Actos Bladder Cancer Report
Actos Bladder Cancer : Before visiting your bladder cancer specialist for the first time, you should gather all of your medical records. It is important to obtain copies of your biopsy and cytology reports, radiology studies, operative reports and any other test reports related to your diagnosis of bladder cancer. In addition to written reports, you should request your actual pathology slides for review by the urological pathologist who works with your urologist. It is also important to obtain actual copies of any radiological exams performed. Often, you can obtain a CD with your exams on it or actual films.
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 your 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.
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IVP pros include its ability to assess how well your kidneys are working and the images that it can obtain of your renal pelvis and ureter. Its cons include x-ray radiation exposure in addition to the risks of an allergic reaction to IV contrast and potential worsening of borderline kidney function. IVPs are still ordered to evaluate people with blood in their urine or a diagnosis of bladder cancer, but it is slowly being replaced by other, more accurate imaging modalities including CT scan and MRI.
A CT, or CAT scan, is a computed tomographic scan that obtains accurate, detailed images of the body and its contents. It allows radiologists to look at detailed images of all your internal organs, including your heart, lungs, liver, brain, kidneys, and bladder, in addition to soft tissues like lymph nodes. CT scans are performed in radiolog)’ departments by radiologists with the assistance of nurses and technicians. The actual exam may only last 15 minutes, but you may be in the radiolog)’ area for an hour. As with the preparation for an IVP, you wall be asked to eat a light dinner the night before, and some doctors prefer bowel preparation with a laxative the day before. You should not eat anything in the 8 hours before your scheduled appointment. Those with diabetes using Glucophage must stop taking these medications several days before die scan if IV dye will be used and will not be able to resume use of these medications for 48-72 hours after the scan. This is because of a potential harmful reaction from the medications and IV dye. Some physicians prefer that this exam be done after drinking a chalky oral dye to better differentiate your intestine from parts of your urinary tract. The pros of CT include the detailed images that it provides in addition to the relatively short amount of time it takes to perform the exam. Its cons are the risk of radiation exposure to the developing child in a pregnant woman and risk of an allergic reaction to IV dye.
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