Breast Cancer Campaign


Blood Donation Camp in Dubai Snooker Club

Nutrition - A Wellness Campaign

Bladder Cancer: an overview

Cells in the body normally reproduce themselves in an orderly manner. But in cancer the cells start dividing uncontrollably, and do not die the way normal cells do. As the cells produce more cells, a mass or tumor may appear. The tumor can invade surrounding tissue and keep the healthy tissue from doing its normal job. There are two kinds of tumors:

  • Benign tumors are not life threatening. They do not invade other tissues and when they are removed they very seldom return.

  • Malignant tumors are cancerous. These tumors contain cells that divide and grow without order. The cells will invade and take over nearby tissues and can spread (metastasize) to other organs by traveling through the body’s bloodstream and lymphatic system.
Survival

Bladder cancer is the sixth most common form of cancer in the United States. The American Cancer Society predicts that in the year 2000 more than 53,000 people will be diagnosed with bladder cancer and more than 12,000 will die from the disease. Men develop bladder cancer three times more often than women do, and it is more common in European-Americans than in African-Americans or Hispanics. Asians have the lowest rate of bladder cancer. Most bladder cancers occur in industrialized countries, and the risk of developing bladder cancer increases with age.

If bladder cancer is found in an early stage and appropriately treated, the survival rate is good--over 93 percent of such patients will be alive after five years. However, if the cancer has already spread to other organs in the pelvis when it is found, the five–year survival rate drops to 49 percent, and if the cancer has spread to distant organs, only 6 percent will still be alive after five years. Early detection is very important.

Types of Bladder Cancer

Three main types of cancer can affect the bladder: transitional cell carcinoma (TCC) , squamous cell carcinoma, and adenocarcinoma. TCC is by far the most common type of bladder cancer, and accounts for 90 percent of all bladder cancers. Squamous cell carcinomas account for another 8 percent, and adenocarcinomas account for only 1 percent to 2 percent of bladder cancers.

Some TCCs are flat and grow horizontally along the lining of the bladder, while others are like tiny, thin-stalked mushrooms called, papillary TCCs, that grow into the hollow center of the bladder. Both flat and papillary TCCs can be either superficial (in situ, or limited to the transitional epithelium layer) or invasive (where the tumor grows into the deeper layers of the bladder).

Squamous cell carcinoma as noted above accounts for 5 percent to 8 percent of bladder cancers in most industrialized nations where schistosomiasis (a parasite infection ) is not widespread and accounts for 75 percent of bladder cancers in areas where schistosomiasis is widespread (Egypt, Africa etc). Treatment for squamous cell carcinoma of the bladder not associated with schistosomiasis includes chemotherapy and cystectomy (surgical removal of the bladder). Chemotherapy regimens include 5-FU and mitomycin C.

Adenocarcinoma of the bladder is uncommon and accounts for 0.5 percent to 2.0 percent of bladder cancers. It may be associated with exstrophy (turning inside out) of the bladder or endometriosis a condition where uterine mucous membrane is found abnormally outside the uterus.

Most cases of adenocarcinoma , however, are not associated with either condition. The age and sex distribution of adenocarcinoma of the bladder is similar to TCC with most cancers in men older than age 50. Adenocarcinomas of the bladder account for 85 percent of those associated with exstrophy and 15 percent of those with a non functioning bladder. Treatment options include chemotherapy and cystectomy. Chemotherapy regimens used include 5FU, doxorubicin and mitomycin C or 5FU and cisplatin with or without mitomycin C.

Urachal cancer is an adenocarcinoma in more than 90 percent of the cases. The remaining types seen are either TCC or squamous cell in origin. In the embryo, the urachus is the continuation of the urinary bladder into the umbilicus The urachus normally seals off before birth. Treatment options include chemotherapy and cystectomy.

Mixed cell bladder cancer is rare and is seen in less than one percent of all bladder cancers. Treatment for these cancers also includes chemotherapy and cystectomy.

Risk Factors

A risk factor is something that increases a person’s chance of getting a disease. For example, smoking is a risk factor for lung cancer, and prolonged sun exposure is a risk factor for skin cancer. But it is important to remember that even though a person has one or more risk factors, it does not mean that the person will get the disease—it just means that it may be more likely.

There are several known risk factors for bladder cancer:

  • Smoking: Smokers have two to five times the risk of getting bladder cancer when compared to nonsmokers. The National Cancer Institute estimates that smoking causes half of the bladder cancers in men and almost a third of the cases in women. One theory holds that carcinogens (cancer-causing chemicals) found in smoke enter the lungs and are carried by the bloodstream to the kidneys. The kidneys filter the carcinogens and concentrate them in the urine, and these concentrated poisons damage the lining of the bladder while the urine is being stored.
  • Chemical exposure: People who have had long exposure to a certain group of chemicals (aromatic amines) are suspected to have a higher risk of developing bladder cancer. Many of these chemicals (such as benzidine and beta-naphthylamine which have been banned) are commonly used in the paint, printing, dye, leather, and rubber industries. Additional industries with a higher risk of bladder cancer are textile, petroleum, hairdressers, aluminum workers and truck drivers.
  • Race: Whites develop bladder cancer twice as often as Blacks or Hispanics, while Asians have the lowest risk.
  • Age: The risk of developing bladder cancer increases with age. People older than 70 years of age have 15 to 20 times the risk of developing bladder cancer than someone who is younger than 54 years of age.
  • Chronic bladder irritation: Patients with a long history of bladder problems (such as frequent urinary tract infections or kidney and bladder stones) have a higher risk of developing squamous cell bladder cancer. These conditions do not cause the cancer, but they irritate the bladder lining and may make it more likely that cancer will develop.
  • History of bladder cancer: Patients with a previous history of bladder cancer have an increased risk of developing a second bladder tumor.                                    TOP

Music Therapy

Arts Medicine

Pianists Pain-Prevention Tips 

        Simple changes in keyboard technique will prevent injury for keyboard players. These helpful free tips are offered from Sound Feelings. If your piano playing is not pain-free, constant, automatic and effortless, you are doing something wrong. This free information explains how-to improve biomechanical efficiency, relaxation, avoid tension by making a few small changes to your approach to the instrument. These suggestions provide necessary injury-retraining support to performing arts medicine treatments to insure that the pain will not return.

Pain-Free Playing Should Be Effortless.

        Pain-free playing should be constant, automatic and effortless. Unfortunately, the way piano is often taught, pain-free playing becomes rare, deliberate and difficult. There are many reasons why this is so.

Combining Two Methods Offers Greatest Advantage.

        I feel grateful that my own training included top teachers of both the “Russian School” and the “German School” of piano technique. Generally, the Russian School teaches how to play with gravity and relaxation. The German School teaches how to play with hand placement and fingering efficiency. There are other piano “schools” but these are usually just a combination of the two main ones described above. Each approach has good and bad aspects. In my own playing and teaching, I have incorporated the good aspects of each and have discarded the bad. The result is a blueprint for biomechanical efficiency.

Strive for Preparation and Relaxation.

        Essentially, pain-free keyboard playing depends on two primary elements: 1) preparation and 2) relaxation. People who strictly follow the German approach are great at preparation of the hand position, playing close to the keys, but neglect to relax the hand at regular intervals. The problem is that tension builds up and leads to injuries. People who strictly follow the Russian approach are initially great at relaxation, but often make many mistakes because their hands simply are not prepared, being further from the keys. This indirectly leads to anxiety and tension in the long run, which also leads to pain and injury.

Learn the B Scale First!

        From the beginning of piano training a mistake is often made. Most teachers teach the C major scale on the very first lesson. It is true that this scale is the easiest on an intellectual level because of the absence of accidentals. However, it is actually the hardest to play from a physical standpoint because the distance the thumb must cross from ‘E’ to ‘F’ is much greater than its counterpart in the B scale (which I like to teach first.) This is setting the student up for a lifetime of bad habits because it encourages the very worst qualities from both schools. Right from the beginning, the student learns how to angle the hand to position the thumb, instead of crossing the thumb under a non-moving hand. Also, with the obligatory “curved fingers,” there is absolutely no room for acquiring a natural sense of relaxation. It would be better to first teach thumb-stretching and hand-relaxation drills.

Sit Far Enough Away.

        Distance to the piano is crucial to pain-free playing. Most people sit too close to the piano and wrongly establish this as the correct distance. Notice if you keep raising your shoulders when you play. This is usually because you are sitting too close and your own body simply blocks the mobility of the arms. The best guideline here is to see if your elbows can touch one another when your hands are placed on the white notes directly in front of you. If not, move back.

Sit So Your Elbows are Just Below Key Level.

        Height is also extremely important. Most people sit too high or too low. We really have to be more respectful of our natural body-type. Are you long-legged or long-torsoed? Usually women have long legs and a short torso, and men have the reverse. The problem is that standard piano bench height is for the short-torso person. This means that the person with a long waist will tend to tower over the piano. Why is this bad? It means that the elbows are positioned above the key level when they actually should be positioned slightly below the key level. The reason for this is that the hand, wrist and forearm should all be in a straight line, to allow the least friction on the tendons of the forearms which actually control the fingers.  People who sit too high, too low, or with a “low wrist” or with a “high wrist” usually acquire pain and ultimately tendinitis, or carpal-tunnel syndrome. This is really so unnecessary! The solution is to get an adjustable bench, or sit on a chair, so that the correct height is achieved.

Practice Fast First!

        Another traditional myth is to practice slowly and then to gradually speed up the passage. The problem here is that at the slow tempo, certain bad habits go unnoticed (extra tension, bad fingering) because they do not interfere with the execution at this slower tempo. But once the tempo becomes faster, all this inefficient choreography has already been built in, and it is too late. It would be better to practice very fast, in small little groups, right from the beginning, to better get a sense of what fingering and hand position will be needed. Then go back and practice it slowly, with this in mind.

Softer Equals Faster.

        Many injuries lately are specific to people who play electronic keyboards. One would think that these lighter-action keyboards would be easier to play, but in fact, they are harder. This is because most people have a tendency to press harder than they would on a naturally-weighted keyboard to overcompensate for the lack of resistance. Also, we get fooled by the artificial sound levels. Because of the electronic aspect of the instrument, we become reliant on the actual volume versus the perceived volume. If we are recording, for example, the ultimate dynamic level may be very loud, but to us as performers, in our monitor, it may seem very soft. So we instinctively try to play harder to create a louder sound, when it really doesn’t help. Meanwhile, the louder we play, the stiffer our fingers become. The stiffer our fingers become, the slower we play and the more we push. The more we push, the more pain and damage we inflict on ourselves. The solution here is to keep mentally reminding ourselves as we play that “softer equals faster.” This keeps the muscle system very relaxed. Let them set the levels in the mix.

        Once you establish the correct habits, you will be able to play for hours at a time and never get tired.

This week.....Share, Compare & Connect...                                                         TOP