scholarly journals Application of nanotechnology in the diagnosis and treatment of bladder cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Yadong Xu ◽  
Cheng Luo ◽  
Jieqiong Wang ◽  
Lingwu Chen ◽  
Junxing Chen ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Diagnosis ◽  
Targeted Delivery ◽  
Complete Removal ◽  
Diagnosis And Treatment ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Management ◽  
Sample Test ◽  
Muscle Invasive

AbstractBladder cancer (BC) is a common malignancy in the genitourinary system and the current theranostic approaches are unsatisfactory. Sensitivity and specificity of current diagnosis methods are not ideal and high recurrence and progression rates after initial treatment indicate the urgent need for management improvements in clinic. Nanotechnology has been proposed as an effective method to improve theranosis efficiency for both non-muscle invasive bladder cancer (NMIBC) and muscle invasive bladder cancer (MIBC). For example, gold nanoparticles (AuNPs) have been developed for simple, fast and sensitive urinary sample test for bladder cancer diagnosis. Nanoparticles targeting bladder cancers can facilitate to distinguish the normal and abnormal bladder tissues during cystoscopy and thus help with the complete removal of malignant lesions. Both intravenous and intravesical agents can be modified by nanotechnology for targeted delivery, high anti-tumor efficiency and excellent tolerability, exhibiting encouraging potential in bladder cancer treatment. Photosensitizers and biological agents can also be delivered by nanotechnology, intermediating phototherapy and targeted therapy. The management of bladder cancer remained almost unchanged for decades with unsatisfactory effect. However, it is likely to change with the fast-developed nanotechnology. Herein we summarized the current utility of nanotechnology in bladder cancer diagnosis and treatment, providing insights for the future designing and discovering novel nanoparticles for bladder cancer management. Graphical Abstract

scholarly journals Reducing delays in the diagnosis and treatment of muscle-invasive bladder cancer using simulation modelling

2018 ◽  
Vol 12 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Daniel Chalk ◽  
Neil Trent ◽  
Sarath Vennam ◽  
John McGrane ◽  
Mark Mantle
Keyword(s):  
Bladder Cancer ◽  
Simulation Model ◽  
Bladder Tumour ◽  
Diagnosis And Treatment ◽  
Invasive Bladder Cancer ◽  
Computer Simulation Model ◽  
Nurse Specialist ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive ◽  
The Impact

Objective: To develop a simulation model to identify key bottlenecks in the bladder cancer pathway at Royal Cornwall Hospital and predict the impact of potential changes to reduce these delays. Materials and methods: The diagnosis and treatment of muscle-invasive bladder cancer can suffer numerous delays, which can significantly affect patient outcomes. We developed a discrete event computer simulation model of the flow of patients through the bladder cancer pathway at the hospital, using anonymised patient records from 2014 and 2015. The changes tested in the model were for patients suspected to have muscle-invasive disease on flexible cystoscopy. Those patients were ‘fast-tracked’ to receive their transurethral resection of bladder tumour (TURBT) treatment using operating slots kept free for these patients. A staging computed tomography scan was booked in the haematuria clinic. Pathology requests were marked as 48 hour turnaround. The nurse specialist would then speak to the patient whilst they were on the ward following their TURBT to give information about their ongoing treatment and provide support. Results: The model predicted that if the changes were implemented, delays in the system could be reduced by around 5 weeks. The changes were implemented, and analysis of 3 months of the data post-implementation shows that the average time in the system was reduced by 5 weeks. The environment created by the changes in the pathway improved referral to treatment times in both muscle-invasive and non-muscle-invasive groups. Conclusion: The simulation model proved an invaluable tool for facilitating the implementation of changes. Simple changes to the pathway led to significant reductions in delays for bladder cancer patients at Royal Cornwall Hospital. Level of evidence: Not applicable for this cohort study.

scholarly journals Clinical Utility of Bladder Cancer Biomarkers

2020 ◽  
Vol 1 (1) ◽  
pp. 62-67
Author(s):  
Laura-Maria Krabbe ◽  
Georgios Gakis ◽  
Yair Lotan
Keyword(s):  
Bladder Cancer ◽  
Cancer Diagnosis ◽  
Local Treatment ◽  
Predictive Biomarkers ◽  
Patient Comfort ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Therapeutic Success ◽  
Muscle Invasive ◽  
Work Up

Each year, there are an estimated 550 000 diagnoses of bladder cancer worldwide, and almost 200 000 deaths from bladder cancer. The need for frequent follow-up, including invasive procedures like cystoscopy, repetitive procedures like transurethral resection of bladder tumors and intravesical instillation therapy in non-muscle invasive stages, as well as systemic treatment with or without radical local treatment in advanced stages, makes bladder cancer one of the most expensive cancers to treat. Prognostic and predictive biomarkers have the potential to fundamentally change bladder cancer treatment algorithms, which may result in improved patient comfort and oncological outcomes and may also decrease the socioeconomic burden of the disease. Intense research has resulted in the recent approval by the U. S. Food and Drug Administration of the first agent for this disease that targets a specific mutation (fibroblast-growth factor receptor). Yet, many areas of bladder cancer diagnosis and treatment have remained unchanged for decades, and this is only in part due to their therapeutic success. In order to integrate biomarkers into clinical practice patterns, specific considerations for the different disease stages and settings should be kept in mind. Especially in the setting of screening, work-up of hematuria, as well as surveillance of patients with non-muscle invasive bladder cancer, (urine-)biomarkers may prove useful. They must, however, demonstrate a high enough sensitivity to pick up a cancer diagnosis or recurrence, allow easy handling (preferably a point-of-care setting) and adequate cost–benefit relationships, while also providing additional information to a full work-up. A biomarker to identify patients with muscle invasive bladder cancer who are in need of—and likely to respond to—neoadjuvant therapy would be very useful. In later disease, early detection of recurrence or progression, as well as biomarkers guiding treatment decisions between the available systemic agents, will be paramount for improved patient care.

Diagnosis and Treatment of Non-Muscle Invasive Bladder Cancer: AUA/SUO Guideline

2016 ◽  
Vol 196 (4) ◽  
pp. 1021-1029 ◽  
Author(s):  
Sam S. Chang ◽  
Stephen A. Boorjian ◽  
Roger Chou ◽  
Peter E. Clark ◽  
Siamak Daneshmand ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Diagnosis And Treatment ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

scholarly journals Trimodal therapy in muscle invasive bladder cancer management

2020 ◽  
Vol 72 (6) ◽  
Author(s):  
Elvira Polo-Alonso ◽  
Cynthia Kuk ◽  
Georgi Guruli ◽  
Asit K. Paul ◽  
George Thalmann ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Management ◽  
Trimodal Therapy ◽  
Muscle Invasive

scholarly journals KRT20, KRT5, ESR1 and ERBB2 Expression Can Predict Pathologic Outcome in Patients Undergoing Neoadjuvant Chemotherapy and Radical Cystectomy for Muscle-Invasive Bladder Cancer

2021 ◽  
Vol 11 (6) ◽  
pp. 473
Author(s):  
Hendrik Jütte ◽  
Moritz Reike ◽  
Ralph M. Wirtz ◽  
Maximilian Kriegmair ◽  
Philipp Erben ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Mrna Expression ◽  
Radical Cystectomy ◽  
Invasive Bladder Cancer ◽  
Muscle Invasive Bladder Cancer ◽  
Cancer Management ◽  
Erbb2 Expression ◽  
Erbb2 Mrna ◽  
Muscle Invasive

Patients with muscle-invasive bladder cancer (MIBC) that underwent neoadjuvant chemotherapy (NAC) prior to radical cystectomy (RC) show improved overall survival, especially those with pathological complete response (pCR). The response to NAC according to molecular subtypes has been discussed. Molecular targets such as estrogen receptor (ESR1) and human epidermal growth factor receptor 2 (ERBB2) play an important role in breast cancer management and have also been associated with urothelial bladder cancer. Hence, the association of Keratin 20 (KRT20) Keratin 5 (KRT5), ESR1, and ERBB2 mRNA expression in MIBC at transurethral resection (TUR-BT) with pCR after NAC was analyzed retrospectively. Formalin-fixed paraffin-embedded tumour tissue samples from TUR-BT of 54 patients (42 males, 12 females, median age of 64) with MIBC were analyzed for KRT20, KRT5, ESR1, and ERBB2 mRNA expression. After NAC, RC was performed, and the specimens were evaluated for pCR. Statistical analyses comprised nonparametric and chi2 testing, partition models, and Spearman correlation analyses. After NAC, 22 out of 54 patients (40.7%) had pCR. Tumours with an elevated expression of markers associated with luminal differentiation (KRT20, ERBB2, ESR1) were associated with a higher chance of pCR (55% vs. 15.8%, p = 0.009). Elevated ERBB2 expression was positively correlated with luminal expression features such as KRT20, and negatively with basal characteristics such as KRT5. Patients with MIBC showing a high expression of ERBB2, ESR1, or KRT20 have a significantly higher chance of pCR following NAC. These findings might improve patient selection for NAC in MIBC.

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