Cystectomy and urinary diversion

Turner, William H.; Studer, Urs E.

doi:10.1002/(sici)1098-2388(199709/10)13:5<350::aid-ssu9>3.0.co;2-c

Cited by 16 publications

(12 citation statements)

References 32 publications

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“…For patients diagnosed with muscle invasive bladder cancer (MIBC; approximately 30% of newly diagnosed BC patients) and those with high-risk progressive noninvasive disease, radical cystectomy with urinary diversion is the gold standard in treatment, providing excellent local cancer control 2–5 . Following cystectomy, urine can either be diverted into: a) an incontinent stoma (ileal conduit procedure); b) a continent urinary reservoir catheterized by the patient; or c) a continent urinary reservoir connected to the urethra (orthotopic neobladder) 6 . The physical and related psychological impact (e.g., urinary incontinence, sexual dysfunction, and poor body image) of these urinary diversion procedures on the patient’s quality of life (QOL) has been documented 2–7 .…”

Section: Introductionmentioning

confidence: 99%

Muscle Invasive Bladder Cancer: Examining Survivor Burden and Unmet Needs

et al. 2014

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Purpose Although improvements in perioperative care have decreased surgical morbidity following radical cystectomy for muscle invasive bladder cancer (MIBC), treatment side effects still have a negative impact on patients’ quality of life (QOL). This study examines patients’ unmet needs along the illness trajectory. Methods and Materials Thirty patients (26.7% women) treated with cystectomy and urinary diversion for MIBC participated in the study. Patients were recruited from the Department of Urology at Mount Sinai and through advertisements on the Bladder Cancer Advocacy Network website between December, 2011 and September, 2012. Data were collected through individual interviews. The interviews were audio-taped and transcribed. Qualitative analyses of transcribed data were used to explore key unmet needs. Results At time of diagnosis, unmet informational needs were predominant, consisting of insufficient discussions of these topics: urinary diversion options and their side-effects, self-care, recovery process, and medical insurance. Unmet psychological needs related to depression and worries about changes in body image and sexual function were reported. Post-surgical unmet needs revolved around medical (e.g., pain, bowel dysfunction), and instrumental needs (e.g., need of support with use of stomal appliances, catheters, and incontinence). During survivorship (i.e., from 6 to 72 months following surgery), unmet needs centered around psychological (i.e., depression, poor body image, sexual dysfunction) and instrumental support (e.g., difficulty adjusting to changes in daily-living). Conclusions Meeting patients’ needs is imperative to ensure patients’ adequate involvement in their healthcare, and to enhance post-surgical QOL. An effective support provision plan should follow changes in patients’ needs.

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Section: Introductionmentioning

confidence: 99%

Muscle Invasive Bladder Cancer: Examining Survivor Burden and Unmet Needs

et al. 2014

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“…Urinary tract deterioration was found in 35% after 5-year followup and in 50% after 15-year followup. Skin irritations due to direct and continuous contact with urine, as well as constipation were also reported [7, 9]. …”

Section: Radical Cystectomymentioning

confidence: 99%

“…The emotional, functional, physical, and social impact of radical surgery on HRQOL significantly varies by the urinary diversion form [4, 7, 9, 12]. Studies have shown that ileal conduits are considered the easiest urinary diversion to perform surgically; however, [15] it is associated with significant psychological and practical side effects that can drastically reduce the emotional well-being of the patient [7, 9].…”

Section: Psychosocial Effects Of Urinary Diversionmentioning

confidence: 99%

Muscle Invasive Bladder Cancer: From Diagnosis to Survivorship

Mohamed

Diefenbach

Goltz

et al. 2012

Advances in Urology

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Bladder cancer is the fifth most commonly diagnosed cancer and the most expensive adult cancer in average healthcare costs incurred per patient in the USA. However, little is known about factors influencing patients' treatment decisions, quality of life, and responses to treatment impairments. The main focus of this paper is to better understand the impact of muscle invasive bladder cancer on patient quality of life and its added implications for primary caregivers and healthcare providers. In this paper, we discuss treatment options, side effects, and challenges that patients and family caregivers face in different phases along the disease trajectory and further identify crucial areas of needed research.

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“…The level of histone acetylation is determined by the concerted action between histone acetyltransferases (HATs) and histone deacetylases (HDACs) [101,102]. HATs catalyze the addition of an acetyl moiety from acetyl-CoA to the ε-amino groups of conserved positively charged lysine residues in the amino-terminal domains of the core histones [101][102][103]. This weakens their …”

Section: Histone Acetylation and Functional Specialization Of Chromatinmentioning

confidence: 99%

“…HDACs catalyze the opposite reaction and thereby reestablish the positive charge in the histones [101][102][103]. Alternatively, histone acetylation might provide an epigenetic marker for gene expression [104].…”

Section: Hdac4mentioning

confidence: 99%

Histone Deacetylase Inhibition: A Differentiation Therapy for Cultured Primary Hepatocytes?

Papeleu

Vanhaecke

Rogiers

2006

CEI

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Histone deacetylase (HDAC) inhibitors are now widely recognized as powerful anticancer agents. Unlike conventional chemotherapeutics, they not only inhibit tumor growth and survival but also reinitiate differentiation processes. Surprisingly, little attention has been paid so far to their capacity as differentiating agents for primary non-malignant cells. Dedifferentiation, however, is a common pernicious event occurring in almost all primary epithelial cell cultures and limits their use in fundamental and applied research. In this review, we elaborate on the innovative concept of HDAC inhibition as a key tool in the development of functional long-term cultures of primary hepatocytes. The need for long-term hepatocyte-based in vitro models is high and underscored by the fact that (sub)-chronic liver toxicity testing still consumes an important number of animals and by recent changes in EU legislation (e.g. chemicals policy REACH and cosmetics Directive 2003/15/EC). In addition, many cell-based therapies would benefit from the availability of highly differentiated primary hepatocytes as well. We believe that the HDAC inhibition approach could be applicable to create stable, differentiated culture systems of other primary cell types as well. In addition, HDAC inhibitors, in combination with tissue-specific growth factors, can be used to generate tissue-specific cell types from stem cells.

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Cystectomy and urinary diversion

Cited by 16 publications

References 32 publications

Muscle Invasive Bladder Cancer: Examining Survivor Burden and Unmet Needs

Muscle Invasive Bladder Cancer: Examining Survivor Burden and Unmet Needs

Muscle Invasive Bladder Cancer: From Diagnosis to Survivorship

Histone Deacetylase Inhibition: A Differentiation Therapy for Cultured Primary Hepatocytes?

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