Bladder cancer: A difficult problem?

	Tweet

According to the Delhi Cancer Registry, in 2003, bladder cancer was the 6 th most common cancer, surpassed in frequency only by cancers of the lung, larynx, tongue, prostate, and esophagus. Fifteen percent of all tobacco-related cancers are bladder cancers. Curiously, in Northern India this disease seems to affect younger patients. The majority of the patients present with superficial disease and are treated by transurethral resection of the bladder tumor. More than half of these patients experience recurrence, with about 20% progressing to muscle invasive disease. Outcomes in superficial and muscle invasive disease have improved over time. Intravesical chemotherapy has been found to prevent recurrence in superficial bladder cancer and the immediate postoperative instillation of mitomycin C has become the standard of care for small superficial tumors that have been resected completely without perforation. With improvements in surgical technique, and the evolution in urinary diversion procedure from ureterosigmoidostomy to orthotopic neobladder, the outcome in muscle invasive carcinoma of the bladder has improved remarkably with respect to both cancer control and quality of life.

This edition of the Indian Journal of Urology focuses on carcinoma of the bladder.

Theodorescu has discussed the molecular aspects of carcinoma bladder. The molecular level understanding of the mechanism of cancer genesis is increasing and carcinoma bladder is no exception. The authors have analyzed, at the molecular level, the factors responsible for two types of carcinoma bladder that have distinct behaviors. They discuss their potential implications (either therapeutic or prognostic) in the clinical management of the disease.

Dr. Jagdish N. Kulkarni has discussed in detail the changes in the staging of carcinoma bladder, with emphasis on the importance of cystoscopy and bimanual examination even in this era of MRI and CT scans.

Ashish Kamat (Prashant) has discussed the management of T1G3 bladder cancer and the role of radical cystectomy in these patients. They have also explored the role of molecular markers such as epidermal growth factor receptor (EGFR) in stage progression of non-muscle-invasive carcinoma of the urinary bladder and the potential therapeutic role of cell cycle inhibitors.

The article by Dr. Rakesh Kapoor of the Sanjay Gandhi Post-Graduate Institute of Medical Sciences (SGPGI), Lucknow, explores the role of BCG in non-muscle-invasive carcinoma bladder and its mechanism of action; he also discusses their experiences at the center.

Dr. Markand Kochikar has reviewed the existing literature in detail for his article on the role of surgery and adjuvant and neoadjuvant chemotherapy in the treatment of locally advanced and metastatic bladder cancer.

Marcus Kcukuz and Axel D. Merseburger have analyzed their results in 21 patients of T4 carcinoma bladder who were offered primary surgery in the form of radical cystoprostatectomy. Finally, there is the article by Dr. Deepak Jain from our center, which discusses the type of urinary diversion done after cystectomy in our country at various centers.

Invasive bladder cancer continues to be a very difficult disease to manage. All of us who are engaged in managing these individuals realize the limitations of aggressive therapy, as most of them do not live long and would succumb to bladder cancer. It is obvious that only surgical or radiation therapy is not the answer.

There is a need to develop better molecular markers, effective chemotherapy and hopefully a gene therapy to alleviate sufferings of patients who get cancer of bladder.

Finally, I take this opportunity to thank all my contributors who have helped me in organizing this symposium. I am grateful to the Editor, Indian Journal of Urology for having provided me this opportunity.

With best wishes for Happy New Year.

Rawal Sudhir
Consultant Uro Onco-Surgeon, Rajiv Gandhi Cancer Hospital, New Delhi, India

Correspondence Address:
Rawal Sudhir
Consultant Uro Onco Surgeon, Rajiv Gandhi Cancer Hospital, New Delhi
India

Rawal S. Bladder cancer: A difficult problem?. Indian J Urol [serial online] 2008 [cited 2008 Feb 10];24:60. Available from: http://www. indianjurol.com/text.asp?2008/24/1/60/38605

RELATED STORIES:
More Intense Bladder Cancer Treatment Does Not Improve Survival   Extract of broccoli sprouts may protect against bladder cancer   Variation in prostate stem cell antigen gene raises bladder cancer risk   UT Southwestern researchers investigate high-risk populations for bladder-cancer screenings   Arsenic cancer risk still high decades later in Chile region   Survival and Response to Therapy of Non-Invasive Bladder Cancer Patients   Measurement of Urinary Protein Can Help Detect Recurrent Bladder Cancer   Urinary tract cancer associated with Chinese herbal products containing aristolochic acid   Cholesterol drug inhibits cancer cells in lab   Meat, Especially If It’s Well Done, May Increase Risk of Bladder Cancer   Robotic Surgery Extends Benefits to Bladder Cancer Patients   Less bladder cancer in frequent painkiller users   Sales jobs tied to bladder cancer risk   Chemicals in meat may be linked to bladder cancer   Not enough evidence for bladder cancer screening   The Predictors of Local Recurrence After Radical Cystectomy in Patients with Invasive Bladder Cancer   Gene test shows which bladder cancer patients may have cancer spread   Delaying bladder cancer surgery increases mortality   Protein Key to Bladder Cancer Spread, Potential Drug Target   Certain Ecologic Factors Associated with Greater Risk of Bladder Cancer   Thomas Jefferson University Hospital adopts new imaging agent to improve detection of bladder cancer   Bladder cancer patients rarely receive recommended care

Comments

[ + Post Your Own ]

Now you're in the public comment zone. What follows is not Armenian Medical Network's stuff; it comes from other people and we don't vouch for it. A reminder: By using this Web site you agree to accept our Terms of Service. Click here to read the Rules of Engagement.

There are no comments for this entry yet. [ + Comment here + ]