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Transitional Cell Carcinoma

Transitional cell carcinoma is the most common bladder cancer. This type of cancer is in the urinary tract and affects the bladder, kidneys, and surrounding tissues and organs. TCC is also the second most common cancer that affects the kidneys accounting for up to 10 percent of urinary tract cancer.

Transitional Cell Carcinoma Symptoms

The following symptoms could be just about any disease of the urinary tract. The early stages of transitional cell carcinoma may not have any symptoms at all. As the cancer grows, symptoms appear including:

  • Urinary frequency
  • Pain during urination
  • Weight loss
  • Severe fatigue
  • Lower back pain that is constant
  • Blood in urine

If any of these symptoms persist for longer than days to weeks, see your doctor as soon as possible. Evaluation for possible cancer and treatment should never be delayed for any reason.

What Causes Transitional Cell Carcinoma?

Researchers are still unsure about the exact cause of transitional cell carcinoma. There may be a connection between smoking, infection, exposure to chemicals, and exposure to radiation. The actual cancer starts when the cell in the urinary tract begin to change and grow more rapidly than usual. The cells do not shed, but continue to grow into tumors.

Transitional cell carcinoma happens in the inside lining of the bladder, the urethra, and ureters. The cells mimic regular cells and open up when the bladder is full and squeeze back together when there is nothing in the bladder.

There are a few risk factors that raise the chances of TCC including:

  • Smoking – This increases the risk of TCC because of exposure to chemicals. The chemicals in cigarettes are passed into the urine and excreted from the body. They can damage the urinary tract and the cells, raising the risk of getting cancer.
  • Chemical Exposure – The urinary tract is one of the body’s main filters for toxins. When you are exposed, many of these chemicals are passed from your bloodstream through the kidneys and into the bladder. Some of the offending chemicals include paint, dye, arsenic, leather, and rubber.
  • Family History – If someone in your family has had bladder or urinary cancer, you are at a higher risk. This includes immediate family like father, brother, sister, mother. This is actually an uncommon risk factor.
  • Male Gender – Being male raises the risk of Transitional cell carcinoma. Women are at risk, but it is much lower.
  • Age – Age over 40 raises the risk of bladder cancer. While anyone can get it at any age, it isn’t as common in younger people.
  • Caucasians – White people tend to get TCC more than other ethnic groups.
  • Diabetic Medication – Actos has been implicated in the development of urinary tract cancer. This is if patients take the medication for more than one year. Other forms of Actos have also been connected to cases of urinary tract cancer.
  • Inflammation – Inflammation of the urinary tract or chronic use of a catheter that may cause infections can increase the risk of cancer in the urinary tract.
  • Radiation – If you had radiation exposure to the pelvic area in the form of treatment for other cancer, you may be at higher risk for transitional cell carcinoma.

Transitional Cell Carcinoma Diagnosis and Staging

If you have symptoms of transitional cell carcinoma, see your doctor as soon as possible. The doctor will ask you about your symptoms, how long they have persisted, any family medical history, and medications you are taking. If TCC is suspected, the doctor may order one or more of the following tests:

  • Cystoscopy – The doctor will use a small thin tube and send it through the urethra into the bladder. There is a light and camera so your doctor can see inside the lower urinary tract.
  • Biopsy – If you doctor finds a mass, a sample of tissue may be taken to check for cancer cells. Smaller biopsies can be done during cystoscopy, but larger ones are done under anesthesia and the procedure is called Transurethral Resection of Bladder Tumor (TURBT). This is also one of the first TCC treatments.
  • Cytology – The doctor may have you give a urine sample which can be looked at in the laboratory for cancer cells.
  • X-Ray and CT Scans – Your doctor may do some imaging tests to check the urinary tract for masses. One test injects dye into the urinary tract, others just look at the structures. These tests can also help the doctor stage the cancer and know how far it has progressed.

Bladder Cancer Staging

Bladder cancer is groups into four stages:

  • Stage I – Transitional cell cancer is localized to just the inner cells of the urinary tract.
  • Stage II – Cancer has grown into the walls of the urinary structures, but still not outside.
  • Stage III – Cancer is outside the urinary structures and tissues surrounding the urinary tract.
  • Stage IV – Transitional cell cancer is found in nearby lymph nodes, organs that are distant from the urinary tract, bones, and lungs and liver.

Transitional Cell Carcinoma Treatments

There are a number of treatments for transitional cell carcinoma and one or a combination may be used depending on the stage of cancer. These include:

Surgery

The doctor may do a transurethral resection of the tumor either during cystoscopy or under general anesthesia. The procedure uses an electrical loop that burns away any damaged and cancerous cells. They are also doing this procedure by laser recently. Side-effects includeblood in the urine and painful urination. If the cancer is at an advanced stage, the bladder may be removed and a pouch built to hold urine.

Biologic Therapy

This uses drugs that buildup the body’s own immunity to fight off the cancer. They take cells from your blood and increase the immune response to cancer cells and send it back into your system. Side-effects include bladder irritation and flu type symptoms.

Chemotherapy

You may need chemotherapy to kill the cancer cells that are still in your body after surgery or slow the growth prior to surgery. You may need one or more cancer drugs for treatment. Side-effects includenausea, vomiting, hair loss, weakness, and fatigue.

Radiation

Doctors may need to send radiation beams to your bladder area to kill off the cancer. This treatment may be used after you have bladder surgery and in combination with chemotherapy if surgery does not get all of the cancer.

Transitional Cell Carcinoma Prognosis and Survival Rate

The survival rate for TCC by stage is as follows:

Stage                   5 Year Survival Rate

Stage 0                98%

Stage I                 91.7%

Stage II                72.6%

Stage III               40.5%

Stage IV                15%

Many people with stage IV TCC survive less than 6 months after diagnosis. 

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