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      Bladder cancer.

      1 , ,
      Lancet (London, England)
      Elsevier BV

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          Abstract

          Bladder cancer is a heterogeneous disease, with 70% of patients presenting with superficial tumours, which tend to recur but are generally not life threatening, and 30% presenting as muscle-invasive disease associated with a high risk of death from distant metastases. The main presenting symptom of all bladder cancers is painless haematuria, and the diagnosis is established by urinary cytology and transurethral tumour resection. Intravesical treatment is used for carcinoma in situ and other high grade non-muscle-invasive tumours. The standard of care for muscle-invasive disease is radical cystoprostatectomy, and several types of urinary diversions are offered to patients, with quality of life as an important consideration. Bladder preservation with transurethral tumour resection, radiation, and chemotherapy can in some cases be equally curative. Several chemotherapeutic agents have proven to be useful as neoadjuvant or adjuvant treatment and in patients with metastatic disease. We discuss bladder preserving approaches, combination chemotherapy including new agents, targeted therapies, and advances in molecular biology.

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          Author and article information

          Journal
          Lancet
          Lancet (London, England)
          Elsevier BV
          1474-547X
          0140-6736
          Jul 18 2009
          : 374
          : 9685
          Affiliations
          [1 ] Department of Medicine, the Claire and John Bertucci Center for Genitourinary Cancers, Massachusetts General Hospital, Boston, MA 02114, USA. dskaufman@partners.org
          Article
          S0140-6736(09)60491-8
          10.1016/S0140-6736(09)60491-8
          19520422
          819d735a-f609-4170-8c3a-8cd68165442a
          History

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