to it, and connect the urethra to it. The patient would use a small tube (catheter) to drain it. If the tumor can be removed with the cytoscopy, survival rate is 95%. With cystectomy, survival rate within ten years in 50%. If the cancer has spread to other parts of the body (metastasis), survival rate is bad. Even with chemotherapy, if the cancer spreads to the muscles, survival rate in a 5-year period is 20%-50%. If it travels to the lymph lodes, the survival rate in a 5-year period is 0%-20%. Because of this, it is much better to detect bladder cancer in the much earlier stage. The only current advancement in treatments are new cytoscopy techniques that work without anesthetics. After a cytoscopy, the patient needs to be monitored routinely for tumor reappearance. After a cystectomy, patients remain in the hospital for a while until they recover. In 1999, 54,200 people were diagnosed with bladder cancer, that’s 0.02% of the population of the US a year. The best ways to prevent bladder cancer is simply not to smoke.
Bibliography
Netherlands Cancer Institute. Understanding Bladder Cancer. December 1, 1996. <<http://telescan.nki.nl/bladder2.html>> March 18, 2002.
PPR Inc. Urothelial and Kidney Cancers. 2001. <<http://www.intouchlive.com/handbook/Urothelial.htm>> March 18, 2002.
Shut Down
and I spilled my spitoon on my keyboard.
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