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Overview of the management of bladder cancer in older adults

Authors
David Graham, MD
Derek Raghavan, MD, PhD, FACP, FASCO
Daniel E Haggstrom, MD
Raghava Induru, MD
Stephen Riggs, MD, FACS
Section Editors
Seth P Lerner, MD
Kenneth E Schmader, MD
Deputy Editor
Michael E Ross, MD

INTRODUCTION

Bladder cancer is the most common malignancy involving the urinary system. Urothelial carcinoma accounts for 90 percent of bladder cancers in the United States and Europe. In other areas of the world, non-urothelial carcinomas are more frequent. Much less commonly, urothelial carcinomas arise in the renal pelvis, ureter, or urethra.

Bladder cancer occurs primarily in older adults, with three-fourths or more of new cases detected in patients greater than 65 years old [1]. Older adults appear to have higher mortality due to urothelial carcinoma than younger individuals. In a study from the United States Surveillance, Epidemiology, and End Results (SEER) database, five-year survival rates declined progressively from 84 percent in those between 65 and 69 years to 60 percent in those 85 and older [2].

One feature that may contribute to differences in biology for urothelial cancer in older versus younger patients is the duration of exposure to carcinogens such as cigarette smoke, dye stuffs, metals, and petroleum products. A longer period of exposure may contribute to the development of additional mutations.

This topic discusses the evaluation and management of older individuals with urothelial cancer. More general discussions of the clinical presentation, diagnosis, and staging of bladder cancer and an overview of treatment are presented separately.

(See "Clinical presentation, diagnosis, and staging of bladder cancer".)

             

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Literature review current through: Nov 2016. | This topic last updated: Tue Jul 07 00:00:00 GMT+00:00 2015.
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