Transitional cell carcinoma is a type of cancer that has recently been recognized as a sub-type of ovarian cancer, but it may also affect the kidneys (renal transitional cell carcinoma), the bladder, or the ureter (the tube that carries urine from the kidney to the bladder).
Transitional cell papilloma refers specifically to transitional cell carcinomas that affect the urinary tract and/or genitals. Transitional cell carcinomas most commonly afflict the bladder, and in fact, they comprise roughly 93% of all bladder cancers diagnosed in the United States.
Most transitional cell carcinoma patients are over age forty, with the vast majority being between sixty and seventy years of age. This type of cancer affects men more often than women, with a sex ratio of five to two.
Signs and Symptoms
Although transitional cell carcinoma is asymptomatic in the early stages, sufferers may experience blood in the urine, abdominal bumps, back or side pain, loss of appetite, tiredness, weight loss, and difficulty in urination as the disease progresses.
Causes and Risk Factors
While the causes of transitional cell carcinoma, like all forms of cancer, are not well understood, several risk factors are evident. First, this type of cancer is strongly linked with cigarette smoking.
Studies have found that this habit increases the likelihood of transitional cell carcinoma anywhere from three to seven times. People who use chewing tobacco or smoke cigars and pipes also run a greater risk of developing this cancer, but the risk is not as great as with cigarette smoking.
Another cause of transitional cell carcinoma is extended exposure to a class of industrial chemicals called arylamines, and especially a chemical called 2-naphthylamine. Cancers caused by this and similar chemicals usually take between fifteen and forty years to develop. Arsenic is another chemical that has been linked to transitional cell carcinoma.
Yet another risk factor for this type of cancer is excessive use of analgesics (pain medicines), or use of these medicines for a very long period of time. Additionally, some individuals develop transitional cell carcinoma due to genetic mutations of the DNA.
Diagnosis
Depending on the type and location of the suspected transitional cell carcinoma, various diagnostic techniques may be used. Imaging methods such as x-rays, CT scans, or ultrasound techniques may be used when the carcinoma is in the kidneys, bladder, or upper urinary tract. Doctors may initially order a urine sample to detect transitional cell carcinoma, but this technique only works for larger tumors.
Another common diagnostic test for this type of cancer involves the use of a cytoscope, which allows doctors a closer look at the inside of the ureter and bladder.
Treatment
Transitional cell carcinoma is most often treated with surgical resection of the tumor, but other methods exist when this is not feasible. In some cases, doctors may recommend immunologic therapy, where an agent called bacillus Calmette-Gueérin (BCG) is applied directly to the bladder, causing the body to destroy the tumor with a natural immune response.
Chemotherapy is another technique that can be successfully used to treat transitional cell carcinoma, especially when the cancer has spread. Radiation therapy may be used in combination with chemotherapy, but it has not been found to be effective on its own. After the initial course of treatment, doctors often recommend regular cytoscopy examinations to help them detect and treat recurrences.
