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Actos Lawsuit : You can live without a bladder. However, you still need something that can perform the two basic func­tions of the bladder: storing and emptying of urine. Physicians have come up with many ways over the years to accomplish these tasks, many of which are still used today. The simplest alternative is to place drainage tubes into the kidneys that come out through the skin and connect to bags on the abdomen. These tubes are known as nephrostomy tubes. Nephrostomy tubes are typically inserted into a person in the X-ray department by an interventional radiologist who uses some light sedation. For the patient, the bag provides an easy way to store urine and can be drained several times a day when convenient by opening a small valve on the bag. These tubes can be uncomfortable, however, and may also be easily removed if tugged; therefore, they are only reasonable solutions for a short period of time or for patients who are too ill to undergo surgery. It is also possible to surgically bring the ureters directly to the skin surface (called a cutaneous ureterostomy). The urine then can be collected with a bag attached to the skin around the opening. Unfortunately, the ureters are rela­tively small, and thus any scarring or narrowing of the opening can cause a blockage of urine. This tendency to get blocked also makes cutaneous ureterostomies a poor long-term solution.

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To provide a good long-term solution, surgeons most commonly use a portion of the small bowel to act as the new bladder. The identified piece of small bowel is removed from the main portion and is fashioned for its new use (see Question 79 for details). The urine that collects within this piece of bowel will ultimately be drained in one of three ways. First, the bowel can simply be left open at the skin for the urine to drain passively out into a bag that is attached to the abdomen. This type of drainage is known as a conduit, and the opening onto the skin is called a urostomy. Urine collects in the bag, which is then drained into a toilet several times each day. Second, the bowel can be sewn into a rough sphere con­nected to the skin by only a small, long channel. This channel prevents urine from leaking out but easily accommodates a small catheter. This is called a conti­nent urinary diversion. With this type of diversion, you must pass a catheter into the new bladder several times a day to drain the urine. This allows you to live without an ostomy bag, but for some patients, passing the catheter several times a day may be difficult or impossible. Third, the new bladder can be directly reattached to the urethra (called an orthotopic neobladder). This allows you to urinate almost normally, although you do need to learn to use different muscles, as the new bladder replacement.

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To understand cancer, we must first understand nor­mal functioning of the body. The body is made up of billions of cells. Each organ of the body is made up of several different types of specialized cells. For example, the liver has cells that filter toxins from the blood, and the brain has nerve cells (called neurons) that are able to conduct electrical signals. Perhaps the most familiar cells are skin cells. Every flake of dry skin is made of millions of cells that are constantly dying and being replaced with new cells. The growth of new cells is care­fully balanced to occur at the same rate as the death of old cells. Your body has many mechanisms in place to regulate the timing of the birth and death of cells. Unfortunately, if one of these mechanisms malfunc­tions, the careful balance can be disrupted. Environ­mental toxins such as cigarette smoke, chemicals, and radiation can damage DNA and can disrupt these control mechanisms. A tumor may develop when new cells are created faster than old cells die. Tumors can be either benign or malignant. A benign tumor is an overgrowth of cells that is unchecked by the body’s normal mechanisms; thus, it will keep getting bigger. It is called benign because it does not cause you illness. Some benign tumors can get to be so large that they do cause problems, especially if they are in a confined space, such as your skull. A malignant tumor is also an overgrowth of cells. The tumor is considered malignant, however, because the cells are no longer confined to the tumor. Cells may spread from the main tumor through the blood and lymph system or grow directly into nearby structures. As the cells begin to grow unchecked in new organs, they gradually cause dysfunction all over the body and may eventually even cause death.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit : The bladder is the container in the body that stores urine. The other term for bladder is “vesical,” which is derived from the Latin word vesicular. The bladder is a soft, round structure that is located in the pelvis. The pubic bone is in front of the bladder; the rectum in men or the uterus in women is behind the bladder. Urine drains into the bladder through an opening on each side at the bottom of the bladder. Urine is stored in the bladder until a person is ready to urinate. In order to urinate, the muscle in the bladder wall squeezes, push­ing the urine out of the bladder through the urethra. In women, the urethra is short, only approximately 1 inch long. In men, it is much longer because it has to pass through the prostate and then the penis before finally opening at the tip of the penis.

In the middle of the abdomen, just beneath the lower ribs, are the kidneys. The kidneys filter the blood to produce urine. The urine that the kidneys produce exits the kidney through the renal pelvis and flows into the ureters. The ureters are soft, muscular tubes that are about the width of a pencil. They carry the urine from the kidneys down to the bladder, where they open into the base of the bladder.

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The adult bladder normally holds approximately 400 ml of urine. The bladder wall has three separate layers. The innermost layer that is in contact with the urine is a thin layer called the urothelium. The middle layer is made of muscle fibers that can squeeze. When the muscles contract, they increase the pressure inside the bladder, squeezing the urine out of the bladder. The outermost layer is a thin but protective layer called serosa.

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The bladder has two functions. The first is the storage of urine, and the second is the emptying of urine. In an infant, the bladder constantly fills and empties without any control by the brain. During toilet training, the brain learns to control the bladder, enabling it to hold (store) the urine until a time when it is socially accept­able to urinate. Emptying is the second function that the bladder must perform. In infancy, before toilet train­ing, this is actually the most important function of the bladder.

Although most of us take these two processes for granted, either one or both can malfunction. If the stor­age function fails, the bladder can become very small and contracted, holding just a tiny amount of urine before it needs to empty. In contrast, it may become floppy and dilated, holding several liters of urine before it is ready to empty. It can also become “overactive,” causing feelings of urgency and the need to urinate more than eight times per day. When the actual emptying function goes wrong, the bladder may only partially empty each time, leaving a high remaining amount of urine (the so-called postvoid residual). The bladder muscle may also weaken to the point where one is completely unable to urinate. This is called urinary retention.

When storing urine, the bladder must do so at a low pressure. This allows the new urine made in the kidneys to flow downward into the bladder. A safe bladder pres­sure is less than 40 cm H2O. When the pressures are higher than this, the urine may “back up” in the kidneys. High pressures in the kidneys over a long period of time may damage the kidneys. During urination, the bladder must squeeze to force the urine out. The pressure in the bladder at these times may be much higher than 40 cm H₂O, but it does not usually damage the kidneys.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit

Actos Lawsuit News- 1/26/2012: Surgery can be as effective in elderly patients as in younger patients, but it does have a higher rate of postoperative complications in older individuals who have other medical problems (comorbidities). Elderly people are particularly sensitive to long-term complications, lilce the metabolic dis­turbances that can follow urinary diversion. In those aged 80 or older, the role of radical cystectomy is controversial. Although newer surgical techniques and improvements in care, before and after the operation, make this an option for increasing numbers of older patients, several studies suggest that its benefit is at best quite minimal, even in relatively fit octogenarians. You need to carefully weigh the benefits and risks of radical cystectomy with your multidisciplinary team before going through such an aggressive operation.

Because bladder cancer surgery can cause serious side effects and debilitation that requires significant healing time and energy, older patients usually tolerate neoadjuvant chemotherapy (given before surgery) better than adjuvant chemotherapy (given after surgery). On the other hand, because not all bladder cancer patients need chemotherapy, giving it after surgery (adjuvant therapy) offers the advantages of treating only those patients who absolutely need it. You should discuss the advantages and disadvantages of both approaches with your multi­disciplinary team.

With regard to choice of chemotherapy, healthy older patients can receive the same regimens as their younger counterparts, including those that are anthracycline-based, like MVAC (see Chapter 3). However, older patients are at increased risk of developing congestive heart failure from these regimens, and gemcitabine-cisplatin is probably a better choice, especially in those with a significant cardiac risk for anthracyclines. Recent studies have shown this regimen to be just as effective as MVAC but with fewer- side effects.

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Managing chemotherapy-associated toxicity with appropri­ate supportive care is crucial in the elderly population to give them the best chance of cure and survival or to provide the best palliation. Reducing tire dose of chemotherapy (or radiation therapy) based purely on chronological age may seriously affect the effectiveness of treatment. Those with metastatic disease may tolerate single-agent chemotherapy better, but tire presence of severe comorbidities, age-related frailly, or underlying severe psychosocial problems may be obstacles, even for these treatment plans. As in younger patients, trimodal therapy with bladder preservation may be an option for selected older individuals with bladder cancer (see Chapter 3). It is an aggressive treatment approach that involves radiation therapy, chemotherapy, and surgery. If an older person is too frail to undergo radical cystectomy, he or she is usually too frail to get trimodal therapy. There are a few exceptions to this general rule, and it is essential that you weigh all of the risks and benefits with your multidisciplinary care team. In frail patients, radiation therapy is sometimes used to control the symptoms of bladder cancer, but it is rarely curative.

The fatigue that usually accompanies radiation therapy can be quite profound in the elderly, even in those who are fit. Often, the logistical details (like daily travel to the hospi­tal for a 6-week course of treatment) are the hardest for older people. It is important that you discuss these potential problems with your family and social worker before starting radiation therapy. Anemia (low red blood cell count) is common in the elderly, especially the frail elderly. It decreases the effectiveness of chemotherapy and often causes fatigue, falls, cognitive decline (for example, dementia, disorientation or confusion), and heart problems. Therefore it is essential that anemia be recognized and corrected with red blood cell transfusions or the appropriate use of erythropoiesis-stimulating agents.

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Kidney function declines as we age. Some of the medicines that older patients take to treat both their cancer (for example, cisplatin, carboplatin, methotrexate, zoledronic acid, nonsteroidal anti-inflammatory drugs) and noncancer- related problems might make this worse. The dehydration that often accompanies cancer and its treatment can put additional stress on the kidneys. Fortunately, it is often possible to minimize these effects by carefully selecting and dosing appropriate drugs, managing “polypharmacy,” and preventing dehydration. Fatigue is a near universal complaint of older cancer patients. It is particularly a problem for those who are socially isolated or depend on others to help them with activities of daily living. It is not necessarily related to depression, but it can be. Depression is quite common in the elderly. In contrast to younger patients who often respond to a cancer diagnosis with anxiety, depression is the more common disorder in older cancer patients. With proper support and medical attention, many of these patients can safely receive anticancer treatment.

fter receiving the diagnosis of cancer, many patients report that they hear very little else their doctor tells them. Although this information will be repeated and clarified over the ensuing visits with your physician, it can also be empowering to find out more information on your own. When searching for information about any healthcare topic, you should look for two criteria. First, the information should be published by a reliable source. Articles or reviews by experts are often the high­est quality resources. Second, the information should be written at an appropriate level for the reader. Very technical writing may not be appropriate for everyone, whereas some patients may want more detailed scientific information. The following resources meet these criteria, are either expert written or reviewed, and offer varying levels of scientific detail.

Our use of the term or terms Actos Lawsuit: is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit: To understand cancer, we must first understand nor­mal functioning of the body. The body is made up of billions of cells. Each organ of the body is made up of several different types of specialized cells. For example, the liver has cells that filter toxins from the blood, and the brain has nerve cells (called neurons) that are able to conduct electrical signals. Perhaps the most familiar cells are skin cells. Every flake of dry skin is made of millions of cells that are constantly dying and being replaced with new cells. The growth of new cells is care­fully balanced to occur at the same rate as the death of old cells. Your body has many mechanisms in place to regulate the timing of the birth and death of cells. Unfortunately, if one of these mechanisms malfunc­tions, the careful balance can be disrupted. Environ­mental toxins such as cigarette smoke, chemicals, and radiation can damage DNA and can disrupt these control mechanisms. A tumor may develop when new cells are created faster than old cells die. Tumors can be either benign or malignant. A benign tumor is an overgrowth of cells that is unchecked by the body’s normal mechanisms; thus, it will keep getting bigger. It is called benign because it does not cause you illness. Some benign tumors can get to be so large that they do cause problems, especially if they are in a confined space, such as your skull. A malignant tumor is also an overgrowth of cells.

You can live without a bladder. However, you still need something that can perform the two basic func­tions of the bladder: storing and emptying of urine. Physicians have come up with many ways over the years to accomplish these tasks, many of which are still used today. The simplest alternative is to place drainage tubes into the kidneys that come out through the skin and connect to bags on the abdomen. These tubes are known as nephrostomy tubes. Nephrostomy tubes are typically inserted into a person in the X-ray department by an interventional radiologist who uses some light sedation. For the patient, the bag provides an easy way to store urine and can be drained several times a day when convenient by opening a small valve on the bag.

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To provide a good long-term solution, surgeons most commonly use a portion of the small bowel to act as the new bladder. The identified piece of small bowel is removed from the main portion and is fashioned for its new use (see Question 79 for details). The urine that collects within this piece of bowel will ultimately be drained in one of three ways. First, the bowel can simply be left open at the skin for the urine to drain passively out into a bag that is attached to the abdomen. This type of drainage is known as a conduit, and the opening onto the skin is called a urostomy. Urine collects in the bag, which is then drained into a toilet several times each day. Second, the bowel can be sewn into a rough sphere con­nected to the skin by only a small, long channel. This channel prevents urine from leaking out but easily accommodates a small catheter. This is called a conti­nent urinary diversion. With this type of diversion, you must pass a catheter into the new bladder several times a day to drain the urine. This allows you to live without an ostomy bag, but for some patients, passing the catheter several times a day may be difficult or impossible. Third, the new bladder can be directly reattached to the urethra (called an orthotopic neobladder).

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Bladder cancer is a malignant overgrowth of the cells of the bladder. Most commonly, the growth occurs in cells that are in the urothelium. The lining of most hollow spaces in the body is made of epithelial cells. The lining of the inside of your cheek, for instance, is an epithelial cell lining. Also, the lining of your stomach, bowels, gallbladder, and—you guessed it—the bladder is made of epithelial cells. Each organ has its own subset of epithelial cells. In the bladder, the lining cells are called transitional epithelial cells. The cancer that grows from these cells is then called transitional cell cancer; 90% to 95% of all bladder cancers are of this type. If the cancer grows from a different type of cell in the bladder, it is given a different name. Other types of uncommon cancers in the bladder include squamous cell carcinoma and adenocarcinoma.

It is also possible that cancer in the bladder did not begin there but spread to the bladder from somewhere else. The bladder is an uncommon place for other tumors to “seed” (or metastasize), but it does occasionally occur. Although metastases are uncommon, tumors can occa­sionally grow directly into the bladder from an adjacent organ, such as the prostate, colon, rectum, or cervix. Bladder cancer is the fourth most common type of cancer in men and the eighth most common in women. The American Cancer Society estimated that in 2009, there would be about 70,980 new cases of bladder cancer diagnosed in the United States. In 2009, 14,330 deaths were expected from bladder cancer. In spite of the increased incidence of bladder cancer over the years, the rate of people dying from bladder cancer has decreased over the past 20 years.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit : TURBT is often the first procedure you will have once diagnosed with a bladder tumor. This surgery is typically performed under general or spinal anesthesia as an out­patient procedure and without any incision, endoscopically through the urethra, which means a cystoscope is placed through the urethra and into the bladder. Through this scope your urologist can see the inside of your bladder and has the ability to resect, or remove, tumors in the bladder under direct vision using electrocautery. The electrocautery is also used to control bleeding after the resection is com­pleted. TURBT is extremely important for the staging of bladder tumors but can also be therapeutic for lower stage bladder cancers. Once the tumor has been removed, it can be analyzed under the microscope by a pathologist. The pathological findings dictate further treatment decisions. If the tumor is low grade and noninvasive, you will likely not need any further therapy at this point except for close follow-up.

By and large, you can expect to go home the same day that this procedure is performed. Depending on the extent and depth of resection, your urologist may decide to send you home with a Foley catheter in place for a few days to allow time for your bladder to heal. Generally, this procedure is well tolerated, but it is not uncommon to see blood in the urine for several days after the procedure. Many patients also experience lower urinary tract symptoms, including painful urination, frequency, and urgency for up to several weeks following the procedure.

Radical cystectomy is the gold standard treatment for muscle-invasive bladder cancer and is also the procedure of choice for individuals with high-grade recurrent bladder tumors. Radical cystectomy has proven to provide excellent long-term cancer-free survival in individuals whose bladder cancer has not spread beyond their bladders or into their lymph nodes. Radical cystectomy is the therapy by which all other treatments are compared and judged.

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Technically speaking, radical cystectomy for men involves removal of the bladder and prostate and also includes removal of the pelvic lymph nodes. In women, the bladder and typically the uterus, ovaries, fallopian tubes, and por­tions of the vagina are removed, although more recently surgeons have been moving toward preservation of some of these structures to improve quality of life. Because the main function of the bladder is to store urine that is made by the kidneys, a mechanism for diversion of urine outside of the body or storage of urine in a newly created reservoir must be performed in the same setting. Various types of urinary diversion are discussed below.

Traditionally, the surgery is performed through a lower abdominal incision in the midline from just below the umbilicus (i.e., “belly button”). Hospitalization for this procedure is generally between 5 and 10 days, and up to 6 weeks are needed for complete recovery. In recent years minimally invasive surgical approaches that replicate the technique of open radical cystectomy have been developed. Both laparoscopic and robotic-assisted radical cystectomies are currently being performed at highly specialized cen­ters. The principles of the surgery are the same, but the procedure is performed through smaller incisions using laparoscopic instruments. Using robotic assistance, your surgeon is able to perform complex operations with higher precision, under magnification. These approaches offer die potential advantage of a shorter recovery time, less blood loss, and less postoperative pain.

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A pelvic lymph node dissection should be performed at the time of your surgery. This involves removal of the lymph node tissue in the most common areas of bladder cancer metastasis (spread of the cancer). The pelvic lymph node dissection has two important roles: to stage the cancer and to guide therapy. Individuals who are found to have cancer in the lymph nodes at the time of surgery generally require additional therapy such as chemotherapy. Studies have shown that up to 30 percent of patients with disease- positive lymph nodes who undergo a pelvic lymph node dissection will be free of disease at 5 years. Although there is debate among urologists as to exactiy how extensive ofapelvic lymph node dissection should be performed, there is no de­bate that one should be performed. Although a pelvic lymph node dissection can add an additional 30-90 minutes to your procedure time, there is little additional morbidity associ­ated when performed by an experienced surgeon.

Regardless of the approach, anyone who undergoes a radical cystectomy will require a form of urinary diversion because the bladder will no longer be there to store urine. This can have a significant psychological and functional impact on an individual’s quality of life. Patients are often hesitant to undergo definitive surgery because of the anxiety associated with long-term urinary diversion. There are two main types of urinary diversion: continent and noncontinent. Both forms require surgically removing a segment of bowel (most commonly the small bowel) from your gastrointestinal (GI) tract and plugging the ureter from each kidney into this segment of bowel to provide drainage of urine.

Noncontinent diversions (ileal conduit) are those in which the piece of bowel is brought up through the abdominal wall to a stoma and the urine drains contin­uously into a drainage bag. This is die most common type of urinary diversion performed in the United States. This procedure requires approximately 8 to 10 centimeters (3 to 4 inches) of small bowel, which is far less than that used for continent urinary diversions. Although the obvious dis­advantage of this procedure is its lack of continence and need for a continuous drainage bag, it has less short- and long-term complications than that of the continent diver­sion. An external urinary drainage appliance is very well tolerated and patients adapt to them very quickly.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit : A history of radiation therapy for a pelvic cancer may increase your risk of bladder cancer. Radiation has a role in the treatment of prostate, cervical, and ovarian cancers. Although the radiation is focused on the involved organ, the bladder and other surrounding structures also absorb radiation that sometimes damages the urothelium and leads to cancer.

Much attention has been paid to the influence of diet on cancer risk and treatment. Thus far, some scientists have suggested that vegetables, fresh fruits, and some fermented milk products appear to decrease one’s risk of developing bladder cancer. A few foods thought to increase the risk of developing bladder cancer are foods rich in animal fat, diose containing a lot of cholesterol, fried foods, and pro­cessed meat with various additives. We are not sure of the exact influence of diet on bladder cancer at this point in time. Scientists around the world are working on uncover­ing potential links between diet and bladder cancer.

As with other cancers that affect different body parts, there are multiple types of bladder cancer. To better understand them, let’s separate bladder cancer into two different groups: primary tumors that originate in the bladder and secondary tumors that spread to the bladder from other places.

Primary bladder cancers form within the bladder. Over 90 percent of primary bladder cancers in the United States are of the urothelial or transitional subtype. These form along the inner lining of the bladder. The second most common type of primary bladder cancer in the United States is squa­mous cell carcinoma, making up approximately 5 percent of all cancers diagnosed. These are often diagnosed in indi­viduals whose bladder has been chronically irritated by an infection, stones, or an indwelling catheter. The third most common subtype of bladder cancer in the United States is adenocarcinoma, accounting for approximately 2 percent of all diagnosed cases. These typically form near the dome of the bladder. There are other types of primary bladder cancer, but these are very rare. If necessary, your urologist will speak to you about these rare types.

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A biopsy is a small piece of tissue obtained during cystos­copy when a urologist looks inside of your bladder. This tissue sample is then sent to the laboratory and looked at under a microscope by a pathologist. Although there are standards that all pathologists follow, there can be small differences that can be seen by a trained eye. This is why it’s important to obtain actual slides and not just the report.

In addition to biopsies, pathologists often look at urine specimens or bladder washings for the presence of abnor­mal cells. It’s important to bring this report to your first appointment as well.

Before youx referral to a bladder cancer specialist, your primary care provider or urologist may order one of a few radiology exams to help evaluate the extent of cancer. We’ll briefly discuss those tests commonly ordered during the workup of someone with bladder cancer. These tests help determine someone’s cancer stage. Again, it is very impor­tant to obtain copies of your images (the actual films or CDs) along with reports.

An ultrasound is a noninvasive test used to evaluate the kidneys and bladder. Ultrasounds are painless and don’t have any associated side effects. Ultrasounds are per­formed by either a radiologist or radiology technician and take approximately 30 minutes to complete. An ultrasound allows doctors to image your kidneys to determine wheth­er or not they are normal in size. An ultrasound can also determine if one of your lddneys is not draining properly, which can occur with bladder cancer. Although images of your bladder can be obtained, an ultrasound cannot rule out evidence of cancer. Ultrasound was a primary test used in the past to evaluate patients with bladder cancer; how­ever, we now have better tests that allow us to image your entire urinary tract in greater detail. Ultrasound pros in­clude its noninvasiveness and lack of radiation, whereas its cons remain its lack of fine details and the fact that some very small tumors can be missed.

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An intravenous pyelogram, or IVP, is a test used to define the anatomy of your urinary tract using intravenous dye and an x-ray machine. Doctors order this test to determine whether or not there are any blockages or tumors in the renal pelvis, ureter, or bladder. Often, patients are asked to have a light meal the night before an IVP and to skip break­fast the morning of the exam. You may be given instruc­tions to perform a bowel prep using magnesium citrate, a laxative available in your local pharmacy or supermarket, This clears out your small intestine and colon as these may interfere with visualization of your urinary tract. If you have diabetes and are using Glucophage (metformin), you may need to stop these medications several days in ad­vance. This should be coordinated by your urologist and primary care physician.

IVPs can take an hour to perform because images are tak­en of your abdomen at various time points. You may feel a warm sensation, become nauseated, or have a metallic taste in your mouth when the dye is injected.

There are several reasons why you should not have an IVP performed, and these will be explained by your doctor. If you have an allergy to IV dye, you could have a potentially severe allergic reaction. In some cases, steroids are given to prevent this from occurring. Either way, this is some­thing that must be discussed with your doctor before the exam. If you have abnormal kidney function, another test will most likely be performed instead of an IVP. This is because the IV dye can worsen your kidney function. If you are pregnant, another test will be performed because of the potentially small risk that the radiation from the x-ray machine poses to the developing fetus. If you have asthma, multiple myeloma, sickle cell disease, pheochromocytoma, or a tumor of your adrenal gland, your physician may order another test because you may also be at greater risk of com­plications from the exam.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit : If you should have a recurrence of superficial urothelial cancer, there is a greater than 50 percent chance that it will happen in the first year after treatment. And there is up to a 30 percent chance that a recurrence will have progressed to a higher, more invasive, stage of the disease.

The stage, grade, and type of your cancer will strongly influence treatment options. (These will be discussed in the next two chapters.) They also are clues to whether your cancer might be aggressive, whether you might have a relapse or recurrence after treatment, and how hopeful the outlook is for a cure.

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If your doctor tells you that you have bladder cancer, what you talk about next depends upon the answers to two questions:

What kind of bladder cancer do I have?

Expect your doctor to tell you whether your cancer is urothelial or transitional cell cancer, squamous cell, adenocarcinoma, or a rarer form of cancer, and to give you a general explanation of how the type of cancer you have generally behaves, including whether your type of cancer often recurs, metastasizes, or is considered highly treatable.

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What stage and grade is my tumor, and what does that mean?

Your doctor is likely to categorize your cancer with a letter, numeral, and stage-—-perhaps something like “T2aNlM0 Stage I”-—and will explain what those symbols mean by describing how deeply the cancer has invaded your body, how abnormal the tumor cells are, and whether the cancer has spread.

When you are comfortable with the answers to your questions, you will be ready to talk about treatment options and your treatment team. You 11 want to know who will be on it, what part each team member will play in your care, and who will serve as your contact point for questions or concerns.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only.  There is no relationship between the owners of this website and the maker of the product discussed in this post.  Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred.  Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls.  If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit : To Help You Talk about Cancer

• The National Cancer Institute offers articles such as “What It’s Like for You” and “Taking Time: Support for People with Cancer” at its website (www.cancer.gov). You can also call 800-422-6237 (800-4-CANCER) to find out about available publications and brochures,

♦ The American Cancer Society offers a number of articles on coping with cancer, including “Helping Children When a Family Member Has Cancer” and “Talking with Children about Cancer” at www.cancer.org. You can also call 800227-2345 (800-ACS-2345) for information on ordering.

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• The Cancer Survivors Network is a forum or message board at the American Cancer Society website (www.cancer.org) where people can ask questions and share information and. resources with other people who are dealing with cancer.
• Your hospital’s social work department will have counseling and resources available for you and your family. Just ask your doctor to put you in touch with the appropriate office.

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• When possible, couch discussions in hopeful and reassuring words by telling your loved ones that you feel positive about your treatment.
• When talking about cancer with children, keep information age-appropriate. The National Cancer Institute offers a guide called Tips for Talking with Children of Different Ages, which you can obtain at www. cancer, gov.
• With your family members, agree to give each other permission to feel stressed or worried or angry—or even happy—without feeling guilty.
• Acknowledge that there may be tough times ahead, but recognize that caring and love will help get you through them.
• Acknowledge that things will change. Talk about changes as they occur.
• Talk often with family and loved ones. Speak from your heart.
• Expect lots of questions. Expect some disagreements. Expect times when you wish that things could go back to the way they were before you had cancer. And expect deeply meaningful moments with the people you love most.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

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Actos Lawsuit : On rare occasions, doctors will recommend another resection procedure. Sometimes the pathologist wants to biopsy muscle tissue from deeper in the bladder wall. And sometimes the tumor is too large to be safely removed all at once.

Sometimes, in an alternative procedure, lasers (high- energy light beams) are used to remove superficial tumors. While patients find this procedure slightly more comfortable than resection, the laser often destroys the tumor tissue, leaving nothing for pathologists to examine. The lack of pathology may limit your medical teams ability to predict recurrence and target your follow-up plan.

If you have been diagnosed with a low-risk tumor, resection may be the only treatment recommended by your medical team. Your team may also recommend a course of intravesical therapy.

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When you have a bladder resection by means of a cystoscopy, as opposed to invasive surgery, you wont have an incision or stitches, as no external cutting or incision is required.

Resecting (sometimes called endoscopic resection) is performed under general anesthesia in a hospital setting. Your doctor will use a resectoscope, which resembles a somewhat larger cystoscope. Like a cystoscope, a resectoscope has a lighted lens and is introduced into your bladder through your urethra. (Don’t worry; you will be asleep under anesthesia and receiving pain medication while this is happening.)

Your doctor will fill your bladder with water or a nonirritating clear liquid such as glycine, which expands the bladder walls and makes it easier to see tumors and abnormalities. Guided by the map made during the initial cystoscopy, your doctor will use a small wire loop (through which a high-energy electrical current runs) to remove the cancer, a margin of healthy tissue, and a small amount of muscle. Any remaining cells are removed with an electric current or sometimes a high-powered laser. Sometimes your doctor will also take a few random tissue samples from other areas of your bladder to make sure abnormal cells are not developing elsewhere. The tumor, healthy tissue, and muscle are then sent to your pathologist for examination.

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A small amount of muscle tissue is included in the tissue sample so the pathologist can verify that the tumor has not spread into the muscle wall. A margin of healthy tissue is removed to decrease the chances that abnormal cells remain in the bladder.

Resection is usually carried out as outpatient surgery. This means that you probably will be able to go home the same day. (You will need a driver to accompany you because you will still be recovering from anesthesia when you are released from the hospital, so you wont be sufficiently alert to drive a car.) You may see some blood in your urine for a few days after a resection, and you may experience pain or stinging when you urinate. The stinging can be eased by drinking lots of fluids and by taking simple pain medications prescribed by your urologist. If either condition lingers longer than two or three days, if other painful conditions occur, or if the bleeding becomes extensive, call your doctor right away.

Our use of the term or terms Actos Lawsuit is for descriptive purposes only. There is no relationship between the owners of this website and the maker of the product discussed in this post. Our use of the words Recall, Class Action Lawsuit and other similar words related to an event do not necessarily mean that this event has occurred. Refer to the website of the United States Food and Drug Administration for information on drug or medical device recalls. If a Class Action Lawsuit is formed in relation to the product discussed in this post we will provide that information at the time the Class Action is formed. A Class Action Lawsuit is not required to exist for you to file a lawsuit if you have been injured by the product discussed in this post.

To keep up to date on Actos Lawsuit visit our site often.

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