Sasha Wainstein FACS Urology
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Male 1: If you do a test to someone who has blood in the urine and you found out that they have cancer of the bladder. Can you tell me something about cancer of the bladder? Male 2: Yes. Cancer of the bladder most of the time, it starts in the octillion lining of the bladder. Then after it starts in the lining, they are usually like a blunt they develop seeds and the roots that they develop over there, they start growing and they grow deep and they grow outside of the bladder. Male 1: Is it fast growing? Male 2: Cancer of the bladder is much fast growing than for example the other one that you can compare with that, cancer of the prostate. Male 1: Is it prone in men or with women again or together? Male 2: Age usually is involved. Male 1: At a certain age it is more apt to get a younger person or older person. Male 2: You can have a younger person and you can have an older person with this cancer. Male 1: And, how it is treated? Male 2: It is treated depending on what you have, the first line of treatment is the resection, it is through the cystoscope you look in there with a telescope, you find the cancer and you scrape it all over the current. It is an electrical current and you scrape it off. You base it on the tissue underneath the cancer to see what amount the cancer has advanced and developed the rooting into it which is growing into the other side of the lining of the bladder. Male 1: So earlier the diagnosis the better yield. Male 2: Very important, cancer of the bladder is one of the important things to make a diagnosis very early. If you see blood in the urine it is nothing. No, blood in the urine is a warning sign, even if it disappears, if you saw it once you should consult. Do not let it go, it is very important to consult and consult very early. Male 2: If you get it early, the prognosis is good. Male1: If it is a superficial type of tumor without invasion, only into the lining, just the simple resection could be more than enough. If it comes back and it is multiple, then you have to treat it with certain medication that is given in the bladder. One of the medications is BCG which is tuberculosis, the same that you use in vaccination which is called BCG (Bacillus Calmette Guerin). That usually is attenuated bacillus of tuberculosis and it used. And, what it does it usually develops the immune system in the bladder. It does not prevent you from getting it in the future but it develops the immunity and it boosts the 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 to 60 to 70 percent. This one would cut it down to approximately about 35 to 40% which is a significant amount of decrease and the possibility of getting this tumor coming back. And as we know, that every time that you get this tumor back there is a possibility that this can start growing into the muscle. That if it grows into the muscle, the best treatment of this is the removal of the bladder. Male: Pretty steep thing. Doctor: Now one of the recommendations right now would be a AUA is that whenever you make a diagnosis and you do the surgery initially, like the scraping of this tumor, the best and single treatment that you can do for your patient is to give him a single shot of chemotherapy into the bladder in the recovery room. Leave it in there for two hours with a gland catheter and take off the catheter and let them urinate on their own. That is the simple best prognostic factor that you can do to a patient. Male: And it works. Doctor: And it works very well because it cuts down on the recurrence and it cuts down on the scene during the procedure because this tumor, this cells would go in their sieve and any place where there is trauma, any kind of abrasion, irritation, scratching with the instruments inside the bladder, and the removal of the tumor by itself if you have floating cells that would sieve again in th
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