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sqadia.com provides supplement to medical students in the form of medical video lectures delivered by experienced medical practitioners with the aim to improve the medical knowledge all around the world. In view of this mission, sqadia.com offers variety of medical lectures on the medical subject of internal medicine. In this lecture of bladder and renal cell carcinomas, medical specialist sheds light on the bladder cancer, its aetiology and staging, what measures to take for the treatment of bladder cancer. Subsequently, Dr. Saima Mushtaq gives important medical explanation of renal cell carcinoma along with its pathology, staging and treatment.
The lecture bladder and renal cell carcinomas made by following the medical book Harrison’s Principles of Internal Medicine'' for MBBS students focuses on the medical aspects of Bladder Cancer. Cigarette smoking is believed to contribute to up to 50% of urothelial cancers, the most common type of bladder cancer, in men and nearly 40% in women. Other implicated agents of blander cancer include aniline dyes, the drugs phenacetin and chlornaphazine, and external beam radiation. Staging of the tumor within the bladder is based on the pattern of growth and depth of invasion. Adenocarcinomas develop primarily in the urachal remnant in the dome of the bladder or in the periurethral tissues. Of the transitional cell tumors, low-grade papillary lesions that grow on a central stalk are most common. Low-grade non-invasive papillary tumors harbour constitutive activation of the receptor tyrosine kinase-Ras signal transduction pathway.
Clinical Features of Bladder Cancer
Clinical features of bladder cancer are discussed comprehensively in the medical video lecture at the platform of sqadia.com for medical and MBBS students. Hematuria occurs in 80–90% of patients and often reflects exophytic tumors. Microscopic hematuria is more commonly of prostate origin. Ureteral obstruction, flank pain, and palpable mass are some other features of bladder cancer. The staging of bladder cancer has been extensively explained by the medical specialist at sqadia.com for the ease of medical students through medically approved staging system i.e. TNM system. The stage T1 in bladder cancer illustrates that cancer invades connective tissue, stage T2a means cancer invades inner muscle layer. In stage T3b, fatty tissues are invaded and so on. Diagnosis of bladder cancer is carried out via biopsy and CT scan, magnetic resonance urogram, intravenous pyelogram, radionuclide imaging of skeleton, ultrasonography.
Treatment of Bladder Cancer
At sqadia.com, medical specialist Saima Mushtaq delivers detailed medical lecture of internal medicine course on the topic of bladder and renal cell carcinomas. This section of the internal medicine lecture is based on treatment of bladder cancer. Management depends on whether the tumor invades muscle and whether it has spread to the regional lymph nodes and beyond. For managing non muscle invasive disease, minimal treatment is complete endoscopic resection with or without intravesical therapy. Transurethral surgery is performed for solitary papillary lesions. For the treatment of muscle invasive disease, radical or partial cystectomy and bladder-sparing approach is carried out. Metastatic disease treatment achieves complete remission with chemotherapy alone or combined modality approach. Chemotherapeutic drugs have activity as single agents such as cisplatin, paclitaxel, and gemcitabine are considered most active. At present, drug combination GC is used more commonly than MVAC based on the results of a comparative trial of MVAC versus GC.
Renal Cell Carcinoma
At sqadia.com, according to the medical syllabus of internal medicine course, renal cell carcinoma is also discussed under the chapter of bladder and renal cell carcinomas. Carcinoma of renal pelvis and ureter is associated with chronic phenacetin abuse and aristolochic acid consumption (Balkan nephropathy). Upper tract urothelial carcinoma is linked to hereditary nonpolyposis colorectal cancer. Common symptom is painless gross hematuria. Notable features of renal cell carcinoma are resistance to cytotoxic agents, infrequent responses to biologic response modifiers. Renal cell carcinoma is most common between ages of 50-70 years. Classification of Renal cell carcinoma is categorized into clear cell carcinoma, papillary tumors, chromophobe tumors, oncocytomas, and collecting or Bellini duct tumor. Signs and symptoms of renal cell carcinoma are hematuria, varicocele, and anemia.
Management of Renal Cell Carcinoma
Diagnosis of renal cell carcinoma is carried out by conducting chest radiograph, urine cytology, CT scan of abdomen and pelvis, and assumed metastatic if not otherwise confirmed. In staging and prognosis of renal cell carcinoma, medical specialist Dr. Saima Mushtaq at sqadia.com elaborates the stages of cancer one after other so that medical students can easily understand and learn the medical knowledge of staging. Stage I tumors are <7 cm in greatest diameter and are confined to kidney. Stage II tumors are ≥7 cm. Stage III tumors extend through renal capsule and are confined to gerota’s fascia. Stage IV disease invade adjacent organs and involve multiple lymph nodes. In localized tumor, partial nephrectomy is applied electively to resect small masses. Management of advanced diseases can be accomplished by surgery, cytoreductive nephrectomy before systemic treatment, cytokine therapy with IL-2 or IFN-α.