Urothelial carcinoma, a type of cancer originating in the urinary system, constitutes approximately 90% of bladder cancers and 7% of kidney cancers. Both bladder and kidney cancers associated with urothelial carcinoma present similar symptoms and prognosis. When detected early, these cancers are typically manageable; however, recurrence is common despite initial treatment.
What is Urothelial Carcinoma (Transitional Cell Carcinoma):
Urothelial carcinoma, also known as transitional cell carcinoma (TCC), is the predominant form of bladder cancer, accounting for the vast majority of cases. This type of cancer originates from the urothelial cells lining the inner walls of the bladder. Interestingly, these same types of cells also coat other parts of the urinary tract, including the renal pelvis, ureters, and urethra. As a result, individuals with bladder cancer may develop tumors in these areas as well. Therefore, a thorough examination of the entire urinary tract is necessary to detect any potential tumors and ensure comprehensive treatment.
Signs and Symptoms:
Urothelial carcinoma might not show symptoms immediately. Typically, the first noticeable sign is blood in the urine. If you observe blood in your urine or experience other symptoms, such as frequent urination or pelvic pain, it’s important to seek medical attention promptly. Signs and symptoms are:
- tiredness
- low-grade fever
- persistent back pain
- unexplained weight loss
- painful urination (dysuria)
- a lump or mass in the kidney area
Causes of Urothelial Carcinoma:
While the exact cause of urothelial carcinoma in the bladder and kidneys remains unclear to medical researchers, they have pinpointed several common risk factors associated with the development of this type of cancer. Some common risk factors are:
Cigarette smoke: Cigarette smoking heightens the likelihood of developing urinary system cancers associated with urothelial carcinoma.
Exposure to certain chemicals: Research indicates that individuals employed in industries involving the use of specific chemicals found in dyes, rubber, leather, paint, textiles, and hairdressing products may face a higher likelihood of developing urinary system cancers associated with urothelial carcinoma.
Diagnosis and Tests:
Healthcare providers have various methods to diagnose bladder and kidney cancer, including urothelial carcinoma. These may include conducting the following tests:
- Urinalysis: A urine test, also known as urinalysis, examines the color and composition of your urine, including factors like sugar, protein, blood, and bacteria presence.
- Urine cytology: Healthcare providers analyze your urine under a microscope to look for any unusual cells. Cancer affecting the kidneys, bladder, or ureter can release cancer cells into the urine, which can be detected through this examination.
- Intravenous pyelogram (IVP): Healthcare providers perform a series of X-rays after injecting contrast dye into a vein to check for cancer in your kidneys, ureter, and bladder. This helps them detect any blockages as the dye moves through these organs.
- Ureteroscopy: Healthcare providers utilize a slender tube-like device equipped with a light and lens to examine the interior of your ureter and renal pelvis, allowing for visual inspection and the collection of tissue samples when necessary.
- Computed tomography (CT scan): CT scans, also known as computerized tomography or computerized axial tomography, use X-ray technology and computer software to create detailed images of the inside of your body.
- Ultrasound: An abdominal ultrasound uses high-energy sound waves to create images of internal organs, helping healthcare providers diagnose conditions like renal pelvis and ureter cancer.
- Magnetic resonance imaging (MRI): MRI, or magnetic resonance imaging, is a procedure that uses a combination of magnets, radio waves, and computer technology to create detailed images of the body, including the pelvis.
How is Urothelial Carcinoma Treated:
Urothelial carcinoma is treated with Enfortumab vedotin-ejfv (Padcev). This medicinal product is specifically approved for adults who have previously received certain types of chemotherapy or immunotherapy.
Padcev works by targeting and destroying cancer cells that express Nectin-4, a protein found on the surface of many urothelial cancer cells. It is typically administered through intravenous infusion and has shown promising results in clinical trials for patients with advanced or metastatic urothelial carcinoma. However, treatment decisions should be made in consultation with a healthcare provider, taking into account individual factors such as the stage and characteristics of the cancer, as well as the patient’s overall health and treatment goals.
Reference:
https://www.padcev.com/
https://www.healthline.com/health/bladder-cancer-stage-4/new-treatment-options#new-therapies
