Sasha Wainstein MD Urology discusses bladder cancer. Maimonides Medical Center
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Male Speaker: You do a test to someone has blood in the urine and found out that they have cancer to the bladder. Can you tell me something about cancer of bladder? Sasha Wainstein: Yes. Cancer of the bladder most of the time it starts at the urothelium which is the lining of the blood. Then after it starts in the lining, it's usually like a plant, they develop seeds and that the roots that they develop over there, they start growing and they grow deep and then they grow outside of the blood. Male Speaker: Is it fast grown? Sasha Wainstein: Cancer of the bladder is much more fast grown than, for example, the other one that you can quarry the cancer of the prostate - Male Speaker: Well in the men or women again? Sasha Wainstein: It's usually in both. Male Speaker: At a certain age, it's more after you get, a younger person, older person? Sasha Wainstein: You can have a younger person, and you can have an older person with this cancer. Male Speaker: And how is it treated? Sasha Wainstein: It's treated depending on what you have. The first line of treatment is the resection. It's through the stethoscope, you look in there with the telescope, you find the cancer and you scrape it with the current. Using electrical current, you scrape it off. You take some tissue underneath the cancer to see whether or not the cancer has advanced and developed the rooting into it which is growing into the other side of the lining of the bladder. Male Speaker: So early the diagnosis, the better you? Sasha Wainstein: Very important. Cancer of the bladder is one of the important thing to make a diagnosis early on. Male Speaker: If you see blood in urine, don't - oh it's nothing. Sasha Wainstein: No, blood in the urine it's a warning sign, even if it disappears. If you saw it once, you should consult. Don't let it go. Very important to consult and consult very early. Male Speaker: And if you get it early prognosis is good or bad? Sasha Wainstein: If it is superficial type of tumor without invasion, only into the lining, just the simple resection could be more than enough. If it comes back in its multiple, then you have to treat it with certain medication that is given in the blood. One of the medications is BCG, which is tuberculosis type of the - the same that you use in, the pediatrics use the vaccination which is called BCG; Bacillus Calmette-Guerin that's usually, an attenuated Bacillus of tuberculosis and it's used in what it does I think, it usually develops the immune system in the blood. It doesn't prevent you from getting it in the future but it develops the immune and it boosts immune system. And it prevents you from the recurrence. It cuts down the recurrence. If you have multiple tumors, your chances of having a recurrence are up to about 60-70%, this one will cut it down to approximately about 35-40% which is a significant amount of decrease and the possibility of getting this tumor coming back. And as we know that every time you get this tumor back, there is a possibility that this can start going and growing into the muscle. Then if it grows into the muscle, the best treatment for this is that removal of the bladder. Male Speaker: Pretty steep end. Sasha Wainstein: Yeah. Now one of the recommendations right now with the AUI is that whenever you make a diagnosis, and you do the surgery initially the scraping of this tumor, then best and single treatment that you can do for your patient is giving him one single shot of chemotherapy into the blood in the recovery one, leave it in there for two hours with the clamped cathode and then take off the cathode and let them urinate on their on. That is the simple best prognostic factor that you can do to a patient. Male Speaker: And it works. Sasha Wainstein: And it works very well because cuts down the recurrence and it cuts down on the seeding doing the procedure because this tumor, the cells will go in the seed in any place where there is trauma, any kind of abrasion, irritation, scratching wit
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