The bladder is a hollow organ lying within pelvis, which collects urine from the kidneys via tubes called ureters and stores it until it is full enough to empty through the urethra.

Bladder cancer is any type of malignant growth in the bladder. There are two main types - superficial and invasive. The superficial tumours, sometimes known as bladder warts, do not spread and are fairly easily treated. Invasive tumours, which have spread beyond the bladder walls, have a poorer prognosis.

Bladder cancer is more common in men, especially those over the age of sixty years. Cigarette smoking is known to be a major risk factor and accounts for about 60% of all new cases. Other risk factors include exposure to chemicals as used in certain industries. Women who have regularly used permanent hair dyes are at greater risk of developing the condition, as are hairdressers. The exact causes however remain unknown and research continues.

The symptoms of bladder malignancy may include blood in the urine, also known as haematuria, and pain or frequency passing urine. These symptoms, however, are not specific and could well be related to other conditions such as urinary tract infections or kidney stones. If you notice blood in your water it is important that you see your doctor as soon as possible for some diagnostic tests. But please do not panic as the blood may be from an entirely benign source. Haematuria does not always indicate bladder cancer but must be checked out.

To diagnose the problem the doctor will take a full medical history, do a physical examination and send a specimen of urine away for testing. Depending on the results the next step may be a cystoscopy, which is a simple procedure, using a fibre-optic tube with a light source attached to inspect the inside of the bladder. The scope is passed into the bladder via the urethra. If any abnormal areas or growths are noted cells can be taken for further examination to see whether they are cancerous or not.

If cancer is diagnosed the next step is to determine whether it is localised or has spread from it’s original location.

Treatment is by surgery, chemotherapy or radiotherapy. The type of cancer, age and general health of the patient will determine which treatment or combination of treatments is used.

Early diagnosis always improves the outcome. If you experience any of the above symptoms please seek immediate medical help. If you notice blood in your urine report it to your doctor so that it can be investigated and any appropriate treatment started.

If you have been diagnosed as having a bladder cancer you will need to attend for regular check ups so the condition can be monitored.

People who smoke 20 cigarettes a day for 10 years have double the risk of developing bladder cancer compared with non-smokers. If you stop smoking the risk is reduced. If you have been diagnosed with superficial bladder cancer and are a smoker, stopping smoking will greatly reduce the risk of any recurrence.

Michael Russell
Your Independent guide to bladder-cancer-guided.com/ Bladder Cancer

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Tags: chemotherapy

Once your pain management team is in place, you can work together to create a plan that anticipates every level of pain and institutes measures for alleviating it. Remember, the key to effective pain management is early intervention — and that starts with you. You need to inform your team when you’re hurting, where, and how much. This is why being able to talk with them comfortably and candidly is so important. (We’ve provided tools ahead that might help with this conversation.)

As you meet with your team members, you might want to share with them the following pain management model. It establishes a continuum of care to track with pain that ranges from mild to severe.

1. Complementary and alternative therapies: We recommend CAM therapies as a starting point because they are the least toxic. Your body will be exposed to plenty of toxins during cancer treatment; it doesn’t need more. Also, with CAM therapies, you spare your body from the side effects of yet another medication. Acupuncture, chiropractic, hypnosis, massage, and meditation are among the options that have proven successful in controlling pain.

2. Psychotropic drugs: Mediated via neurotransmitters, these medications help manage emotional distresses like depression and anxiety, both of which aggravate pain. Since scientists have determined that neurotransmitters inhabit the entire body, not just the brain, psychotropics have become some of the most frequently prescribed drugs for pain management.

3. Over-the-counter medications: Among the most common OTC pain relievers are acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. They may be enough to alleviate mild pain.

4. Low-dose opioids: Seventy to 90 percent of cancer patients control moderate pain with oral opioids such as Darvon, Percodan, and Percocet. The long-term use of these medications has not been shown to worsen pain. If that should happen in individual cases, the patients may be advised to switch to an opioid other than the one they have been using.

5. Slow-or fast-release opioids: Perhaps the best known of the opioids is morphine, which is sold under several brand names. It’s the most commonly prescribed medication for severe pain and is available in slow-or fast-release forms. Other slow-release opioids, which tend to have longer-lasting effects, include Fentanyl, Levorphanol, methadone, MS Contin, and Oramorph. In the fast-release category are codeine, hydromorphone, and oxycodone. When taken as prescribed, opioids — though quite potent — rarely lead to addiction.

6. Invasive procedures: For acute pain and some chronic pain, a nerve block can provide temporary relief. In this procedure, the physician injects a local anesthetic into or around nerves or below the skin at the site of pain. The anesthetic interrupts the transmission of pain signals to the brain, providing relief for up to several hours. In some instances where drug therapy is ineffective, the pain pathways may be redirected or severed through surgery or controlled with implanted devices.

Reprinted from: When It’s Cancer: The 10 Essential Steps to Follow After Your Diagnosis by Toni Bernay, PhD, and Saar Porrath, MD (March 2006; $15.95US/$22.95CAN; 1-57954-823-7) © 2006 Toni Bernay, PhD Permission granted by Rodale, Inc., Emmaus, PA 18098. Available wherever books are sold or directly from the publisher by calling (800) 848-4735 or visit their website at www.rodalestore.com.

Toni Bernay, Ph.D., is a nationally recognized psychologist and executive coach. She serves as president of the Porrath Foundation for Cancer Patient Advocacy and is a principal in the Leadership Equation Institute, a national consulting firm for executives and entrepreneurs. She resides in Beverly Hills.

Her husband, Saar Porrath, M.D., was a preeminent breast oncologist at the forefront of numerous advances in breast health and care. He established the nationally known Woman’s Breast Center in 1983. For his contributions to health care, he was honored by Los Angeles County, as well as the cities of Los Angeles and Santa Monica.

For more information, please visit porrathfoundation.org porrathfoundation.org.

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Former President Clinton had a basal cell skin cancer removed from his back while he was in office, attracting national press attention to this common form of cancer. There are three main types of skin cancers. President Clinton did not have a melanoma, a skin cancer that starts in moles and can spread rapidly through your body and kill you. Moles that have irregular borders and multiple colors should be removed to be checked for melanoma. Moles that have smooth circular borders and are of one color are almost never melanoma cancers.

President Clinton did not have the second type of skin cancer called squamous cell cancer. The can occasionally spread through the body and kill you. He did have a basal cell skin cancer that rarely spreads through the body and can be cured just by taking out 100% of the lesion. They are called cancers because they keep on growing through everything around them until they are completely removed. Basal cell skin cancers fall apart and feel like marshmallows when they are scraped. All a doctor has to do to cure it is to inject an anaesthetic into the lesion, scrape the basal cell cancer until he feels the hard resistance of normal skin. Then burn an area of normal skin around the lesion to guarantee the removal of the entire cancer.

You can suspect that you have a basal cell skin cancer when you develop a red scaly area on the surface of a light-exposed area of skin. That is probably an actinic keratosis that can often be removed just by applying a special cream. However, if you leave the red area in place, it can go deeper and became a skin cancer. You can suspect that the actinic keratosis has gone deeper when the surface feels rough like sandpaper. If you let it grow further, it can become an elevated area with a fine pearly border.

It seems that one of the requirements to become either president or vice president of the United States is to have a skin cancer. Lyndon Johnson, Ronald Reagan and the elder George Bush all had skin cancers removed when they were president. Vice president Al Gore also exposed too much of his body to sunlight and had a skin cancer removed in 1996. Vice president Dick Cheney also had a skin cancer removed. Should we conclude that exposing your skin to too much sunlight is associated with becoming president or vice president of the United States?

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Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in four specialties, including sports medicine. Read or listen to hundreds of his fitness and health reports at drmirkin.com DrMirkin.com

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. What is breast cancer?

Breast cancer is caused by the abnormal or uncontrollable growth of breast cells. It has the potential to also spread to other parts of the body. While cancer is almost always caused by an abnormal gene the chances of inheriting it from your mother or father is only 5 to 10 percent. The genetic abnormalities that occur as a result of the ageing process and other factors however cause 90 percent of the breast cancers.

. Who is affected by breast cancer?

Women are the most affected by the commonest cancer that is breast cancer. 216,000 new cases of invasive cancer and 59,000 new cases of non-invasive breast cancer were diagnosed in the USA in 2004.

Every woman at some point in her life is at risk from breast cancer. Each woman will have different risk factors.

. The period in your life when you gain weight also affects the risk of breast cancer.

After menopause, a woman who is overweight is at greater risk from breast cancer when compared to a woman of average weight. Being overweight also increases the risk of the disease coming back in women who have had it earlier.

Studies also show that the risk factor is greater for women who gain a significant amount of weight as an adult when compared with women who maintained more or less the same weight. Studies also show that gaining weight after menopause also increases the risk of breast cancer. Therefore maintaining a healthy weight as you advance in age will help minimize your risk of breast cancer.

. Having ovarian cysts means your chances of getting breast cancer are low.

Benign ovarian cysts, generally a result of hormonal imbalance, cause several problems such as irregular menstrual cycles and infertility and were originally thought to be linked with a higher risk of breast cancer. Research has shown however that the opposite is true, that is, women with ovarian cysts are less likely to get breast cancer. The reason for this association is still not clear.

. Taking the contraceptive pill may increase your risk of getting breast cancer.

According to research, it is shown that taking the contraceptive pill slightly increases your risk of getting breast cancer. For women who are most at risk from developing breast cancer, that is, women who have given birth and who have used the pill for a period of 4 years before they became pregnant for the first time, the absolute risk is minimal.

There are certain benefits too from taking contraceptive pills. They are that it improves bone mineral density, it decreases the chances of an individual getting endometrial and ovarian cancer and it relieves menstrual disorders, ovarian cysts and pelvic inflammatory disease.

. A history of family breast cancer means your chances of getting ovarian cancer are high.

Research has shown that not only is an individual at high risk if she has a family history of breast cancer, but it also increases the risk of ovarian cancer. The risk is relatively low though.

Michael Russell

Your independent guide to

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