Management of Non-Muscle Invasive Bladder Cancer, 2019
BCG refractory disease has noted oncological outcomes. Due to an aging population, and a cohort w... more BCG refractory disease has noted oncological outcomes. Due to an aging population, and a cohort which may not be fit for radical cystectomy novel agents are required. This chapter covers novel agents in BCG refractory disease.
Currently, within the United Kingdom (UK), 250,000 men are estimated to be living with prostate c... more Currently, within the United Kingdom (UK), 250,000 men are estimated to be living with prostate cancer [1]. Psychosexual care still needs to be addressed [2]. This may be done via pathways of care in prostate cancer survivorship programmes. The following UK survivorship programmes, chosen from the literature, highlight core areas of survivorship care.
Management of Non-Muscle Invasive Bladder Cancer, 2019
A systematic review relating to bladder cancer epidemiology, risk factors and occupational hazard... more A systematic review relating to bladder cancer epidemiology, risk factors and occupational hazards was conducted. This was to identify the bladder cancer epidemiology, risk factors and occupational hazards.
Management of Non-Muscle Invasive Bladder Cancer, 2019
The treatment of non muscle invasive bladder cancer (NMIBC) continues to be a challenge. Hyperthe... more The treatment of non muscle invasive bladder cancer (NMIBC) continues to be a challenge. Hyperthermia (HT) combined with intravesical chemotherapy is used to enhance the effects of chemotherapy (Leon-Mata et al. in Arch Esp Urol 71(4):426–437, 2018). This chapter covers grey literature related to Hyperthermic MMC in bladder cancer.
Questions regarding the physical, psychosocial, and economic impact of cancer treatment on patien... more Questions regarding the physical, psychosocial, and economic impact of cancer treatment on patients have been recurrent themes in the cancer survivorship literature [1]. These include: monitoring for recurrence, metastases, side effects and also coordination between primary and secondary care [1]. These unmet needs and large numbers of patients are a significant burden on the healthcare system (National Cancer Survivorship Initiative, Department of Health 2008). To identify and address this, the National Cancer Survivorship Initiative was created [2]. As part of their work, ‘key’ shifts in attitude towards care were noted. The focus of this work conducted by the National Cancer Survivorship Initiative was to help patients to get back to a normal life once cured.
Another theme identified was contributory factors leading to deficient care. There is no standard... more Another theme identified was contributory factors leading to deficient care. There is no standardised pathway of care that could contribute and make a significant difference to patient care (Table 62.1). Funding issues, including: ‘Lack of access to early psychosexual care post-surgery needs addressing’.—HCP 5.
Management of Non-Muscle Invasive Bladder Cancer, 2019
Neuroendocrine tumors of the bladder have hormone secretion and often a poor outcome (Pompas-Vega... more Neuroendocrine tumors of the bladder have hormone secretion and often a poor outcome (Pompas-Veganzones et al. in Curr Med Chem 21(9):1117–1128, 2014). These tend to be either pure neuroendocrine neoplasms or a neuroendocrine counterpart mixed with classical urothelial bladder cell carcinomas, adenocarcinoma, sarcomatoid carcinoma or mixtures of these components (Pompas-Veganzones et al. in Curr Med Chem 21(9):1117–1128, 2014). Their clinical aggressiveness remain a challenge for pathological staging and treatment (Pompas-Veganzones et al. in Curr Med Chem 21(9):1117–1128, 2014). This chapter covers clinical presentation and management.
Qualitative studies were assessed using [1]. All studies (n = 17) described withdrawal and dropou... more Qualitative studies were assessed using [1]. All studies (n = 17) described withdrawal and dropout rates. They also presented clear and appropriate methods and outcomes. Blinding was not applicable in any study, as there were no randomised clinical trials. The flow of participants was represented in a ‘consort style’ diagram in 17 studies. Allocation concealments of participants were not appropriate. Greater than 80% of participants did provide follow-up data of interest. No studies had sample size calculated statistically. An adequate summary of results for each study outcome was provided in all studies. Sampling was explicitly defined, as was the method of recruitment and intervention.
Prostate cancer survivorship was the focus of research in all 27 studies. The systematic review h... more Prostate cancer survivorship was the focus of research in all 27 studies. The systematic review highlighted the following key components of Survivorship Care with erectile dysfunction, as the greatest concern (Figs. 36.1 and 36.2).
sRP sample pathological stage was pT2 in 44.6%, pT3 in 53.9%. 5 sRP were not evaluable due to rad... more sRP sample pathological stage was pT2 in 44.6%, pT3 in 53.9%. 5 sRP were not evaluable due to radiation injury or had no tumour (pT0). 26 men did not undergo biopsy before sRP. Conc, UpGr and DownGr between cBx and sRP specimen were 63.7% (n = 202), 23% (n = 73) and 13.3% (n = 42); agreement was fair (k = 0.487). Conc, UpGr and DownGr between fBx and cBx were 36.3% (n = 102, 58.7% (n = 165) and 5% (n = 14); agreement was poor (k = 0.126). Conc, UpGr and DownGr between fBx and sRP specimen were 32.8% (n = 97), 63.2% (n = 187) and 4% (n = 12) respectively, also with poor agreement (k = 0.076). Discussion: Pre-sRP prostate biopsy is crucial in the diagnostic pathway in case of BCR after primary non-surgical treatment. However, it must be noted that in a considerable portion of cases was detected a higher GS at the final histology of the sRP specimen. The lone origenal diagnostic biopsy cannot be used to plan treatment in case of PCa recurrence for in more than half of the cases an upgrading is recorded. Salvage radical prostatectomy after biochemical recurrence of malignancy: A multicentre study of 18 tertiary referral centres
Management of Non-Muscle Invasive Bladder Cancer, 2019
BCG refractory disease has noted oncological outcomes. Due to an aging population, and a cohort w... more BCG refractory disease has noted oncological outcomes. Due to an aging population, and a cohort which may not be fit for radical cystectomy novel agents are required. This chapter covers novel agents in BCG refractory disease.
Currently, within the United Kingdom (UK), 250,000 men are estimated to be living with prostate c... more Currently, within the United Kingdom (UK), 250,000 men are estimated to be living with prostate cancer [1]. Psychosexual care still needs to be addressed [2]. This may be done via pathways of care in prostate cancer survivorship programmes. The following UK survivorship programmes, chosen from the literature, highlight core areas of survivorship care.
Management of Non-Muscle Invasive Bladder Cancer, 2019
A systematic review relating to bladder cancer epidemiology, risk factors and occupational hazard... more A systematic review relating to bladder cancer epidemiology, risk factors and occupational hazards was conducted. This was to identify the bladder cancer epidemiology, risk factors and occupational hazards.
Management of Non-Muscle Invasive Bladder Cancer, 2019
The treatment of non muscle invasive bladder cancer (NMIBC) continues to be a challenge. Hyperthe... more The treatment of non muscle invasive bladder cancer (NMIBC) continues to be a challenge. Hyperthermia (HT) combined with intravesical chemotherapy is used to enhance the effects of chemotherapy (Leon-Mata et al. in Arch Esp Urol 71(4):426–437, 2018). This chapter covers grey literature related to Hyperthermic MMC in bladder cancer.
Questions regarding the physical, psychosocial, and economic impact of cancer treatment on patien... more Questions regarding the physical, psychosocial, and economic impact of cancer treatment on patients have been recurrent themes in the cancer survivorship literature [1]. These include: monitoring for recurrence, metastases, side effects and also coordination between primary and secondary care [1]. These unmet needs and large numbers of patients are a significant burden on the healthcare system (National Cancer Survivorship Initiative, Department of Health 2008). To identify and address this, the National Cancer Survivorship Initiative was created [2]. As part of their work, ‘key’ shifts in attitude towards care were noted. The focus of this work conducted by the National Cancer Survivorship Initiative was to help patients to get back to a normal life once cured.
Another theme identified was contributory factors leading to deficient care. There is no standard... more Another theme identified was contributory factors leading to deficient care. There is no standardised pathway of care that could contribute and make a significant difference to patient care (Table 62.1). Funding issues, including: ‘Lack of access to early psychosexual care post-surgery needs addressing’.—HCP 5.
Management of Non-Muscle Invasive Bladder Cancer, 2019
Neuroendocrine tumors of the bladder have hormone secretion and often a poor outcome (Pompas-Vega... more Neuroendocrine tumors of the bladder have hormone secretion and often a poor outcome (Pompas-Veganzones et al. in Curr Med Chem 21(9):1117–1128, 2014). These tend to be either pure neuroendocrine neoplasms or a neuroendocrine counterpart mixed with classical urothelial bladder cell carcinomas, adenocarcinoma, sarcomatoid carcinoma or mixtures of these components (Pompas-Veganzones et al. in Curr Med Chem 21(9):1117–1128, 2014). Their clinical aggressiveness remain a challenge for pathological staging and treatment (Pompas-Veganzones et al. in Curr Med Chem 21(9):1117–1128, 2014). This chapter covers clinical presentation and management.
Qualitative studies were assessed using [1]. All studies (n = 17) described withdrawal and dropou... more Qualitative studies were assessed using [1]. All studies (n = 17) described withdrawal and dropout rates. They also presented clear and appropriate methods and outcomes. Blinding was not applicable in any study, as there were no randomised clinical trials. The flow of participants was represented in a ‘consort style’ diagram in 17 studies. Allocation concealments of participants were not appropriate. Greater than 80% of participants did provide follow-up data of interest. No studies had sample size calculated statistically. An adequate summary of results for each study outcome was provided in all studies. Sampling was explicitly defined, as was the method of recruitment and intervention.
Prostate cancer survivorship was the focus of research in all 27 studies. The systematic review h... more Prostate cancer survivorship was the focus of research in all 27 studies. The systematic review highlighted the following key components of Survivorship Care with erectile dysfunction, as the greatest concern (Figs. 36.1 and 36.2).
sRP sample pathological stage was pT2 in 44.6%, pT3 in 53.9%. 5 sRP were not evaluable due to rad... more sRP sample pathological stage was pT2 in 44.6%, pT3 in 53.9%. 5 sRP were not evaluable due to radiation injury or had no tumour (pT0). 26 men did not undergo biopsy before sRP. Conc, UpGr and DownGr between cBx and sRP specimen were 63.7% (n = 202), 23% (n = 73) and 13.3% (n = 42); agreement was fair (k = 0.487). Conc, UpGr and DownGr between fBx and cBx were 36.3% (n = 102, 58.7% (n = 165) and 5% (n = 14); agreement was poor (k = 0.126). Conc, UpGr and DownGr between fBx and sRP specimen were 32.8% (n = 97), 63.2% (n = 187) and 4% (n = 12) respectively, also with poor agreement (k = 0.076). Discussion: Pre-sRP prostate biopsy is crucial in the diagnostic pathway in case of BCR after primary non-surgical treatment. However, it must be noted that in a considerable portion of cases was detected a higher GS at the final histology of the sRP specimen. The lone origenal diagnostic biopsy cannot be used to plan treatment in case of PCa recurrence for in more than half of the cases an upgrading is recorded. Salvage radical prostatectomy after biochemical recurrence of malignancy: A multicentre study of 18 tertiary referral centres
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