would treatment of a mass in the bladder of a 95 yr old male who has dementi be advisebal ?

Are there any bladder control problems in older men?

Mar 30, 2020 · Be sure that you clean the site where the catheter enters the penis so that your dad doesn’t get a bladder infection. Also keep his skin dry and maybe put an ointment (like desitin, made for babies diaper rash) on the entire genital area. …

Is there an optimum management of bladder cancer in the elderly?

A mass (tumor) that is found on the bladder – the muscular sac in the pelvic region that stores urine – can sometimes be indicative of bladder cancer. In other cases, a bladder mass could be a benign (noncancerous) polyp, which is a small, cauliflower-like growth that can potentially turn into bladder cancer in the future.

What is a bladder mass?

Bladder cancer illustrates well the association between cancer and aging, and occurs most commonly in the elderly: the median age at diagnosis is 69 years for men and 71 years for women. 4 Bladder cancer is also the fourth and eighth most common malignancy in men and women, respectively, and the number of diagnosed cases is increasing annually ...

How do you treat overactive bladder in the elderly?

Apr 21, 2022 · Tel.: +1 708 216 5098 Fax: +1 708 216 1699 [email protected]. Sidebar. Sidebar. Executive Summary. Bladder cancer is primarily a disease in the elderly, who represent one of the fastest growing ...

How is bladder cancer treated in the elderly?

What can be done for a mass in bladder?

How long can an elderly person live with bladder cancer?

What happens if tumor in bladder is not removed?

How serious is a tumor in the bladder?

What is a mass in the bladder?

What are the signs that bladder cancer has spread?

Does bladder cancer spread quickly?

What happens in the last stages of bladder cancer?

How do they remove a tumor from the bladder?

Is a 5 cm bladder tumor large?

How long is recovery from bladder tumor surgery?

What does it mean when you have a mass on your bladder?

What Does a Mass on the Bladder Mean? A mass (tumor) that is found on the bladder – the muscular sac in the pelvic region that stores urine – can sometimes be indicative of bladder cancer. In other cases, a bladder mass could be a benign (noncancerous) polyp, which is a small, cauliflower-like growth that can potentially turn into bladder cancer in ...

What to do if you notice changes in your urine?

If you notice changes in your urination or have any symptoms that concern you, be sure to promptly speak with a physician. It’s also a good idea to let your physician know if anyone in your family has been diagnosed with bladder cancer or if you have experienced bladder problems before.

What does it feel like to pee when you have bladder cancer?

Burning sensations or pain while urinating. Difficulty emptying the bladder. An unusually weak urine stream. A frequent urge to urinate, even when the bladder is empty. Low back pain on one side. It’s important to note that bladder cancer shares many symptoms with urinary tract infections and other benign conditions.

Can you detect bladder cancer on your own?

You probably can’t detect a bladder mass on your own, so it’s beneficial to be familiar with the potential symptoms of bladder cancer and seek medical care if they occur. Some of the most common signs of this condition include:

How many people die from bladder cancer in 2050?

[ 101] Bladder cancer is primarily a disease of the elderly with the peak incidence occurring at 85 years. [ 2] With current estimates of approximately 70,530 new cases of bladder cancer being diagnosed in the US per year and 14,680 deaths attributed to the disease, bladder cancer will probably be a major public health problem as the population continues to age. [ 3]

What is radical cystectomy?

Radical cystectomy with pelvic lymphadenectomy and urinary diversion remains the standard treatment for clinically-localized MIBC, as well as high-risk nonmuscle-invasive disease and select patients with locally advanced bladder cancer. The procedure has evolved to include wider resection margins and extended lymph node dissections as a result of an appreciation for the aggressive nature of the disease. The associated short-term and long-term morbidity of the surgery can be formidable even in otherwise healthy patients. A comprehensive multi-institutional collaborative review noted complication rates in the elderly of up to 50% or greater. [ 10] A retrospective review of 283 cystectomy patients by Svatek et al. found that the incidence of any adverse event was approximately 50%; however, on further analysis, age was not associated with the rate of complications. [ 11] Nontheless, these relatively high morbidity rates are likely to temper the enthusiasm for radical cystectomy in elderly patients despite clear clinical indications. [ 12–14]

Is cystectomy a major surgery?

Even with recent advances in minimally invasive and robotic-assisted techniques, radical cystectomy with urinary diversion remains a major surgical undertaking with associated risks of metabolic, physiologic and psychologic alterations in both the short- and long-term. While previous reports have suggested acceptable outcomes in the elderly, it must be kept in mind that these represent highly select patients (felt to be acceptable surgical candidates) being treated at high volume tertiary referral centers. This is highlighted by the fact that population-based reports show a much lower utilization of radical cystectomy in this patient population. [ 9, 13, 16, 22] In the report from Bolenz et al., this exact issue of concordance with established treatment guidelines in elderly patients was investigated. They retrospectively reviewed the records of 206 consecutive patients aged over 75 years with biopsy-proven bladder cancer and compared their subsequent treatment with the established European Association of Urology (EAU) and American Urological Association (AUA) guideline recommendations. The actual treatment patterns for these patients (focusing on utilization of perioperative intravesical chemotherapy, restaging transurethral resections, and timely use of cystectomy and/or systemic chemotherapy when indicated) were then scored as concordant or discordant with the published guidelines. Median follow-up was 14.7 months and overall survival was the main study end point. The prognostic significance of clinicopathologic variables, including various comorbidity risk scores, and treatment pattern concordance on overall survival were then determined by multivariable regression analysis. They reported that of the 99 patients aged over 75 years who met the criteria for cystectomy, 87 patients were treated with curative intent with either cystectomy or definitive chemoradiation. This simply demonstrates that properly selected elderly patients with MIBC are often referred to high-volume academic centers for surgical management. [ 1]

Is bladder cancer a disease?

Executive Summary. Bladder cancer is primarily a disease in the elderly, who represent one of the fastest growing segments of the population. Prior studies have indicated that the majority of elderly patients with clinically localized muscle invasive bladder cancer do not undergo radical cystectomy as recommended by evidence-based guidelines.

Is radical cystectomy a recovery process?

Radical cystectomy can be associated with a formidable recovery process even for young and otherwise healthy individuals. For elderly patients who often have preexisting comorbid conditions there is little room for error. Attention to detail is absolutely critical to ensure acceptable perioperative outcomes. Even minor complications can lead to a 'slippery slope' of further related morbidity in patients with preexisting limited functional reserve.

What is the most important prognostic factor in cases of solitary fibrous tumor of the bladder?

Resectability is the most important prognostic factor in cases of solitary fibrous tumor of the bladder, followed by location, margins, size, and histopathologic appearance. [1] After resection, careful follow-up and surveillance are important.

What is the size of a bladder tumor?

Gross examination of the bladder revealed a 9.0 × 7.0 × 7.0–cm multilobulated mass involving most of the left lateral wall and trigone area of the bladder (Figure 2). Cross section of the tumor showed a smooth, tan parenchyma with an irregular lighter area of firm and more fibrous tissue.

What is the best way to diagnose a solitary fibrous tumor?

Therefore, diagnostic work-up should include immunostaining for tissue markers, as well as careful histopathologic examination to rule out the presence of malignant features.

How many cases of a solitary fibrous tumor in the urinary tract are malignant?

A literature review shows that of 16 cases reported in the urinary bladder, only 2 were malignant. Solitary fibrous tumors of the bladder lack distinctive patterns in symptoms, radiologic imaging, and patient demographics, which can make clinical diagnosis challenging.

Why is adjuvant therapy not used for solitary fibrous tumors?

Adjuvant chemotherapy and radiotherapy were not administered because of the tumor’s negative margins. The efficacy of adjuvant therapy in the management of solitary fibrous tumors remains controversial but is generally reserved for nonresectable, metastatic, and recurrent disease. [1-3] Six weeks after his cystoprostatectomy, the patient’s hemoglobin level had risen to 9.9 g/dL and his PSA level was < 0.01 ng/mL. After more than 1 year of follow-up, he is well and without recurrent, residual, or metastatic disease per MR and CT imaging performed at various times after the surgery.

Why was the tumor not resected?

A significant amount of the tumor was not resected because of its size and because of the patient’s known coagulopathy.

Is a spindle cell neoplasm malignant?

Histopathology examination of this second TURBT revealed a spindle cell neoplasm with histologic features and immunophenotype very similar to those of the previous specimen, but with the addition of atypical features consistent with a malignant nature . These findings were confirmed after consultation with two other in-house pathologists, and the consensus diagnosis was a malignant solitary fibrous tumor, invasive into fragments of muscularis propria, consistent with pathology stage pT2.

How long can you live with bladder cancer?

Many people treated for bladder cancer will go on to live long, healthy lives well in excess of 15 years. 18 .

Why do men get bladder cancer?

Like any cancer, bladder cancer is due to mutated cells that proliferate and form a tumor —in this case, in the bladder. For reasons not entirely understood, bladder cancer affects men three to four times more often than women, with nine out of 10 cases occurring over age 55. 7 The disease is more common in white than black men.

What is the fourth leading malignancy in men?

What many people fail to realize is that another form— bladder cancer —is the fourth leading malignancy in men, far outpacing testicular cancer by a rate of about six to one.

What is the gold standard for bladder cancer?

The gold standard for diagnosis of bladder cancer is cystoscopy. 12 The direct viewing technique is performed under local anesthesia to numb the urethra (the tube through which urine exits the body).

What mutations can cause bladder cancer?

Certain genetic mutations (particularly the FGFR3, RB1, HRAS, TP53, and TSC1 mutations ) may further predispose you to bladder cancer. 10

What is the underlying layer of bladder cancer called?

4  Those that involve the underlying layer of cells, called the lamina propria, are referred to as non-muscle invasive carcinoma. Those that penetrate even deeper into the muscles of the bladder wall are classified as invasive carcinomas.

What is the most common type of bladder cancer?

By far the most common bladder cancer in the United States is transitional cell carcinoma (TCC), also known as urothelial carcinoma. 3  This type is limited to the innermost lining of the bladder (known as the transitional epithelium). Because the transitional epithelium is only a few cells thick, catching cancer at this early stage—when it is considered non-invasive—translates to high rates of treatment success.

How old is the average person diagnosed with bladder cancer?

So, currently in the United States the median, not even the mean, age of diagnosis is 73 years old. And as we grow up we see that the number catches up and significantly in males over the age of 70. So, it’s a very common phenomenon, and indeed this is data from our multidisciplinary bladder cancer clinic. You can see that the third at least of the patients are nona and octogenarians, and those are coming to a tertiary center to get an opinion regarding, and even takeover obviously, of therapy in their specific situation.

Why is bladder cancer so common in elderly patients?

Why is bladder cancer, or muscle invasive bladder cancer, so common in elderly patients? So, it may be that it’s a more aggressive superficial disease. There’s certainly an element of delaying diagnosis, and probably some different biology. In terms of more aggressive superficial bladder cancer there is plenty of papers about that. This is just one that is very interesting looking at the differences in terms of progression and recurrence in patients that received, that had non-muscle invasive bladder cancer. They received TURBT and intravesical BCG, and one can see that age was an independent risk factor for tumor recurrence and progression. Essentially recurrence was 2.3 times in patients over the age of 80, compared to younger patients. And this is another way to look at the data. You can see the significance, odds of recurring and progressing even despite the intravesical BCG and the TURBT in elderly patients.

Can octogenarians have radical cystectomy?

We have to acknowledge though that octogenarians that undergo radical cystectomy are often found with a more aggressive disease. Now, we in our clinic, in our multidisciplinary clinic, tend not to recommend often neoadjuvant chemotherapy for octogenarian and nonagenarians. I will be interested to discuss that potentially with the forum, but the idea is that the studies that showed the benefit for neoadjuvant chemotherapy using translates to five years from the neoadjuvant chemotherapy. So, if your expected survival would be five years I’m not sure that the 5% of advantage of survival within five years justifies the morbidity of neoadjuvant chemotherapy. But bear in mind that octogenarians and nonagenarians will have a more aggressive disease on pathology.

Is bladder cancer more common in octogenarians?

Recurrence and progression of non-muscle invasive bladder cancer are more common in octogenarians. Compared to other treatment radical cystectomy seems to result in the best oncological outcome in octogenarians with muscle invasive bladder cancer. Again, this is not prospective data.

Is cystectomy more advanced in octogenarians?

This is suggested by a retrospective analysis, which is obviously biased. And the T stage is typically more advanced.

Do you have to give cisplatin for bladder cancer?

I think quite low, and we do have some, we didn’t publish that, but data from our own bladder cancer clinic. Yes, you don’t have to give certainly cisplatin chemotherapy in combination with a bladder preserva tion. This is a very nice study from England.

Can elderly patients tolerate cystectomy?

The perception would be well, those are elderly patients, they will not tolerate radical cystectomy, and urinary diversion because they’re A, because of their age, frailty, other comorbidities. And what we do is we usually eyeball that, but that’s wrong, and we need to get over that and incorporate tools that have been suggested by for example the geriatric society to better risk stratify patients for, cancer patients for major cancer surgeries. And you can see that age can be only a chronological marker and not necessarily a functional marker, and there are many tests and many algorithms that we do not use frankly as urologists, as medical oncologists potentially, as radiation oncologists, we don’t use them. For example, how many of you do use the activity of daily living, the instrumental activity of daily living, the Geriatric Depression Scale for example, to assess when you come to decide whether to do a radical cystectomy on an elderly patient. And these scales have been shown to be associated with 30 days of mortality. I guess few of us do it because are not aware of that or we’re just ignoring it.

How to correct bladder problems?

There are several ways to “train” the bladder using techniques like timed voiding and pelvic floor exercises.

How to help a person with bladder problems?

Encourage your loved one to talk to their doctor about their bladder control issues; there’s no need to be embarrassed. Their physician may be able to prescribe medicine to calm abnormal nerve signals to the bladder. Other medicines can be used to relax the bladder or shrink the prostate to improve urine flow. Surgery is a treatment option that is often considered as a last resort, but surgical procedures can help correct bladder control problems caused by nerve damage or irregularities of the urinary tract.

Why does my bladder leak when I urinate?

Urine leakage that follows a sudden, strong urge to urinate (OAB does not always cause UI) UI and OAB may be caused by prostate, muscle or nerve problems, but in other instances, the cause of overactive bladder is not clear.

Why does my urine feel so bad?

Frequent or painful urination, especially with blood in the urine, could be signs of a more serious underlying condition, such as prostate cancer, bladder cancer, bladder stones or a urinary tract infection (UTI). If your loved one exhibits these symptoms, it’s important to notify their doctor immediately.

How to know if you have an overactive bladder?

Overactive bladder (OAB) is a condition in which the bladder contracts to squeeze urine out at the wrong time. It is a type of urge incontinence. Your loved one may have OAB if he experiences two or more of these symptoms: 1 Urination eight or more times a day or two or more times at night 2 The sudden, strong need to urinate immediately 3 Urine leakage that follows a sudden, strong urge to urinate (OAB does not always cause UI)

How to treat OAB and UI?

Lifestyle changes and alterations to daily habits are the best place to start. For example, limiting fluids at certain times of the day, like in the hours before bed, and planning regular trips to the bathroom can help an elderly man avoid accidents. Losing weight, avoiding foods and drinks that irritate the bladder, and exercising regularly can also minimize symptoms of OAB and UI.

How to train your bladder?

There are several ways to “train” the bladder using techniques like timed voiding and pelvic floor exercises. Ask your doctor about bladder control techniques that can help. Bladder training usually takes time to improve symptoms, so it is wise to use incontinence products throughout this process to prevent accidents.

What are some ways to treat bladder retention?

If home remedies don’t work to treat bladder retention, medical intervention may be required. Bladder drainage, urethral dilation, urethral stents, prostate medications and even surgery are some forms of medical treatments for distended bladder.

What is it called when you can't empty your bladder?

Another condition occurs when a person cannot empty their bladder or even urinate. This condition is known as distended bladder. Distended bladder can be quite painful and when severe, life-threatening.

What causes a distended bladder?

The cause of distended bladder will best determine what treatment should be used. If distended bladder is linked with a medication, a change in that medication is in order. Furthermore, if distended bladder is caused by an infection, primary treatment will revolve around treating the infection.

How to tell if your bladder is distended?

Symptoms of a distended bladder include: Lower abdominal, lower back or chest pain. Bladder leakage. Inability to urinate (Anuria) Small amounts of urine that are expelled. Straining while urinating. Delay when attempting to urinate. Fever or abnormal sweating. Red or bloody urine (Hematuria)

Why does my bladder leak?

A person with bladder incontinence may have to wear diapers or pads to prevent the leakage from being noticeable. Another condition occurs when a person cannot empty their bladder or even urinate. This condition is known as distended bladder.

Can a enlarged prostate cause a distended bladder?

In males, an enlarged prostate can put additional pressure on the bladder, resulting in distended bladder. In other cases, medications can also lead to distended bladder. If you notice changes in your urination habits upon starting a prescription medication, you may wish to speak with your doctor.

Can over the counter medications cause a distended bladder?

Over the counter medications can also cause a distended bladder. Common culprits are antihistamines and other medications intended to treat a cold or allergies. Medical conditions, like blood clots and stroke, can contribute to distended bladder as they affect the spinal cord.

Why do people have incontinence at the end of life?

6  This can be a result of a surgery or illness, or because the person is simply too weak to use the bathroom. At the very end, when the muscles relax entirely, the patient will often release the contents of their bowels.

When is Memorial Sloan Kettering Cancer Center's "Toward the End of Life" published?

Memorial Sloan Kettering Cancer Center. Toward the end of life: What you and your family can expect. Published March 4, 2021.