“Hepatitis means inflammation of the liver. When the liver is inflamed or damaged, its function can be affected. Heavy alcohol use, toxins, some medications, and certain medical conditions can all cause hepatitis. However, hepatitis is often caused by a virus. In the United States, the most common hepatitis viruses are hepatitis A virus, hepatitis B virus, and hepatitis C virus.

Hepatitis C is a liver infection caused by the hepatitis C virus. Hepatitis C can range from a mild illness lasting a few weeks to a serious, long-term illness. Hepatitis C is often described as “acute,” meaning a new infection, or “chronic,” meaning long-term infection.

Hepatitis C can range from a mild illness lasting a few weeks to a serious, long-term illness. Hepatitis C is often described as “acute,” meaning a new infection, or “chronic,” meaning long-term infection.

• Acute hepatitis C occurs within the first 6 months after someone is exposed to the hepatitis C virus. Hepatitis C can be a short-term illness, but for most people, acute infection leads to chronic infection.
• Chronic hepatitis C can be a lifelong infection if left untreated. Chronic hepatitis C can cause serious health problems, including liver damage, cirrhosis (scarring of the liver), liver cancer, and even death.

There are vaccines to prevent hepatitis A and hepatitis B; however, there is no vaccine for hepatitis C.  Cirrhosis due to chronic hepatitis C is the leading indication for liver transplantation in Europe, United States and Japan.”

Centers for Disease Control and Prevention – CDC (https://www.cdc.gov/hepatitis/hcv/cfaq.htm)

Hepatitis C is an infectious disease affecting primarily the liver, caused by the hepatitis C virus (HCV). The infection is often asymptomatic, but chronic infection can lead to scarring of the liver and ultimately to cirrhosis, which is generally apparent after many years. In some cases, those with cirrhosis will go on to develop liver failure, liver cancer, or life-threatening esophageal and gastric varices.

HCV is spread primarily by blood-to-blood contact associated with intravenous drug use, poorly sterilized medical equipment, and transfusions. An estimated 150–200 million people worldwide are infected with hepatitis C^. The existence of hepatitis C – originally identifiable only as a type of non-A non-B hepatitis – was suggested in the 1970s and proven in 1989^.  Hepatitis C infects only humans and chimpanzees. It is one of five known hepatitis viruses: A, B, C, D, and E.

The virus persists in the liver in about 85% of those infected. This infection of the liver is caused by the hepatitis virus. About 3.2 million people in the U.S. have the disease. But it causes few symptoms, so most of them don’t know.

There are many forms of the hepatitis C virus. The most common in the U.S. is type 1. None is more serious than any other, but they respond differently to treatment.

Jaundice (a condition that causes yellow eyes and skin, as well as dark urine), Stomach pain, Loss of appetite, Nausea, and Fatigue.

HOW IT’S TRANSMITTED

The virus spreads through the blood or body fluids of an infected person.

You can catch it from:

-Sharing drugs and needles

-Having sex, especially if you have an STD, an HIV infection, several partners, or have rough sex.

-Being stuck by infected needles

-Birth — a mother can pass it to a child

Hepatitis C isn’t spread through food, water, or by casual contact.

HOW IT’S DIAGNOSED

You can get a blood test to see if you have the hepatitis C virus.

Are There Any Long-Term Effects?

Yes. About 75% to 85% of people who have it develop a long-term infection called chronic hepatitis C. It can lead to conditions like liver cancer and cirrhosis, or scarring of the liver. This is one of the top reasons people get liver transplants.

WHAT’S THE TREATMENT:

Hepatitis C treatments have changed a lot in recent years. The latest is a once-daily pill called Harvoni that cures the disease in most people in 8-12 weeks. It combines two drugs: sofosbuvir (Sovaldi) and ledipasvir. In clinical trials, the most common side effects were fatigue and headache. However, the medicine is expensive.  Interferon and ribavirin used to be the main treatments for hepatitis C. They can have side effects like fatigue, flu-like symptoms, anemia, skin rash, mild anxiety, depression, nausea, and diarrhea.

THOSE AT HIGHEST RISK:

Certain things may increase your risk of becoming infected with the hepatitis C virus. Just because you are at risk for getting hepatitis C does not mean that you have the virus.

Many people do not know how they became infected with hepatitis C.

Recommended Related to Hepatitis

Tips to Deal With Hepatitis C Fatigue

When you have hepatitis C, being tired — really tired — can be a fact of life. But there are ways you can boost your energy. Here, three people who have experience with fatigue from the disease share their tips.

You can get hepatitis from:                                                           

–Sharing needles and other equipment (such as cotton, spoons, and water) used to inject drugs.              

-Having your ears or another body part pierced, getting a tattoo, or having acupuncture with needles that have not been sterilized properly. The risk of getting hepatitis C in these ways is very low.                          

-Working in a health care environment where you are exposed to fresh blood or where you may be pricked with a used needle. Following standard precautions for health care workers makes this risk very low.

“With five different types of viral hepatitis, it can be difficult to understand the differences between them. Some forms of hepatitis get more attention than others, but it is still important to know how they are transmitted, what they do, and the steps that you can take to protect yourself and your liver!

While hepatitis A and B both impact the liver, the two viruses differ greatly from one another. Hepatitis B is a blood-borne pathogen; its primary mode of transmission is through direct blood-to-blood contact with an infected person. In contrast, hepatitis A can be spread by fecal-oral transmission or by consuming food or water that has been contaminated. It is important to note that a person cannot contract hepatitis B through casual interactions such as holding hands, sharing a meal with, or eating foods prepared by someone who is infected. There is no need to keep plates and utensils separate. However, hepatitis A can be spread through food that is prepared by an infected person. Hepatitis A is primarily caused by poor sanitation and personal hygiene. Poor sanitation and hygiene can be the result of a lack of essential infrastructure like waste management or clean water systems. It can also result from a lack of education.”

Hepatitis B Foundation (https://www.hepb.org/blog/whats-difference-hepatitis-vs-hepatitis-b/)

Viral hepatitis, including hepatitis A, hepatitis B, and hepatitis C, are distinct diseases that affect the liver and have different hepatitis symptoms and treatments. Other causes of hepatitis include recreational drugs and prescription medications. Hepatitis type is determined by laboratory tests.  The infection leads to inflammation of the liver with any hepatitis. The liver processes blood and filter toxins so they don’t cause damage to your body but when the organ is inflamed problems happen with the infection that caused the inflammation.

HEPATITIS A:

If you have this infection, you have inflammation in your liver that’s caused by a virus. You don’t always get symptoms, but when you do, you might have: Jaundice (yellowing of the skin), Pain in your belly, Loss of appetite, Nausea, Fever, Diarrhea, Fatigue, Loss of weight, fever, sore muscles, **Pain on the right side of the belly, under the rib cage-where your liver is located** (if not a combination of these symptoms).

Children often have the disease with few symptoms.

You can spread the Hepatitis A virus about 2 weeks before your symptoms appear and during the first week they show up, or even if you don’t have any.

How it’s transmitted:

-You can catch the disease if you drink water or food that’s been contaminated with the stool of someone with the virus.                                                                                                                                                  

You can also get infected if you:   HOW?  Well: -Eat fruits, vegetables, or other foods that were contaminated during handling.                                        

-Eat raw shellfish harvested from water that’s got the virus in it.                                                                        

-Swallow contaminated food. Exampes: Sometimes a group of people who eat at the same restaurant can get hepatitis A. This can happen when an employee with hepatitis A doesn’t wash his or her hands well after using the bathroom and then prepares food. It can also happen when a food item is contaminated by raw sewage or by an infected garden worker.                                                                                                                                                        

 -The disease can also spread in day care centers. Children, especially those in diapers, may get stool on their hands and then touch objects that other children put into their mouths. And workers can spread the virus if they don’t wash their hands well after changing a diaper.                                                                                                                                        

How Is It Diagnosed?

Blood tests allow doctors to diagnose it. **It is important to identify the type of hepatitis virus causing the infection to prevent it from spreading and to start the proper treatment. Since this Hepatitis A virus infection is spread through food or water that has been contaminated by the feces (stool) of an infected person.**

Are There Any Long-Term Effects?

Usually the virus doesn’t cause any long-term problems or complications. But according to the CDC, 10% to 15% of people with hepatitis A will have symptoms that last a long time or come back over a 6- to 9-month period. In rare situations, some people may have liver failure or need a transplant.

What’s the Treatment?

No treatments can cure the disease. Your doctor may take tests that check your liver function to be sure your body is healing.

Who is at highest risk for this?

-Live with or have sex with someone who’s -Travel to countries where hepatitis A is common

Remember the people who are also at risk:

-Men who have sex with men.                                                                                                                                       

-People who inject illegal drugs                                                                                                                                  

-Kids in child care and their teachers

-The virus can also be transmitted through close physical contact with an infectious person, although casual contact among people does not spread the virus.

HEPATITIS B

Hepatitis B is a serious disease caused by the hepatitis B virus (HBV). Infection with this virus can cause scarring of the liver, liver failure, liver cancer, and even death. What happens to most cases of Hepatitis patients is the adult cases (up to 95%), hepatitis B causes limited infection. Usually people manage to fight off the infection successfully within a few months, developing an immunity that lasts a lifetime. (This means you won’t get the infection again).  Blood tests show evidence of this immunity, but no signs of active infection. Unfortunately, this is not true in infants and young children in which 90% of infants and 30% to 50% of children will develop a chronic infection.

Symptoms of acute infection (when a person is first infected with hepatitis) include:

–Jaundice (yellowing of the skin or whites of the eyes and/or a brownish or orange tint to the urine) -Unusually light colored stool  -Unexplained fatigue that persists for weeks or months    

-Flu-like symptoms such as fever, loss of appetite, nausea, and vomiting –Abdominal pain

Often, symptoms occur one to six months after exposure, with an average of three month. An estimated 30% of those infected do not have any symptoms at all.

How it’s transmitted:

Hepatitis B is spread in infected blood and other bodily fluids such as semen and vaginal secretions. It is spread in the same way that the virus that causes AIDS (HIV) is spread but hepatitis B is 50 to 100 times more infectious. Most people who are infected with hepatitis B in the U.S. do not know they have it. If you’re pregnant and you’ve got hepatitis B, you could give the disease to your unborn child. If you deliver a baby who’s got it, he needs to get treatment in the first 12 hours after birth.

How it’s diagnosed:                                                                                                              

If your doctor suspects that you may have hepatitis B, he or she will perform a complete physical exam and order blood tests to look at the function of your liver. Hepatitis B is confirmed with blood tests that detect the virus.

If your disease becomes chronic, liver biopsies (tissue samples) may be obtained to detect the severity of the disease.

Are There Any Long-Term Effects?

Liver damage if the virus is not taken care will happen with multiple organ crash from putting affect on other organs from doing their jobs.

WHAT’S THE TREATMENT:

Treatment depends on whether you:

-Have been recently infected with the virus (treating acute hepatitis B).

-Have the symptoms of an acute infection.                                                                                                                  

-Have chronic infection (Have had the hepatitis B for a chronic period of time).                                        

-Acute vs Chronic=different RX.

Acute Hep B. you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B vaccine(What is a PDF document?). It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you receive treatment after exposure, the better the treatment works.

Regarding Chronic Hep B treatment depends on how active the virus is in your body and your chance of liver damage. The goal of treatment is to stop liver damage by keeping the virus from multiplying.

Antiviral medicine is used if the virus is active and you are at risk for liver damage. Medicine slows the ability of the virus to multiply.

Antiviral treatment isn’t given to everyone who has chronic hepatitis B.

Follow-up visits

Whether or not you take medicine, you will need to visit your doctor regularly. He or she will do blood tests to check your liver and the activity of the hepatitis B virus in your body.

Some of the tests can find out whether the virus is multiplying in your liver, which would increase your risk of liver damage.

Liver transplant

If you develop advanced liver damage and your condition becomes life-threatening, you may need a liver transplant. But not everyone is a good candidate for a liver transplant.

If you have not gotten a hepatitis B vaccine and think you may have been exposed to the virus, you should get a shot of hepatitis B immunoglobulin (HBIG) and the first of three shots of the hepatitis B vaccine(What is a PDF document?). It is important to receive this treatment within 7 days after a needle stick and within 2 weeks after sexual contact that may have exposed you to the virus. The sooner you receive treatment after exposure, the better the treatment works.

THOSE AT HIGHEST RISK FOR HEPATITIS B:

-Being born in, or spending more than 6 months in, parts of the world where hepatitis B is common or where a large number of people have been infected for a long time. Such areas include Southeast and Central Asia, the islands of the South Pacific, the Amazon River basin, the Middle East, Africa, Eastern Europe, and China.

-Being a man who has sex with men.

-Being sexually active. This includes having unprotected sex with someone who is infected with the virus or whose sexual history is unknown to you.

-Having more than one sex partner. (Your risk is higher if you have another sexually transmitted infection such as chlamydia.)

-Living with someone who has a chronic hepatitis B infection.

-Getting body piercings or tattoos from someone who doesn’t sterilize his or her equipment.

-Sharing needles or other equipment (such as cotton, spoons, and water) to inject illegal drugs.

“Borderline personality disorder (BPD) is a mental health condition marked by extreme mood fluctuations, instability in interpersonal relationships and impulsivity.

People with BPD have an intense fear of abandonment and have trouble regulating their emotions, especially anger. They also tend to show impulsive and dangerous behaviors, such as reckless driving and threatening self-harm. All of these behaviors make it difficult for them to maintain relationships.

Borderline personality disorder is one of a group of conditions called “Cluster B” personality disorders, which involve dramatic and erratic behaviors. Personality disorders are chronic (long-term) dysfunctional behavior patterns that are inflexible, prevalent and lead to social issues and distress.

Many people who live with borderline personality disorder don’t know they have it and may not realize there’s a healthier way to behave and relate to others.”

Cleveland Clinic (https://my.clevelandclinic.org/health/diseases/9762-borderline-personality-disorder-bpd)

What is borderline personality disorder?

Borderline personality disorder is a mental health condition that affects the way people feel about themselves and others, making it hard to function in everyday life. It includes a pattern of unstable, intense relationships, as well as impulsiveness and an unhealthy way of seeing themselves. Impulsiveness involves having extreme emotions and acting or doing things without thinking about them first.

People with borderline personality disorder have a strong fear of abandonment or being left alone. Even though they want to have loving and lasting relationships, the fear of being abandoned often leads to mood swings and anger. It also leads to impulsiveness and self-injury that may push others away.

Borderline personality disorder usually begins by early adulthood. The condition is most serious in young adulthood. Mood swings, anger and impulsiveness often get better with age. But the main issues of self-image and fear of being abandoned, as well as relationship issues, go on.

If you have borderline personality disorder, know that many people with this condition get better with treatment. They can learn to live stabler, more-fulfilling lives.

The signs and symptoms of the borderline personality disorder:

Borderline personality disorder affects how you feel about yourself, relate to others and behave.

Symptoms may include:

• A strong fear of abandonment. This includes going to extreme measures so you’re not separated or rejected, even if these fears are made up.
• A pattern of unstable, intense relationships, such as believing someone is perfect one moment and then suddenly believing the person doesn’t care enough or is cruel.
• Quick changes in how you see yourself. This includes shifting goals and values, as well as seeing yourself as bad or as if you don’t exist.
• Periods of stress-related paranoia and loss of contact with reality. These periods can last from a few minutes to a few hours.
• Impulsive and risky behavior, such as gambling, dangerous driving, unsafe sex, spending sprees, binge eating, drug misuse, or sabotaging success by suddenly quitting a good job or ending a positive relationship.
• Threats of suicide or self-injury, often in response to fears of separation or rejection.
• Wide mood swings that last from a few hours to a few days. These mood swings can include periods of being very happy, irritable or anxious, or feeling shame.
• Ongoing feelings of emptiness.
• Inappropriate, strong anger, such as losing your temper often, being sarcastic or bitter, or physically fighting.

How borderline personality disorder is diagnosed:

Personality disorders, including borderline personality disorder, are diagnosed based on a:

• Detailed interview with your doctor or a mental health professional.
• Mental health evaluation that may include completing a series of questions.
• Medical history and exam.
• Discussion of your symptoms.

A diagnosis of borderline personality disorder usually is made in adults — not in children or teenagers. That’s because what may appear to be symptoms of borderline personality disorder in children or teenagers may go away as they get older and mature.

When to see a doctor:

If you’re aware that you have any of the symptoms above, talk to your doctor or other regular healthcare professional or see a mental health professional.

If you have thoughts about suicide

If you have fantasies or mental images about hurting yourself, or you have thoughts about suicide, get help right away by taking one of these actions:

• Call 911 or your local emergency number right away.
• Contact a suicide hotline. In the U.S., call or text 988 to reach the 988 Suicide & Crisis Lifeline, available 24 hours a day, seven days a week. Or use the Lifeline Chat. Services are free and confidential.
• U.S. veterans or service members who are in crisis can call 988 and then press “1” for the Veterans Crisis Line. Or text 838255. Or chat online.
• The Suicide & Crisis Lifeline in the U.S. has a Spanish language phone line at 1-888-628-9454 (toll-free).
• Call your mental health professional, doctor or another member of your healthcare team.
• Reach out to a loved one, close friend, trusted peer or co-worker.
• Contact someone from your faith community.

If you notice symptoms in a family member or friend, talk to that person about seeing a doctor or mental health professional. But you can’t force someone to change. If the relationship causes you a lot of stress, you may find it helpful to see a therapist.

Treatments for borderline personality disorder patients:

Borderline personality disorder is mainly treated using psychotherapy, which also is known as talk therapy. But medicine may be added. Your doctor also may recommend that you stay in the hospital if your safety is at risk.

Treatment can help you learn skills to manage and cope with your condition. You also should be treated for any other mental health conditions that often occur along with borderline personality disorder, such as depression or substance misuse. With treatment, you can feel better about yourself and have a stabler, more fulfilling life.

Talk therapy

Talk therapy is a basic treatment approach for borderline personality disorder. Your mental health professional may adjust the type of therapy to best meet your needs.

Talk therapy seeks to help you:

• Focus on your ability to function.
• Learn to manage emotions that feel uncomfortable.
• Reduce your impulsiveness by helping you note feelings rather than act on them.
• Work on making relationships better by being aware of your feelings and those of others.
• Learn about borderline personality disorder.

Management of borderline personality disorder mainly focuses on making sense of moments that are emotionally hard by thinking about what happened in your relationships that led to those moments. Good mental health management tends to include a combination of individual therapy, group therapy, family education and medicines for related conditions.

Types of talk therapy that have been found to be effective include:

• Dialectical behavior therapy (DBT). DBT includes group and individual therapy designed to treat borderline personality disorder. DBT uses a skills-based approach to teach you how to manage your emotions, handle distress and understand relationships better.
• Cognitive behavioral therapy (CBT). CBT helps you change your beliefs that come from distorted ways of seeing things. It also can help with relationship issues. The goal is to learn to pinpoint negative thoughts and cope with those thoughts. This treatment can reduce mood swings and make you less anxious. It also can make it less likely that you’ll harm yourself or attempt suicide.
• Schema-focused therapy. Schema-focused therapy focuses on changing negative thought patterns.
• Mentalization-based therapy (MBT). MBT helps you note your thoughts and feelings and see things differently. MBT stresses thinking before reacting.
• Systems Training for Emotional Predictability and Problem-Solving (STEPPS). STEPPS is a 20-week treatment program where you work in groups that include your family members, caregivers, friends or significant others. STEPPS is used in addition to other types of talk therapy.
• Transference-focused psychotherapy (TFP). Also called psychodynamic psychotherapy, TFP aims to help you learn about your emotions and issues relating to others by creating a relationship between you and your therapist. You then apply what you learn to other situations.

Medicines

The Food and Drug Administration hasn’t approved any drugs specifically to treat borderline personality disorder. But some medicines may help with symptoms. And some medicines can help with conditions that occur with borderline personality disorder, such as depression, impulsiveness, aggression or anxiety. Medicines used to treat these conditions may include antidepressants, antipsychotics or mood-stabilizing drugs.

Talk to your doctor or mental health professional about the benefits and side effects of medicines.

Hospitalization

At times, you may need to be treated in a psychiatric hospital or clinic. Staying in the hospital also may keep you safe from harming yourself or help you talk about thoughts or behaviors related to suicide.

Recovery takes time

Learning to manage your emotions, thoughts and behaviors takes time. Most people improve greatly, but some people always struggle with some symptoms of borderline personality disorder. You may have times when your symptoms are better or worse. But treatment can make it easier to function and help you feel better about yourself.

You have the best chance for success when you work with a mental health professional who has experience treating borderline personality disorder.

“Bladder Cancer. These two words deliver a devastating impact. Every year, over 610,000 people are diagnosed with bladder cancer, and 1.9m people find themselves living with the condition. It is the 9^th most commonly diagnosed cancer and the 13^th cause of death from cancer globally. But, a timely diagnosis significantly increases the chance of long-term survival and quality of life.

Blood in the urine is the most important warning sign of bladder cancer to watch out for.

Yet bladder cancer is the forgotten cancer and what many don’t know is early diagnosis offers people a higher chance of successful treatment and long-term survival. We need to get people talking about this important statistic and we need them to share this fact. World Bladder Cancer Awareness month in May 2024 is a chance for us to do exactly that.”

World Bladder Cancer Patient Coalition (https://worldbladdercancer.org/awareness-month/)

Prevention of bladder cancer:

Although there’s no guaranteed way to prevent bladder cancer, you can take steps to help reduce your risk. For instance:

• Don’t smoke. If you don’t smoke, don’t start. If you smoke, talk to your doctor about a plan to help you stop. Support groups, medications and other methods may help you quit.
• Take caution around chemicals. If you work with chemicals, follow all safety instructions to avoid exposure.
• Choose a variety of fruits and vegetables. Choose a diet rich in a variety of colorful fruits and vegetables. The antioxidants in fruits and vegetables may help reduce your risk of cancer.

How bladder cancer is diagnosed could include the following:

• Using a scope to examine the inside of your bladder (cystoscopy). To perform cystoscopy, your doctor inserts a small, narrow tube (cystoscope) through your urethra. The cystoscope has a lens that allows your doctor to see the inside of your urethra and bladder, to examine these structures for signs of disease. Cystoscopy can be done in a doctor’s office or in the hospital.
• Removing a sample of tissue for testing (biopsy). During cystoscopy, your doctor may pass a special tool through the scope and into your bladder to collect a cell sample (biopsy) for testing. This procedure is sometimes called transurethral resection of bladder tumor (TURBT). TURBT can also be used to treat bladder cancer.
• Examining a urine sample (urine cytology). A sample of your urine is analyzed under a microscope to check for cancer cells in a procedure called urine cytology.
• Imaging tests. Imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, allow your doctor to examine the structures of your urinary tract.During a CT urogram, a contrast dye injected into a vein in your hand eventually flows into your kidneys, ureters and bladder. X-ray images taken during the test provide a detailed view of your urinary tract and help your doctor identify any areas that might be cancer.

  Retrograde pyelogram is an X-ray exam used to get a detailed look at the upper urinary tract. During this test, your doctor threads a thin tube (catheter) through your urethra and into your bladder to inject contrast dye into your ureters. The dye then flows into your kidneys while X-ray images are captured.

Determining the extent of the cancer

After confirming that you have bladder cancer, your doctor may recommend additional tests to determine whether your cancer has spread to your lymph nodes or to other areas of your body.

Tests may include:

• CT scan
• Magnetic resonance imaging (MRI)
• Positron emission tomography (PET)
• Bone scan
• Chest X-ray

Staging of Bladder Cancer:

Your doctor uses these diagnostic tests listed above for information from these procedures to assign your cancer a stage.

The stages of bladder cancer are indicated by Roman numerals ranging from 0 to IV. The lowest stages indicate a cancer that’s confined to the inner layers of the bladder and that hasn’t grown to affect the muscular bladder wall. The highest stage — stage IV — indicates cancer that has spread to lymph nodes or organs in distant areas of the body, like a lot of other cancers are staged I through IV.

Treatments of bladder cancer:

If cancer invades the muscles of the bladder, doctors will usually treat it with chemotherapy to shrink the tumor, followed by surgery to remove the bladder. However, a recent clinical trial found that adding immunotherapy to chemotherapy may allow certain patients to avoid surgery.

Bladder cancer treatment may include: Surgery, to remove the cancer cells. Chemotherapy in the bladder (intravesical chemotherapy), to treat cancers that are confined to the lining of the bladder but have a high risk of recurrence or progression to a higher stage.

Approaches to bladder cancer surgery might be used could include:

• Transurethral resection of bladder tumor (TURBT). TURBT is a procedure to diagnose bladder cancer and to remove cancers confined to the inner layers of the bladder — those that aren’t yet muscle-invasive cancers. During the procedure, a surgeon passes an electric wire loop through a cystoscope and into the bladder. The electric current in the wire is used to cut away or burn away the cancer. Alternatively, a high-energy laser may be used.Because doctors perform the procedure through the urethra, you won’t have any cuts (incisions) in your abdomen.

  As part of the TURBT procedure, your doctor may recommend a one-time injection of cancer-killing medication (chemotherapy) into your bladder to destroy any remaining cancer cells and to prevent cancer from coming back. The medication remains in your bladder for a period of time and then is drained.

• Cystectomy. Cystectomy is surgery to remove all or part of the bladder. During a partial cystectomy, your surgeon removes only the portion of the bladder that contains a single cancerous tumor.A radical cystectomy is an operation to remove the entire bladder and the surrounding lymph nodes. In men, radical cystectomy typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy may involve removal of the uterus, ovaries and part of the vagina.

  Radical cystectomy can be performed through an incision on the lower portion of the belly or with multiple small incisions using robotic surgery. During robotic surgery, the surgeon sits at a nearby console and uses hand controls to precisely move robotic surgical instruments.

• Neobladder reconstruction. After a radical cystectomy, your surgeon must create a new way for urine to leave your body (urinary diversion). One option for urinary diversion is neobladder reconstruction. Your surgeon creates a sphere-shaped reservoir out of a piece of your intestine. This reservoir, often called a neobladder, sits inside your body and is attached to your urethra. The neobladder allows most people to urinate normally. A small number of people difficulty emptying the neobladder and may need to use a catheter periodically to drain all the urine from the neobladder.
• Ileal conduit. For this type of urinary diversion, your surgeon creates a tube (ileal conduit) using a piece of your intestine. The tube runs from your ureters, which drain your kidneys, to the outside of your body, where urine empties into a pouch (urostomy bag) you wear on your abdomen.
• Continent urinary reservoir. During this type of urinary diversion procedure, your surgeon uses a section of intestine to create a small pouch (reservoir) to hold urine, located inside your body. You drain urine from the reservoir through an opening in your abdomen using a catheter a few times each day.

Chemotherapy drugs can be given:

• 1-Through a vein (intravenously). Intravenous chemotherapy is frequently used before bladder removal surgery to increase the chances of curing the cancer. Chemotherapy is going in your system generally through the blood stream and chemo may also be used to kill cancer cells that might remain after surgery. In certain situations, chemotherapy may be combined with radiation therapy.
• 2-Directly into the bladder (intravesical therapy). During intravesical chemotherapy, a tube is passed through your urethra directly to your bladder. The chemotherapy is placed in the bladder for a set period of time before being drained. It can be used as the primary treatment for superficial bladder cancer, where the cancer cells affect only the lining of the bladder and not the deeper muscle tissue.

Radiation therapy:

Radiation therapy uses beams of powerful energy, such as X-rays and protons, to destroy the cancer cells. Radiation therapy for bladder cancer usually is delivered from a machine that moves around your body, directing the energy beams to precise points.

Radiation therapy is sometimes combined with chemotherapy to treat bladder cancer in certain situations, such as when surgery isn’t an option or isn’t desired at that time or ever depending on your stage of cancer.

Immunotherapy:

Immunotherapy is a drug treatment that helps your immune system to fight cancer.

Immunotherapy can be given:

• Directly into the bladder (intravesical therapy). Intravesical immunotherapy might be recommended after TURBT for small bladder cancers that haven’t grown into the deeper muscle layers of the bladder. This treatment uses bacillus Calmette-Guerin (BCG), which was developed as a vaccine used to protect against tuberculosis. BCG causes an immune system reaction that directs germ-fighting cells to the bladder.
• Through a vein (intravenously). Immunotherapy can be given intravenously for bladder cancer that’s advanced or that comes back after initial treatment. Several immunotherapy drugs are available. These drugs help your immune system identify and fight the cancer cells.

Targeted therapy:

Targeted therapy drugs focus on specific weaknesses present within cancer cells. By targeting these weaknesses, targeted drug treatments can cause cancer cells to die. Your cancer cells may be tested to see if targeted therapy is likely to be effective.

Targeted therapy may be an option for treating advanced bladder cancer when other treatments haven’t helped.

Bladder preservation:

In certain situations, people with muscle-invasive bladder cancer who don’t want to undergo surgery to remove the bladder may consider trying a combination of treatments instead. Known as trimodality therapy, this approach combines TURBT, chemotherapy and radiation therapy.

First, your surgeon performs a TURBT procedure to remove as much of the cancer as possible from your bladder while preserving bladder function. After TURBT, you undergo a regimen of chemotherapy along with radiation therapy.

If, after trying trimodality therapy, not all of the cancer is gone or you have a recurrence of muscle-invasive cancer, your doctor may recommend a radical cystectomy.

After bladder cancer treatment:

Bladder cancer may recur, even after successful treatment. Because of this, people with bladder cancer need follow-up testing for years after successful treatment. What tests you’ll have and how often depends on your type of bladder cancer and how it was treated, among other factors.

In general, doctors recommend a test to examine the inside of your urethra and bladder (cystoscopy) every three to six months for the first few years after bladder cancer treatment. After a few years of surveillance without detecting cancer recurrence, you may need a cystoscopy exam only once a year. Your doctor may recommend other tests at regular intervals as well.

People with aggressive cancers may undergo more-frequent testing. Those with less aggressive cancers may undergo testing less often.

“Bladder cancer makes up about 4% of cancers in the US. It is the fourth most common cancer in men, but it’s less common in women.

The American Cancer Society’s estimates for bladder cancer in the United States for 2024 are:

• About 83,190 new cases of bladder cancer (about 63,070 in men and 20,120 in women)
• About 16,840 deaths from bladder cancer (about 12,290 in men and 4,550 in women)

The rates of both new bladder cancers and deaths from bladder cancer have been dropping in recent years.

Bladder cancer occurs mainly in older people. About 9 out of 10 people with this cancer are over the age of 55. The average age of people when they are diagnosed with bladder cancer is 73.

Overall, the chance men will develop this cancer during their lifetime is about 1 in 28. For women, the chance is about 1 in 89. However, each person’s chances of getting bladder cancer might be higher or lower than this, depending on their risk factors.”

American Cancer Society (https://www.cancer.org/cancer/types/bladder-cancer/about/key-statistics.html)

Bladder cancer is a common type of cancer that begins in the cells of the bladder. The bladder is a hollow muscular organ in your lower abdomen that stores urine.

Bladder cancer most often begins in the cells (urothelial cells) that line the inside of your bladder. Urothelial cells are also found in your kidneys and the tubes (ureters) that connect the kidneys to the bladder. Urothelial cancer can happen in the kidneys and ureters, too, but it’s much more common in the bladder.

Most bladder cancers are diagnosed at an early stage, when the cancer is highly treatable. But even early-stage bladder cancers can come back after successful treatment like many other cancers. For this reason, people with bladder cancer typically need follow-up tests for years after treatment to look for bladder cancer that recurs.

Signs and symptoms of Bladder Cancer may include the following:

• Blood in urine (hematuria), which may cause urine to appear bright red or cola colored, though sometimes the urine appears normal and blood is detected on a lab test
• Frequent urination
• Painful urination
• Back pain

Bladder cancer begins when cells in the bladder develop changes (mutations) in their DNA. A cell’s DNA contains instructions that tell the cell what to do. The changes tell the cell to multiply rapidly and to go on living when healthy cells would die. The abnormal cells form a tumor that can invade and destroy normal body tissue. In time, the abnormal cells can break away and spread (metastasize) through the body.

How common is Bladder cancer:

Urinary Bladder Cancer is the sixth most common type of cancer in the United States. In 2024, approximately 83,190 people will receive a diagnosis of bladder cancer, and some 16,840 people are expected to die from it, according to estimates by the Surveillance, Epidemiology, and End Results Program (SEER) of the National Cancer Institute (NCI).

Bladder cancer is most likely to affect white men. In fact, the incidence rate of bladder cancer is four times higher among men than among women. It is also twice as high in white males as among Black, Hispanic or Asian/Pacific Islander men.

The NCI explains that there are three major types of bladder cancer. The name of each type of cancer indicates the kind of cells that become malignant.

• Transitional cell carcinoma begins in cells in the innermost tissue layer of the bladder.
• Squamous cell carcinoma begins in the squamous cells. This type may form after long-term infection or irritation.
• Adenocarcinoma begins in glandular (secretory) cells in the lining of the bladder.

Cancer in the lining of the bladder is called superficial bladder cancer. Cancer that has spread through the lining of the bladder and has invaded the muscle wall of the organ, or has spread to nearby organs and lymph nodes, is called invasive bladder cancer.

Survival Rate:

Approximately 78 percent of people diagnosed with bladder cancer survived five years or more after diagnosis between 2012 and 2019, according to federal estimates.

Types of bladder cancer:

Different types of cells in your bladder can become cancerous. The type of bladder cell where cancer begins determines the type of bladder cancer. Doctors use this information to determine which treatments may work best for you.

Types of bladder cancer include:

• Urothelial carcinoma. Urothelial carcinoma, previously called transitional cell carcinoma, occurs in the cells that line the inside of the bladder. Urothelial cells expand when your bladder is full and contract when your bladder is empty. These same cells line the inside of the ureters and the urethra, and cancers can form in those places as well. Urothelial carcinoma is the most common type of bladder cancer in the United States.
• Squamous cell carcinoma. Squamous cell carcinoma is associated with chronic irritation of the bladder — for instance, from an infection or from long-term use of a urinary catheter. Squamous cell bladder cancer is rare in the United States. It’s more common in parts of the world where a certain parasitic infection (schistosomiasis) is a common cause of bladder infections.
• Adenocarcinoma. Adenocarcinoma begins in cells that make up mucus-secreting glands in the bladder. Adenocarcinoma of the bladder is very rare.

Some bladder cancers include more than one type of cell.

Risk factors:

Factors that may increase bladder cancer risk include:

• Smoking. Smoking cigarettes, cigars or pipes may increase the risk of bladder cancer by causing harmful chemicals to accumulate in the urine. When you smoke, your body processes the chemicals in the smoke and excretes some of them in your urine. These harmful chemicals may damage the lining of your bladder, which can increase your risk of cancer.
• Increasing age. Bladder cancer risk increases as you age. Though it can occur at any age, most people diagnosed with bladder cancer are older than 55.
• Being male. Men are more likely to develop bladder cancer than women are.
• Exposure to certain chemicals. Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it’s thought that being around certain chemicals may increase the risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.
• Previous cancer treatment. Treatment with the anti-cancer drug cyclophosphamide increases the risk of bladder cancer. People who received radiation treatments aimed at the pelvis for a previous cancer have a higher risk of developing bladder cancer.
• Chronic bladder inflammation. Chronic or repeated urinary infections or inflammations (cystitis), such as might happen with long-term use of a urinary catheter, may increase the risk of a squamous cell bladder cancer. In some areas of the world, squamous cell carcinoma is linked to chronic bladder inflammation caused by the parasitic infection known as schistosomiasis.
• Personal or family history of cancer. If you’ve had bladder cancer, you’re more likely to get it again. If one of your blood relatives — a parent, sibling or child — has a history of bladder cancer, you may have an increased risk of the disease, although it’s rare for bladder cancer to run in families. A family history of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), can increase the risk of cancer in the urinary system, as well as in the colon, uterus, ovaries and other organs.