What is Hospice Care?
Hospice care is designed to provide care to patients at the end of life. The term originates from the same root as “hospitality,” the idea of providing shelter to a sick or weary traveler. According...
Hospice care is designed to provide care to patients at the end of life. The term originates from the same root as “hospitality,” the idea of providing shelter to a sick or weary traveler. According...
The most basic credo of modern medicine is “first, do no harm.” Many of the treatments that we now have available, although often lifesaving, can be painful or difficult for patients and their families. We...
I have never thought of dying before, but now that I have been diagnosed with bladder cancer, I find myself wondering, are there things that I should do to prepare for death? None of us...
Most patients become involved in a clinical trial at the invitation of their own physician. Even at the largest centers, any individual physician will be involved in only a small number of trials, which may...
A clinical trial is the process through which new medications or therapies are tested to determine their ability to perform their stated task. They are also used to evaluate surgeries, radiation, and combinations of these...
Metastatic bladder cancer is generally quite difficult to treat. Current treatment for bladder cancer that has spread outside of the bladder is aggressive chemotherapy. Most often, a combination of four drugs is given. These medications...
Some cancers produce specific substances that can be measured in the blood. Many readers will be familiar with the relationship of PSA to prostate cancer. After surgery for prostate cancer, the blood levels of PSA...
The spread of any cancer outside of its organ of origin is called a metastasis. Bladder cancer tends to metastasize first to the lymph nodes in the pelvis. This is why the lymph nodes are...
Whether bladder cancer is superficial or invasive, it must still be confined to the bladder to be treated successfully by surgery. Once the tumor escapes from the bladder, it is difficult or impossible to remove...
If we know that bladder cancer results from damage to a cell’s genes, can’t we just fix the genes? There has been much excitement in recent years about our growing understanding of genetics and the...
Bladder-sparing protocols have largely shown similar rates of long-term survival compared with immediate cystectomy. The studies have been criticized, however, as falsely improving their results by selecting only those patients who were already likely to...
Bladder-sparing therapy refers to any approach to the management of muscle-invasive bladder cancer in which the goal is to avoid radical cystectomy. There are a variety of approaches, mostly based on the use of chemotherapy...
A ureteral stent is a long, soft tube that stretches from the kidney to the bladder. You have probably heard about cardiac stents for people who have clogged arteries. These stents hold the arteries open...
The immediate surgical risks of a partial cystectomy are similar to the risks for a radical cystectomy. These include bleeding, infection, damage to adjacent organs, and so forth (see Question 39). During a radical cystectomy,...
To be eligible for a partial cystectomy, the tumor must be just in the right place and just the right size. Tumors at the dome (top) of the bladder are the most amenable to partial...
A partial cystectomy is the removal of only that part of the bladder that has cancer in it. It essentially takes the place of the TURBT in other bladder-sparing protocols. It potentially improves the removal...
A continent urinary diversion provides a reservoir for the urine that can be drained every few hours by a catheter inserted by the patient. A segment of bowel is used to create a pouch inside...
Long-term problems after an ileal conduit are not uncommon. Overall, up to two thirds of patients will experience some type of problem. These problems can be categorized as follows. Stoma: About one in four patients...
Having a bag on your abdomen will not prevent you from doing the things that you used to do before surgery. The bag is pretty secure when snapped onto the wafer properly. Some individuals who...
Removal of the entire bladder, radical cystectomy, is the gold standard treatment for invasive bladder cancer. Rarely, individuals may be candidates for less invasive surgery or bladder-sparing regimens. Historically, the primary option to divert the...
The advantages of a neobladder over a urostomy or continent diversion are primarily lifestyle related and cosmetic. A neobladder is an attempt to replace the bladder with as close to a normal bladder, and therefore...
A neobladder is one of the options for reconstruction of the urinary tract after surgery. Other options include an ileal conduit or a continent cutaneous diversion. A neobladder is an attempt to replace the normal...
The most important part of the decision-making process is to talk with your urologist openly about your concerns. The two of you should decide together which option is best given any other medical problems, lifestyle,...
This is an important question. Obviously, your body still needs to make urine. It would be ideal to replace your bladder with an artificial or synthetic bladder. Unfortunately, no one has found a man-made material...
More attention has been focused on the effects of surgery on male sexual dysfunction than has been focused on female sexual dysfunction. Surprisingly, it is only in recent years that any attention has been focused...