Bladder Cancer Patient Advocate, Navigator or Health Advocate
The concept of patient advocacy in its current form was developed in 1950’s as the treatment of cancer patients grew more and more technically complicated, as a means to make the voice of the patient more readily heard. In today’s world of constantly evolving medical techniques, treatments, and services, the average individual cannot be expected to be thoroughly acquainted with any and all this material. So it becomes the function of the bladder cancer patient advocate to perform a variety of services to ease the burden of the patient, and their family, as they learn to deal with every aspect of the disease.
The primary concern of the bladder cancer advocate is to support the cancer patient in all aspects of life with the disease, whether they be physical, emotional, or financial. An advocate can assist the patient in investigating available treatment options and educating the patient on the efficacy of each of them, be it pharmacological or surgical. By educating the patient, the advocate can be of great assistance in helping them make an informed decision about their course of action, and the possible side effects and outcomes. Support may also involve recommending counseling services for the patient, and their family members, to help them cope from day to day. Bladder cancer patient advocates may also be of assistance in helping the patient, and their caregivers, deal with any physical debilitation resulting from the disease, and its treatment.
Another aspect of bladder cancer patient advocacy is assistance in navigating the financial aspects of treating the disease. An advocate can act as a liaison between the patient and his or her insurance company, assuring that the patient receives any and all benefits to which they are entitled. When one is dealing with a serious disease, it is quite easy to lose track of other aspects of your life. An advocate can help to seek out sources of assistance which can ease the financial burden of the patient.
Education is also a major function of a cancer advocate. Both the patient, and their caregivers, are often in need of information about how the disease will affect their lives, both during its progression, and in its aftermath. Patients must be informed about how their condition will affect their mobility, the ability to care for themselves, and if they will be left with any permanent impairment to their lifestyle. Caregivers need to be instructed in mechanisms, or techniques they must use to cope with the patient’s daily care, such as injections, proper care of surgical dressings, etc.
The cancer patient, above everything else, needs to know that there is someone in their corner. Someone who will help them find their way through the confusing, and sometimes daunting, world of modern medicine. Someone who will have their best interests in mind as they face challenges presented every day in their struggle to find, secure, and finance the best treatment available.
What is Bladder Cancer?
Bladder cancer can occur at any age but it is more common in the aged. It usually starts from the bladder lining. In most cases the cancer is detected early and is treatable. Unfortunately recurrence is a real possibility. There are three types of bladder cancer:
1. Transitional cell carcinoma. This type occurs in the cells lining the inside of the bladder and ureters.
2. Adenocarcinoma which arise from the glands responsible for mucus secretion.
3. Squamous cell carcinoma is more common in schistosomiasis endemic areas.
4. Mixed cell type bladder cancers are seen sometimes.
Early symptoms relate to urinating disorders like pain on micturition, cloudy urine, blood in urine – hematuria, lower abdominal pain and may be a sense of incomplete bladder emptying. Other symptoms are back and pelvic pains. General symptoms common with cancers may also be noted especially if the disease has been present for a while. These are loss of weight, lethargy and anorexia among other symptoms.
Causes and Risk Factors
Like other cancers the reason why the DNA undergoes abnormal and harmful changes to give rise to malignant changes is not well understood. There are however, factors that appear to promote the appearance of the cancer. Some of these are:
· Gender. Men are affected more than women.
· Race. White people are more likely to be affected.
· Exposure to toxic substances like arsenic and other compounds used in leather and textile industries.
· Using the antidiabetic drug, pioglitazone for more than one year.
· Family history of the cancer.
· History of cancer treatment.
· Recurrent bladder irritation and infection as seen in the parasitic infection, schistosomiasis.
Routine urine tests may be done to rule out other causes of symptomatic urinary system disorders. The tests also help in staging the disease. This staging is important as it determines the treatment approach to the disease. Specific tests will include:
· Bladder ultrasound.
· Bone scans
· CT or CAT scans
· Pelvic and back X-rays.
· Bladder biopsy.
· I.V.P (intravenous pyelogram) may be done to assess the kidneys, ureters and the bladder.
· Other tests may be done depending on the primary investigations findings.
· Surgery is done through an open abdominal incision or through the urethra – trans-urethral resection (TUR). It may involve removal of the tumor alone or removal of the tumor and part of the bladder. Invasive cancer will prompt radical surgery that will involve total removal of the bladder and the prostate and seminal ducts for men and for women; removal of the uterus and ovaries as well as part of the vagina.
· Chemotherapy can be used before surgery to shrink the tumor or it can be used after surgery to kill any cancer cells remnants.
· Biological therapy this method modifies the body’s immune system so that it is able to kill the abnormal cancer cells. The method is relatively safer from bad side effects associated with chemo or radiotherapy.
· Avoiding known risk factors may help in preventing recurrence after bladder cancer treatment.
U.S. Statistics for Bladder Cancer
The American Cancer Society estimates for the year 2015 on bladder cancer are:
There will be about 74000 new cases with 56 320 of them being men.
In the same year 16 000 deaths will occur. Of these, 11 510 will be men.
There are more than 500 000 people who are cancer survivors in the U.S.A.
Risk of men getting bladder cancer is 3-4 times higher than women.
Early diagnosis and treatment offers the best prognosis in bladder cancer patients.