The James Buchanan Brady Urological Institute
 
 
 
  BLADDER CANCER      
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Surgical, medical and radiation oncology experts at Johns Hopkins work together as a team to coordinate care for bladder cancer patients. They continue ground-breaking research and clinical trials to improve detection and treatment.

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Screening and Detection

Micro satellite urinary sediment (MAUS) testing development consists of a urine test which will screen for either early detection or recurrence of bladder cancer

The micro satellite urinary sediment test uses molecular biology to diagnose bladder cancer. The bladder cancer research effort at the Johns Hopkins Medical Institutions has been grounded in clinical and translational research for over 50 years. In the late 1940's Drs. Jewett and Strong conceived the first staging system for superficial and invasive bladder cancer at Johns Hopkins which is still used today.

Group A
bladder cancer detection
Submucosal infiltration

Group B
bladder cancer sign and detection
Muscular infiltration
Group C
bladder cancer sign and detection
Perivesical infiltration

 No. of cases 3
 Metastases 0
 Perivesical lymph only 0
 Perivesical fixation only 0
 Potentially curable 100%

 No. of cases 15
 Metastases 1
 Perivesical lymph only 1
 Perivesical fixation only 0
 Potentially curable 86.6%

 No. of cases 89
 Metastases 52
 Perivesical lymph only 6
 Perivesical fixation only 8
 Potentially curable 26%

Jewett Staging Diagram Journal of Urology 1946 55: 366

Recent efforts in bladder cancer research have focused on finding the molecular origins of the disease. This important research conducted in the laboratory of Bladder Cancer Research member and University Professor, Dr. David Sidransky, has focused on understanding the relationship between genetic alterations in the bladder cancer cell and a tumor's ability to recur and progress.
Multiple publications have shown that alterations of specific genes on chromosome 9 probably contribute to the development of most bladder cancers. Detailed molecular maps of bladder cancers have been constructed in the laboratory and provide preliminary work for understanding how bladder tumors arise and recur. These observations have led Dr. Sidransky's group to the novel application of specific molecular analytic laboratory techniques to diagnose bladder cancers. Specific types of molecular abnormalities can be identified in the urine of bladder cancer patients utilizing a new diagnostic bladder cancer test developed in Dr. Sidransky's laboratory. This test, called micro satellite analysis is a very sensitive and accurate identifier of bladder cancer cells in voided urine. Pilot studies have already demonstrated that this test can correctly diagnose bladder cancer in greater than 90%of patients, six month earlier than conventional diagnostic testing. Ongoing studies will help define the clinical role of this new test for bladder cancer detection and prevention.

Industrial monitoring program is a cancer detection program that uses the micro-satellite urine test to monitor individuals who have been occupationally exposed to chemicals that are linked to bladder cancer.

Exposure to chemical carcinogens significantly increases ones risk for developing bladder cancer. Approximately one-fourth to one-third of all cases of bladder cancer are believed to be caused by occupational exposure (Catalona, 1991). Those individuals at greatest risk include textile workers, painters, leather and metal workers and workers in the rubber industries (Brettschneider & Orihuela, 1990). All of these occupations carry a high risk of exposure to chemical carcinogens.

The Johns Hopkins Bladder Cancer Research Center has established a surveillance program that provides periodic screening for bladder cancer. One current industrial monitoring research protocol provides for yearly screening utilizing micro-satellite analysis and cytology of voided urine in a high risk population of workers exposed to a pesticide.



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