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NCI CANCERLIT® Search: Therapy of Bladder Cancer - March 2002
National Cancer Institute®
Ultima Vez Modificado: 1 de marzo del 2002
Table of Contents
1
UI - 11544830
AU - Zlatnik EIu; Kapkina NN; Zaderin VP; Zakora GI
TI -
[Immunocorrective effect of alternating magnetic field in the
postoperative period in malignant bladder cancer]
SO - Vopr Onkol 2001;47(3):312-4
AD - Research Institute of Oncology, Ministry of Health of the RF,
Rostov-on-Don.
The study deals with immune status of patients operated for bladder
cancer and exposed postoperatively to alternating magnetic field (MF)
(hypothalamus and operative field). MF application was followed by
higher T- and B-lymphocyte and CD4+, CD16+ cell levels as well as
enhanced T-cell activity; no postoperative complications were registered
and tumor relapse rates were relatively low. The effect was likely to be
due to antistressor influence of MF. The procedure may substitute drug
therapy for immunocorrection and to avoid recurrence of bladder cancer.
2
UI - 11776112
AU - Zang Z; Xu H; Yu L; Yang D; Xie S; Shi Y; Li Z; Li J; Wang J; Li M; Guo
TI -
Y; Gu F
Intravesical immunotoxin as adjuvant therapy to prevent the recurrence
of bladder cancer.
SO - Chin Med J (Engl) 2000 Nov;113(11):1002-6
AD - Department of Urology, Second Hospital Affiliated to Kunming Medical
College, Kunming 650101, China.
OBJECTIVE: To assess the intravesical application of immunotoxin as
adjuvant therapy to prevent recurrence after tumor resection in bladder
cancer patients. METHODS: An anti-human immunotoxin against bladder
carcinoma, BDI-1-RT, was prepared and its in vitro targeting
cytotoxicity estimated. The immunoreactivity of BDI-1-RT with human
bladder cancer tissue of different grades and stages was detected by
immunohistochemical analysis. After safety test, intravesical
administration of BDI-1-RT was performed in 31 patients while mitomycin
C (MMC) was used in 36 patients serving as a control group. The
recurrence rates and side effects in both groups were recorded. In
addition, the development of human anti-mouse antibodies (HAMA) was
determined by ELISA, to assess the potential safety of this immunotoxin.
RESULTS: In our study, BDI-1-RT had immunoreactivity with 81.6% of
bladder transitional cell carcinomas. The immunoreactivity of BDI-1-RT
correlated with tumor grade. High-grade carcinoma had stronger staining
than low-grade (P < 0.05). There was no significant difference between
the BDI-1-RT group (10%) and MMC group (19.3%) in recurrence rate (P >
0.05). Side effects, including systemic and local, were more frequent in
the MMC group (11 of 36 patients versus 2 of 31, P < 0.05). HAMA was not
detected in any of 7 patients. CONCLUSION: Immunotoxin may have
considerable potential in the prophylaxis of bladder transition cell
carcinoma.
3
UI - 11769882
AU - Moyad MA
TI -
An introduction to aspirin, NSAids, and COX-2 inhibitors for the primary
prevention of cardiovascular events and cancer and their potential
preventive role in bladder carcinogenesis: part II.
SO - Semin Urol Oncol 2001 Nov;19(4):306-16
AD - Department of Surgery, University of Michigan Medical Center, Ann Arbor
48109-0330, USA.
Aspirin and the nonselective nonsteroidal anti-inflammatory drugs
(NSAIDs) have been commercially available for decades, and their ability
to reduce pain and inflammation are well known. The ability of some of
these agents to also reduce a primary or secondary cardiovascular event
or to potentially reduce the risk of colorectal cancer has also been
documented. These observations collectively have initiated a wide
variety of investigations to determine whether or not these agents may
have an ability to reduce the risk or progression of numerous cancers.
Some urologic cancers have been included in these recent studies. For
example, prostate cancer may be sensitive to these compounds based on a
small number of preliminary studies. Bladder cancer may also be
sensitive to the effects of these agents. Older patients and those with
more aggressive tumors may benefit most from these initial studies. Many
cancers also demonstrate a greater upregulation of cyclooxygenase-2
(COX-2), and this has lead to recent interest, especially in colorectal
cancer, to test the ability of these selective agents against the
development of precancerous colon polyps. High-risk patients for
colorectal cancer may have benefited by taking a selective COX-2
inhibitor in a recent randomized trial, but whether or not this benefit
continues to occur after the COX-2 inhibitor is removed remains
controversial and needs further study. Prostate and bladder cancer also
seem to demonstrate an upregulation of COX-2, and laboratory studies
suggest that these selective NSAIDs may have a greater effect on
reducing the development of these tumors. Randomized clinical trials are
needed, but because numerous individuals are currently using COX-2
inhibitors, a large volume of data should make at least retrospective
studies more plausible in the near future. The challenge for researchers
and clinicians is to further understand which NSAIDs and what dosage and
duration may provide the optimal benefit (if any), and to accurately
construe the available current data on these agents for patients
inquiring about these compounds.
4
UI - 11852763
AU - Lebret T
TI -
[Treatment of bladder tumors]
SO - Rev Prat 2002 Jan 1;52(1):36-42
AD - Service d'urologie Hopital Foch 92151 Suresnes. lebret@worldnet.fr
The bladder tumour treatment closely depends on initial diagnosis. For
superficial bladder tumour a conservative treatment is required using
endoscopic resection. Adjuvant instillations (BCG or mitomycine C) can
be proposed for high grade tumour. In case of muscular layer invasion or
in case of frequent non controlled recurrence, cystectomy is necessary.
Progress in anaesthesia, surgery and postoperative care permitted to
enteroplasty to be much less morbid, it must be considered as the
urinary diversion of choice. To prevent recurrence, both (superficial or
infiltrating) tumour require very strict follow-up for many years.
5
UI - 11849152
AU - Hara I; Miyake H; Hara S; Gotoh A; Nakamura I; Okada H; Arakawa S;
TI -
Kamidono S
Health-related quality of life after radical cystectomy for bladder
cancer: a comparison of ileal conduit and orthotopic bladder
replacement.
SO - BJU Int 2002 Jan;89(1):10-3
AD - Department of Urology, Kobe University School of Medicine, Kobe, Japan.
hara@med.kobe-u.ac.jp
OBJECTIVE: To compare the health-related quality of life (HRQoL) after
radical cystectomy in patients with an ileal conduit or an orthotopic
neobladder. PATIENTS AND METHODS: The study included 85 men who
underwent radical cystectomy for bladder cancer, comprising 48 with an
orthotopic neobladder (26 with an ileal and 22 with a colon neobladder)
and 37 with an ileal conduit. HRQoL was evaluated using the Short
Form-36 survey containing 36 questions assessing eight aspects,
including physical functioning, role-physical functioning, bodily pain,
general health, vitality, social functioning, role-emotional functioning
and mental health. RESULTS: The mean follow-up periods for patients with
a neobladder (ileal and sigmoid) and with an ileal conduit was 45.9
(38.2 and 53.1, respectively) and 130.9 months, respectively. Scale
scores were not affected by the duration of follow-up in either group.
There was no significant difference in any scale scores between the
neobladder and ileal conduit groups. However, general health and social
functioning in both the neobladder and ileal conduit groups appeared to
be significantly lower than those in the general population in the USA.
Furthermore, patients with a colon neobladder had a significantly higher
score for role-emotional functioning than those with an ileal
neobladder, while there was no significant difference in the remaining
seven scores between patients with ileal and colon neobladders.
CONCLUSIONS: Six of the eight scales of HRQoL were favourable in both
patients with a neobladder or an ileal conduit, and there was no
significant difference between these groups. In addition, the HRQoL of
patients with an orthotopic neobladder (except for role-emotional
functioning) was unaffected by the segment of the intestine used for
neobladder construction. Therefore, patients with both types of urinary
diversion were generally satisfied with their overall health and quality
of life.
6
UI - 11564036
AU - Dryhurst DJ; Fowler CG
TI -
Flexible cystodiathermy can be rendered painless by using 2% lignocaine
solution to provide intravesical anaesthesia.
SO - BJU Int 2001 Sep;88(4):437-8
AD - Academic Urological Unit, The Royal London Hospital, London, UK.
djdryhurst@mds.qmw.ac.uk
7
UI - 11844814
AU - Vaughn DJ; Broome CM; Hussain M; Gutheil JC; Markowitz AB
TI -
Phase II trial of weekly paclitaxel in patients with previously treated
advanced urothelial cancer.
SO - J Clin Oncol 2002 Feb 15;20(4):937-40
AD - University of Pennsylvania Cancer Center, Philadelphia, PA 19104, USA.
djv@mail.med.upenn.edu
PURPOSE: We evaluated the efficacy and toxicity of weekly paclitaxel in
patients with previously treated advanced urothelial cancer. PATIENTS
AND METHODS: Patients with urothelial cancer who had received one prior
systemic chemotherapy regimen for advanced disease and had evidence of
disease progression were eligible for enrollment. Patients received
paclitaxel 80 mg/m(2) by 1-hour intravenous infusion weekly. A cycle of
therapy consisted of four weekly treatments. RESULTS: The study enrolled
31 patients. Mean age was 66 years, and 45% of patients had three or
more involved metastatic sites. Only 26% of patients had responded to
prior chemotherapy. The median number of cycles delivered was three
(range, one to eight) at a mean weekly paclitaxel dose of 79 mg/m(2).
Three patients achieved a partial response (10%; 95% confidence
interval, 0% to 20%). Median time to progression was 2.2 months, and
median overall survival time was 7.2 months. Therapy was well tolerated
with minimal hematologic toxicity. Grade 3 nonhematologic toxicities
were also uncommon. CONCLUSION: Although the overall response rate to
weekly paclitaxel in patients with previously treated advanced
urothelial cancer was modest, the chemotherapy-refractory nature of the
study population should be considered.
8
UI - 11844817
AU - Kuball J; Wen SF; Leissner J; Atkins D; Meinhardt P; Quijano E; Engler
TI -
H; Hutchins B; Maneval DC; Grace MJ; Fritz MA; Storkel S; Thuroff JW;
Huber C; Schuler M
Successful adenovirus-mediated wild-type p53 gene transfer in patients
with bladder cancer by intravesical vector instillation.
SO - J Clin Oncol 2002 Feb 15;20(4):957-65
AD - Department of Medicine III, Johannes Gutenberg University, Mainz,
Germany.
PURPOSE: To study safety, feasibility, and biologic activity of
adenovirus-mediated p53 gene transfer in patients with bladder cancer.
PATIENTS AND METHODS: Twelve patients with histologically confirmed
bladder cancer scheduled for cystectomy were treated on day 1 with a
single intratumoral injection of SCH 58500 (rAd/p53) at cystoscopy at
one dose level (7.5 x 10(11) particles) or a single intravesical
instillation of SCH 58500 with a transduction-enhancing agent (Big CHAP)
at three dose levels (7.5 x 10(11) to 7.5 x 10(13) particles).
Cystectomies were performed in 11 patients on day 3, and transgene
expression, vector distribution, and biologic markers of transgene
activity were assessed by molecular and immunohistochemical methods in
tumors and normal bladder samples. RESULTS: Specific transgene
expression was detected in tissues from seven of eight assessable
patients treated with intravesical instillation of SCH 58500 but in none
of three assessable patients treated with intratumoral injection of SCH
58500. Induction of RNA and protein expression of the p53 target gene
p21/WAF1 was demonstrated in samples from patients treated with SCH
58500 instillation at higher dose levels. Distribution studies after
intravesical instillation of SCH 58500 revealed both high transduction
efficacy and vector penetration throughout the whole urothelium and into
submucosal tumor cells. No dose-limiting toxicity was observed, and side
effects were local and of transient nature. CONCLUSION: Intravesical
instillation of SCH 58500 combined with a transduction-enhancing agent
is safe, feasible, and biologically active in patients with bladder
cancer. Studies to evaluate the clinical efficacy of this treatment in
patients with localized high-risk bladder cancer are warranted.
9
UI - 11880082
AU - Peyromaure M; Weibing S; Sebe P; Verpillat P; Toublanc M; Dauge MC;
TI -
Boccon-Gibod L; Ravery V
Prognostic value of p53 overexpression in T1G3 bladder tumors treated
with bacillus Calmette-Guerin therapy.
SO - Urology 2002 Mar;59(3):409-13
AD - Department of Urology, Bichat-Claude Bernard Hospital, Paris, France.
OBJECTIVES: To evaluate the correlation between the overexpression of
mutant protein p53 and disease recurrence and progression in patients
treated with bacillus Calmette-Guerin (BCG) intravesical therapy for
T1G3 bladder cancer. METHODS: We analyzed the outcome of 29 consecutive
patients treated for T1G3 bladder tumor with transurethral resection.
Patients previously treated for a bladder tumor, those who underwent
incomplete resection, and those in whom no assessment of the muscle cell
layer was possible were excluded from the study. p53 overexpression was
determined using monoclonal p53-DO7 antibody, with a 20% cutoff for
definition of positivity. After the initial transurethral resection, all
patients were treated with Pasteur BCG (75 mg in 50 mL saline), weekly
for 6 weeks. The correlation between p53 overexpression and disease
recurrence and progression was assessed by the Fisher exact test.
RESULTS: The median follow-up was 36.7 months (range 1 to 108). Of the
29 patients, 18 (62.1%) were p53 positive and 11 (37.9%) were p53
negative. Both groups were similar according to age, tumoral substage
(T1a/T1b), association with carcinoma in situ, multifocality, and length
of follow-up. The recurrence rate was 54.4% in the p53-negative group
versus 38.9% in the p53-positive group (P = 0.47). The progression rate
was 18.2% in the p53-negative group versus 33.3% in the p53-positive
group (P = 0.67). CONCLUSIONS: These findings suggest that
overexpression of p53, as determined immunohistochemically, has no
predictive value for recurrence and progression in T1G3 bladder cancers
treated with intravesical BCG.
10
UI - 11880083
AU - Iori F; Di Seri M; De Nunzio C; Leonardo C; Franco G; Spalletta B;
TI -
Laurenti C
Long-term maintenance bacille Calmette-Guerin therapy in high-grade
superficial bladder cancer.
SO - Urology 2002 Mar;59(3):414-8
AD - Department of Urology, Division III, University of Rome La Sapienza,
Rome, Italy.
OBJECTIVES: To assess the long-term results of intravesical bacille
Calmette-Guerin (BCG) induction plus long-term maintenance treatment for
high-grade superficial bladder cancer. METHODS: Between 1994 and 2000,
41 patients who presented to our clinic with superficial urothelial
carcinoma of the bladder (T1G3, T1G3 plus carcinoma in situ, or
recurrent TaG2-3) were treated by transurethral resection of all visible
tumor and an induction cycle of BCG plus a long-term maintenance BCG
course consisting of 11 monthly instillations followed by 4 quarterly
instillations and then by 6 six-monthly instillations. The median
follow-up was 40 months. RESULTS: Thirty patients remained tumor free
throughout the follow-up period. Ten patients had a recurrence of
superficial tumor, 9 patients during the monthly instillation course and
1 patient during the quarterly instillation course. One patient
presented with progression. CONCLUSIONS: Adjuvant immunotherapy with BCG
after complete transurethral resection of bladder tumor represents a
highly effective primary treatment for high-grade superficial bladder
cancer. Our maintenance course of BCG seemed to improve the worldwide
accepted effectiveness of the BCG induction course without any important
side effects.
11
UI - 11751531
AU - Gazzaniga P; Gradilone A; Frati L; Agliano AM
TI -
Epidermal growth factor receptor mRNA expression in peripheral blood of
bladder cancer patients: a potential marker to detect treatment failure.
SO - Clin Cancer Res 2001 Dec;7(12):4288-9
12
UI - 11687012
AU - Shelley MD; Barber J; Mason MD
TI -
Surgery versus radiotherapy for muscle invasive bladder cancer.
SO - Cochrane Database Syst Rev 2001;(3):CD002079
AD - Research Laboratories, Velindre NHS Trust, Velindre Road, Whitchurch,
Cardiff, Wales, UK, CF4 7XL. mike.shelley@velindre-tr.wales.nhs.uk
BACKGROUND: Muscle invasive bladder cancer is a serious clinical problem
and is fatal for the majority of patients. Alternative treatments for
this condition are radical cystectomy or radical radiotherapy. The
choice of treatment varies according to the resident country. The ideal
treatment would be a bladder preserving therapy with total eradication
of the tumour without compromising survival. OBJECTIVES: The objective
of this review was to compare the survival after radical surgery
(cystectomy) versus radical radiotherapy in patients with muscle
invasive cancer. SEARCH STRATEGY: We searched the Cochrane Controlled
authors of unpublished data were undertaken. SELECTION CRITERIA:
Randomised trials comparing surgery versus radiotherapy were eligible
for assessment. DATA COLLECTION AND ANALYSIS: Three reviewers assessed
trial quality based on the Cochrane Guidelines. Data was extracted from
the text of the article or extrapolated from the Kaplan-Meier plot. The
Peto odds ratio was determined to compare the overall-survival and
disease-specific survival. Analysis was performed on an
intention-to-treat basis and treatment actually received. MAIN RESULTS:
Three randomised trials comparing pre-operative radiotherapy followed by
radical cystectomy (surgery) versus radical radiotherapy with salvage
cystectomy (radical radiotherapy) were eligible for assessment. These
trials represented a total of 439 patients, 221 randomised to surgery
and 218 to radical radiotherapy. Peto odds ratio analysis consistently
favoured surgery in terms of survival. It was significant at 3 (OR =
2.11, 95% CI 1.10,4.07) and 5 years (OR = 2.40, 95% CI 1.35, 4.29) for
overall survival and at 3 years (OR = 1.96, 95% CI 1.06,3.65) for
disease-specific survival for patients that actually received the
protocol treatment. On an intention-to-treat analysis for
disease-specific survival, the results were significantly in favour of
surgery at 3 years (OR = 1.96, 95% CI 1.06,3.65) but not at 5 years.
REVIEWER'S CONCLUSIONS: The evidence from this review suggests that
there is no overall statistically significant benefit to radiotherapy or
surgery ( with pre-operative radiotherapy) in muscle invasive bladder
cancer in terms of survival, but the trends consistently favour surgery.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.
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