Actos Bladder Cancer
The first T level refers to Ta or Tl tumors, which are superficial in nature. These noninvasive tumors can be papillary or carcinoma in situ (CIS), and have penetrated only the epithelium or intermediate cell layers of the bladder. This is an early, highly treatable stage of bladder cancer. The Ta tumor is the least invasive (or most superficial) variant, whereas theTl tumor shows the beginnings of invasion into the first layer of the bladder wall (before muscle is reached).
Tumors that are invasive and have moved into the muscle layer of the bladder are classified as T2. The lowercase letters a and b are used to describe how far into the muscle the tumor has spread. A T2a tumor has not penetrated as deeply into the muscle as a T2b tumor.
Tumors classified as T3, which can be further classified by the letters a and b, have penetrated beyond the bladder wall and into the fatty tissue surrounding the outside of the bladder. A T3a tumor is visible only with a microscope. A T3b tumor is visible in scans or to the naked eye during surgery.
AT4 tumor, the most serious and advanced of this local tumor grouping, has spread to other tissues or organs. A T4a tumor has inyaded the nearby uterus or vagina in a woman or the prostate in a man. A T4b tumor has spread through the pelvic or abdominal wall into the body.
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The letter N, followed by a numeral from one to three (1 to 3), tells your doctor whether your cancer has spread to lymph nodes near the bladder and how deeply the cancer has penetrated the nodes. The higher the number, the more lymph nodes are involved and the more enlarged the nodes are.
The letter Mfollowed by a one or a zero (1 or 0) indicates whether your cancer has spread to lymph nodes in other parts of the body (beyond the pelvis) or to other organs such as the lungs or liver. A zero indicates that the cancer has not spread to other organs; the number one means that it has.
Once your doctor and pathologist have determined your TNM values, the results will be combined and expressed as Roman numerals from zero to four (0 to IV). Stage IV, for example, is the most advanced and serious stage of cancer. The stages help predict rates of survival five years after treatment; they range from 98 percent survival in the Stage 0 category to about 15 percent in the Stage IV category. The stage of your cancer also helps doctors decide how aggressive to be in recommending treatment options,
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The terms Stage I or Stage IVare like medical shorthand, giving your physician a quick indication of overall prognosis and the general type of treatment that will be needed.
Grading tumors is another tool for your doctor. Instead of measuring how invasive the tumor is, grading indicates how abnormal the tumor cells appear under the microscope. The more abnormal, or undifferentiated, the tumor cells are, the more likely it is your cancer will spread aggressively.
Pathologists use the numerals one, two, or three (1, 2, or 3) or the words low, medium, or high to describe how abnormal the tumor cells appear. A tumor graded three (3) or higher is the most likely to spread aggressively. In some systems, grading is done on a scale of one to four.
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