Urothelial Carcinoma

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The urothelium is the epithelial lining of renal collecting ducts, calyces, ureters, bladder, and urethra. Urothelial carcinoma (UC), previously referred to as transitional cell carcinoma, is a histopathologic type of cancer that typically arises from the urothelium.

Urological tumours represent approximately 25% of all human cancers. The majority of cases presenting UC are bladder cancers (BC), whereas upper urinary tract urothelial cancer (UTUC) accounts for only 5%–10% of all urothelial malignancies.

Bladder cancer (BC) is the seventh most commonly diagnosed cancer in the male population worldwide, while it drops to tenth when both genders are considered. About 1 in 100 men and 1 in 400 women will be diagnosed with BC sometime in life. Approximately 3.0% of all new cancer diagnoses and 2.1% of all cancer deaths are due to UC worldwide.

                                                                                                                        Histopathology of urothelial carcinoma of the urinary bladder.                                                                                Transurethral biopsy. Hematoxylin and eosin stain. (ref. wikipedia)

In the European Union, the age-standardised incidence rate is 20 for men and 4.6 for women.
In Norway, BC is the 4th most common cancer disease in men. The median age is 73, i. e. half of the patients getting UC are more than 73 years.

About 75 % of patients with BC present with a disease located to the mucosa and submucosa classified respectively as stage Ta, CIS and T1. These patients have a favourable prognosis and the majority will survive their cancer. The severe cases are the muscle infiltrating tumours that need more aggressive treatment and surveillance.

The current gold standard method for detection, diagnosis, and monitoring of BC is still a combination of urine cytology, cystoscopy, and conventional imaging such as computed tomography.

Because a lot of patients with BC survive there is a huge population to follow up with different types of interventions (most of the patients has to be followed rest of their lifetime).  This is why UC is the most costly cancer to follow up for the health system and it would be of huge interest to find a diagnostic test that could reduce these costs. 

About the Author Kjell H Kjellevold

A doctor and specialist in pathology. He has always been concerned about health and how to manage a good and healthy lifestyle. The blog will mainly be about the use of essential oils, health, and training.

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