AboutJuliet Seigle, MD Expertise I am a fully trained radiation oncologist and can answer many questions about cancer and its treatment. I can't answer questions about specific chemotherapy agents. I have also worked in general medicine and emergency medicine, so I can give advice about these areas as well. I would like to do this based on my very positive experience with one of your experts (real estate).
Experience I currently am working as a radiation oncologist in the DC metropolitan area. I have done research and given talks on neurooncology (tumors of the nervous system) at national meetings. I have been trained in use of a new technology, the CyberKnife. I was emergency physician at a busy communicty hospital (Calvert Memorial Hospital) in Maryland for 3 years (1989-1991).
Organizations ASTRO (American Society of Therapeutic Radiation Oncology)
Education/Credentials Georgetown University Hospital: fellowship radiation oncology 2005-2007
Georgetown University Hospital: residency radiation oncology 1991-1994
Georgetown University Hospital: residency neurosurgery 1984-88
Awards and Honors Award for best abstract - CyberKnife Users meeting 2005 (topic: chordoma)
ASTRO research award $30,000, 1993
Question QUESTION: Hi my name is Leanne and I am almost 39 and female and have never smoked in my life although I have been exposed to passive smoking many times in my life. what I want to ask is why to epithial cells that are very high that come out in the urine form mases? I have bladder cancer and had the cystocopy 3 weeks ago and the CT IPV done last week. I have been geting of ande on seen and unseen blood in my urine for about `1 year now. I can go for weeks and weeks without blood in my urine and then it comes back agan, and the pain in my lower back is not going away at all. Now on the cytoscopy exam with the Uroligys he saw some abnormal white cells, but did now know where they were coming from that is why he ordered at CT IPV, and these scans picked up my mallignant cells. I have a tumour in my right groin my lymph node area. I will be going back to see the specialist next friday the 7th but I did get a phone call from the hospital outpatinets on monday this week one working day after the surgen got back to the clinic as he is only there once per week and that is on a fridays in the afternoon. Now what I would like to know is why with bladder cancer do high epithial cells that are very high grow in your body and become cancerous? because this happend to me, and no I do not have any infections as all of this has been ruled out. I also get most of the time an offensive odour from inside of me and sometimes I get itchy I have to scratch down below. I have been checked for any UTIs, bladder infection and any infection and I do not have any of them. Could this be part of the bladder cancer? One more question If I can. My dad is a vietnam war veteran and fought a war and was exposed to various kinds of chemicals before I was concieved. Could this have put me at risk of getting this? I look forward to your response very soon. Leanne
ANSWER: Leanne,
I understood parts of your question but not other parts. I will answer what I can.
Most people who get cancer never know why it happens. There are some patients who have families in which cancer occurs a lot, but these are the minority. Most people with cancer do not have strong family histories of cancer, and they don't necessarily have specific risk factors (such as smoking, chemical exposure, etc). Therefore, what is happening in your case is typical.
Cancer is a process which occurs in several steps. As a result of a series of changes in the cell's DNA (the DMA is like the brain of the cell, telling the parts of the cell what to do and when to do it), cancer cells lose their ability to stop reproducing. Thus, they keep dividing and a cancerous mass is the result. If the cells get into the circulation, they can spread to other parts of the body (metastasize). This is the basis of most cancers, though it is not known why one person gets cancer and their sibling doesn't get it, for example.
A bad smell which does not go away when you wash thoroughly can be related to cancer. Groups of cancer cells collecting inside your body can lead to odors which come from deep inside. You may not have access to this area and therefore can't clean it and wash the smell away. You should ask your doctor about this.
I don't know of any studies of Vietnam chemical exposure and bladder cancer. I am not an expert in this area. In general, though, these kinds of occupational exposures tend to affect the exposed person rather than their children.
I hope this helps you.
Sincerely,
J. Seigle, MD
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QUESTION: Hi it is Leanne Again thank you for your quick reply. I will try and make the first half of my question easy to understand. I wanted to know why wtih blader cacner is there so many epithial cells as when I do a urine test it shows up there. Here in Austraia the normal range is under 10 and mine is most of the time over 100. so is this normal for bladder cancer patients? Thank you so much. Leanne
Answer Leanne,
With bladder cancer, there often are several areas of cancer, not just one, which are on the inner surface of the bladder. This is why they can be seen with a cystoscope, which is the instrument the urologist uses to look into the bladder. Also, With any cancerous tumor, there is a high turnover rate - that is, lots of cells reproduce and lots of cells die. Cells slough off into the urine and show up on the test in unusually high numbers.
