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"Past is never dead. It's not even past."—William Faulkner
Black-on-black commentary is only slightly an inside story. For under the halo of "Negro Sunshine," at the entrance to Glenn Ligon: AMERICA, I experienced moments of real cultural nostalgia. My mother and the dream book and the endless numbers racket, with its weird logic and odd asymmetrical poetry, were somehow lodged in Glenn Ligon's magical series of numbered paintings. Apart from the unusually personal in Ligon's piercing vision, conceptualism—that somewhat elusive creature—seems to find its most complete expression in his oeuvre. Ligon is prepared to stream unflinchingly through various media, extracting elegantly exquisite beauty swathed in a tireless drama of inventions. Here the iniquities of history are refracted and recast. The heroes and heroines are unknown, enfeebled, and lost in time. Irony is legible and graphic, taking the form of a children's coloring book. He places specificity within our universal American culture and, in doing so, subjects all of us—black and white—to the same memories, more or less. Ligon's mid-career retrospective directly confronts the not-so-paradoxical complexity of the black male—its frightening history, its Dionysian beauty, its sexuality, its homoeroticism, its fearless honesty, and its dubiously artful texture as America's existential fall guy.
Installation view, Glenn Ligon: AMERICA, Los Angeles County Museum of Art, © Glenn Ligon, photo © 2011 Museum Associates/LACMA
With a litany of literary heroes, Ligon transubstantiates and time travels, morphing in and out of his own modernity. In conceptualist garb, he is prepared to be the captive of the deep and harrowing effect of the "peculiar institution" of slavery and the Fugitive Slave Act. Sensitively exploring the alternate self, Ligon is metaphorically boxed as Henry Boxcar Brown. The Narratives series includes WANTED signs and tales in which Ligon himself is implicated. Somehow we are vicariously the searchers. He signals the debilitating psychodramatic manacles of Jim Crow that so tragically traumatized black consciousness. And yet in his own time—in the post-Stonewall, glamorous, ribald, loose, very gay, and irony-rich era—Ligon painstakingly constructs exquisite, modernist, gestural-infused tablet-like paintings of literary, despairing speech that I might have heard around the kitchen table, as though a refrain that hangs in the air as some haunting vestigial "other." The mimetic chant, the clipped phrases repeated as unholy utterance like an echo in its stencil form, painted over and over again, resulting in a thick accumulation of oil stick caking downward and blurring to a blackness, a sort of shamanistic ending—black angst as blood memory. Or take the contentious Notes on the Margin of the Black Book, where AIDS, black beauty, and stereotyping vie for the naked truth. Ligon repositions Robert Mapplethorpe's photos as if to capture the rapidly escaping asteroid of black memory, the increasing velocity of which will be flung from our earthly residence to the outer edges of a black emotional solar system.
Installation view, Glenn Ligon: AMERICA, Los Angeles County Museum of Art, © Glenn Ligon, photo © 2011 Museum Associates/LACMA
And yet, of course, it's art. Ligon is foremost a painter. And though his art is replete with those sticky questions of identity that reside in a fragile balance, he filters it through not-entirely-incompatible attractions of modernism and postmodernism, historical racism and a "post-racial" era. Add to that the crosscurrent of homosexuality, which I suggest is the bravest. I sense in Ligon's work an inherent duality. He mitigates or sidesteps the rage of the hyper-hetero hip-hop gangsta rapper of his generation, who would readily diss the hyper-sexualized males of Notes on the Margin and A Feast of Scraps. The self-deprecation and the perceptual double edge in the brilliantly bold, neon-colored, profanity-rich "dirty talk" paintings of Richard Pryor's comedy act, with their reference to "faggot," shows the fearlessness of his art. Rejection and once again attraction, "gays stay home" yields a source of grandness with the dark indelible photo ink-jet images of Million Man March in Screen and Hands, which seem more universal than simply about a black movement. In my opinion, Glenn Ligon's art achieves greatness for it possesses what throughout the ages was a quality that digs into our very emotional center—spiritual alienation.
Glenn Ligon, Mirror, 2002, collection of Mellody Hobson, courtesy of the artist and Regen Projects, Los Angeles, © Glenn Ligon
And finally, I was most touched by a painting in the James Baldwin series, Mirror. Here the sparkling coal-dust encrusted night bleeds from the canvas. Its dark beauty, as if seen by candlelight, is faintly revealed a letter at a time. Some are captured, but most are lost. Ligon withholds meaning, the clear narrative. More a form of crystal gazing, I move into the interior of the imagination, a felt impulse where texture, blindness, and reach oblige surrender to the lush inscrutableness, which is so often art.
Hylan Booker


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subset: commoncrawl


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Cleveland rates a mention in a story from The Economist that highlights a conundrum: America's rampant health spending threatens its economic future, but it also supports tens of millions of jobs. From the piece: In 2011 America spent $2.7 trillion on health, equal to 17.9% of GDP. The government paid for nearly half of this. As public health spending continues to grow, it threatens to widen America's deficit and eclipse other public programmes, such as infrastructure and education. Nearly every politician, regardless of party, agrees that this is dangerous. On the local level, however, the mood is rather different. The trillions spent on health care do not disappear into the ether, but support hospitals, drug companies, insurers, nursing homes, information-technology firms and the millions of people they employ. Health spending may be disastrous for America's economic future; for many local economies, it is a boon. Cleveland is one of the cities seen as "eager to cash in," The Economist says. The magazine says Cleveland, "a city long eager to reinvent itself, may succeed at last with health care. It is home to good hospitals, including the famous Cleveland Clinic. Local groups such as BioEnterprise are trying to foster a new generation of health entrepreneurs, with some success. Last year 43 biomedical startups attracted $227m in venture-capital funding. "A community college is retraining car- and steelworkers for jobs with drug and device manufacturers. In a riskier move, Cleveland's surrounding county has spent about $465m on a new convention centre and a Global Center for Health Innovation, an exhibition building for medical companies. Local leaders hope that these will attract conferences."
Editor's Choice
Health care spending is killing America, but helping Cleveland
This CNNMoney.com story might make you wish you had no friends. The estimated 69 million Americans who will be attending weddings this year are "shelling out hundreds or even thousands of dollars" for the privilege — and the number keeps growing, the website says. "Between travel, gifts, attire and other costs, guests are expected to spend an average of $539 per wedding this year — up more than 50% from last year's average expected expense of $339," CNNMoney.com reports. Cleveland resident Christopher Sledzik in the past 18 months has attended 12 weddings, three of which he was in the wedding party. "For me, vacation time has been devoted to (weddings) for the past couple of years," Mr. Sledzik, 27, an account executive at marketing firm Marcus Thomas, tells CNNMoney.com. "I'm at that age where everybody's getting married, or at least it seems that way." The story notes Mr. Sledzik has attended six out-of-town nuptials, as well as four bachelor parties in cities ranging from Nashville, Tenn., to Austin, Texas. Between the travel, tux rentals and wedding gifts, the website notes, "he racked up roughly $10,000 in credit card debt, which he expects he'll be paying off for years." (The introductory 0% rate on the credit card he used has expired, and his bill is now accumulating $130 in interest each month.) But he has no regrets. "It's one of those things that at first I had to mentally justify, saying, 'Am I really going to take on debt at a time in my life when I really don't want to?'" Mr. Sledzik tells CNNMoney.com. "But the memories that I made and being there for friends' big moments was worth it."
The Obama administration must like the way things are going at the National Additive Manufacturing Innovation Institute in Youngstown. The Wall Street Journal reports the administration on Thursday "promised to set up three more federally funded research institutes to explore novel technologies, as part of its aim of spurring a revival in U.S. manufacturing." The White House "said it would provide a total of $200 million to launch the institutes, to be matched by funding from state and local governments and other sources, perhaps including private companies," according to the newspaper. The institutes would join one that opened last year in Youngstown "to work on additive manufacturing, a production technique often dubbed 3-D printing." No sites have been selected. Ed Morris, the Youngstown institute's director, tells The Journal that more research spending is essential to bolster U.S. manufacturing. "We're in an economic war" with other parts of the world, he says. "Some would argue that we're losing."
Here's yet another reason to love dogs, even if, in this New York Times story, a Cleveland Clinic cardiologist poo-poos the rationale behind it. The Times notes that the nation's largest cardiovascular health organization says owning a dog may protect you from heart disease. "The unusual message was contained in a scientific statement published on Thursday by the American Heart Association, which convened a panel of experts to review years of data on the cardiovascular benefits of owning a pet," according to the story. "The group concluded that owning a dog, in particular, was 'probably associated' with a reduced risk of heart disease," mostly because people who own dogs have more reason to get outside and take walks. That certainly makes sense. However, Dr. Richard Krasuski of the Clinic tells The Times that he views the new statement as an indictment of societal attitudes toward exercise. "Very few people are meeting their exercise goals," he says. "In an ideal society, where people are actually listening to physician recommendations, you wouldn't need pets to drag people outside."
YouTube data make it official: We are living in "a Charles Ramsey America." That's TheAtlanticCities.com's interpretation of numbers from the new YouTube Trends Map — a geographic display of who's watching what in cities across the United States. The Trends Map "displays viewing and sharing behavior among registered users on the YouTube Dashboard within the past 12-to-24 hours," according to the website. (YouTube says it surveyed only those U.S. metropolitan regions — about 150 — large enough to return reliable results during this period.) "Hovering over a city shows the three most popular videos in that region, how many times it's been viewed, and how many other cities across the country have the same top ranking," according to the story. A quick glance last night, for instance, "showed that there was no Red America or Blue America but rather a Charles Ramsey America," TheAtlanticCities.com says. The songified version of Mr. Ramsey's interview about the horrible Cleveland kidnappings was the top-viewed video in 58% of the tracked regions.
You also can follow me on Twitter for more news about business and Northeast Ohio.


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As one of Canada's largest holders of gold, silver, and platinum bullion, our company's mission is to make precious metals ownership open to everyone. It doesn't matter what age you are or how much investment experience you have, we can help you set up a precious metals portfolio.
Silver Bullion
Silver's growing industrial demand sets it apart from other precious metals. Every year, new uses for silver's unique chemical properties are discovered, ranging from biotech to electronics. Because there isn't enough silver to meet growing demands, many investors feel that silver is a good choice for their portfolio.
Investment Opportunity
Historically, 12 ounces of silver equal 1 ounce of gold, a 12:1 ratio that dates back centuries. The current ratio of 75:1 indicates that silver is vastly undervalued. Many analysts and experts believe silver should be trading at several times its current price.
Silver is considered relatively safe.
When political and economic insecurity is widespread in the world, investors tend to eschew legal tender in favour of tangible assets such as silver or gold.
It's a kind of money.
While stocks, bonds, and other financial instruments are all recognized sources of wealth, they are basically promissory notes. That makes them susceptible to devaluation as a consequence of policies like quantitative easing. Silver bullion is a tangible asset. Although it's susceptible to market swings, it is unlikely to ever collapse entirely due to its intrinsic worth. Investors also like the variety of purchase options available for silver such as silver coins, silver bullion bars and our exclusive Sprott Silver.
It's much more affordable than gold.
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Silver provides a greater rate of return than gold.
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This precious metal has long been recognized for its intrinsic worth, and thus there is an expectation that, unlike fiat currencies, it will remain strong. When investors invest in real silver, whether through buying a silver ingot, pure silver, silver coins, or another form of silver, they feel a sense of security that its value will grow.
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Silver bars also come in much larger sizes than most coins or rounds, which is another factor that contributes to them costing less per ounce. Silver bars range in size from just 1 gram to 1000+ troy ounces.
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PHOENIX (AP) — The jury has rendered its verdict — Jodi Arias is guilty of first-degree murder — but the trial is far from finished.
The same jury now returns to the courtroom Thursday to decide whether she deserves to die for killing her one-time boyfriend on June 4, 2008 at his suburban Phoenix home.
The sheer brutality of the attack and previous testimony from the Maricopa County Medical Examiner that Travis Alexander did not die a quick death will be at the heart of the prosecution's argument that Jodi should receive the ultimate punishment for her crime.
Alexander was stabbed and slashed nearly 30 times, shot in the forehead and had slit his throat from ear to ear, leaving the motivational speaker and businessman nearly decapitated. His decomposing body was found in his shower about five days later by friends.
Arias spoke out about the verdict minutes after her conviction Wednesday, telling a TV station that she would "prefer to die sooner than later."
"Longevity runs in my family, and I don't want to spend the rest of my natural life in one place," a tearful Arias told Fox affiliate KSAZ. "I believe death is the ultimate freedom and I'd rather have my freedom as soon as I can get it."
Arias, 32, fought back tears as a court clerk read aloud the highly anticipated verdict after a four-month trial in which the jury heard 18 days of testimony from the defendant, saw a series of gruesome crime scene photos and heard a raunchy phone sex chat between Arias recorded with Alexander just weeks before he died.
The next portion of the trial is called the "aggravation phase," and it will focus on whether the jury believes the crime was committed in an especially cruel, heinous and depraved manner. If jurors find the aggravators exist, the next step will be the penalty phase during which the panel will recommend either life in prison or death. The process could take several more weeks to wrap up.
The trial quickly became an Internet sensation and transformed Arias from a little-known waitress to a morbid curiosity and a star of a real-life true-crime drama that the public followed incessantly. The presence of cameras in the courtroom, the advance of Internet streaming video and social media, the salacious details of the case, and the attention it got on cable networks like HLN gave the trial the feel of a celebrity proceeding.
The jury heard all about the stormy relationship between Alexander and Arias after they met at a conference in Las Vegas in 2006 and he persuaded her to convert to Mormonism. They began dating but broke up five months later, at which point prosecutors said she began stalking him and became increasingly obsessed with Alexander.
The 30-year-old victim was a rising star at a legal services company called Prepaid Legal, where he gave rousing motivational speeches to colleagues and was a beloved co-worker to people across the organization.
Arias sought to portray him as an abusive sexual deviant in her trial, hoping that the jury would buy her claims that she killed him in self-defense after being unable to take the abuse anymore. She claimed he attacked her and forced her to fight for her life. Prosecutors said she killed out of jealous rage after Alexander wanted to end their affair and planned to take a trip to Mexico with another woman.
Alexander's family members wept and hugged each other after the verdict. They thanked prosecutor Juan Martinez and the lead detective on the case, but declined comment until after sentencing.
Alexander's friend Chris Hughes said he was happy with the verdict, pointing out a bold proclamation Arias made in one of her jailhouse interviews that she wouldn't be found guilty.
"She said, 'No jury would convict me. Mark my words.' This jury convicted her," Hughes said. "Luckily we had 12 smart jurors. They nailed it."
When asked about Alexander's family, Arias told the station, "I just hope that now that a verdict has been rendered, that they'll be able to find peace."
Arias seemed to cry silently when asked about her mother. With tears falling, she said her mom "has been a saint and I haven't treated her very well."
The Maricopa County Sheriff's Office said no more media interviews with Arias would be granted. She has been placed on suicide watch.
Outside court, more than 200 spectators and reporters watched for the verdict on their smart phones. A ripple of relief spread as people learned the result. The crowd cheered, with some people jumping, waving, high-fiving and dancing in approval.
Hughes said it was frustrating to hear the defense besmirch his friend's reputation during the trial, but praised the jurors for the verdict. He said he and the Alexander family were shocked by the international attention the case had received.
"Travis was grandiose, so it's interesting how this played out ... it is a bit of a circus. We were all surprised that it's like this," he said.
Testimony began in early January. The trial quickly snowballed into a made-for-the-tabloids drama, garnering daily coverage from cable news networks and spawning a virtual cottage industry for talk shows, legal experts and even Arias, who used her notoriety to sell artwork she made in jail. She also sent out tweets via an intermediary, attracting tens of thousands of followers.
Arias said she recalled Alexander attacking her in a fury after a day of sex. She said Alexander came at her "like a linebacker," body-slamming her to the tile floor. She managed to wriggle free and ran into his closet to retrieve a gun he kept on a shelf. She said she fired in self-defense but had no memory of stabbing him.
She acknowledged trying to clean the scene of the killing, dumping the gun in the desert and working on an alibi to avoid suspicion. She said she was too scared and ashamed to tell the truth. However, none of Arias' allegations that Alexander had physically abused her in the months before his death, that he owned a gun and had sexual desires for young boys, were corroborated by witnesses or evidence during the trial. She acknowledged lying repeatedly before and after her arrest but insisted she was telling the truth in court.
Arias spent 18 days on the witness stand describing an abusive childhood, cheating boyfriends, dead-end jobs, a shocking sexual relationship with Alexander, and her contention that he had grown physically violent in hopes of gaining sympathy from jurors.
But aside from her admitted lies, Arias had yet another formidable obstacle to overcome.
Her grandparents had reported a .25-caliber handgun stolen from their Northern California home about a week before Alexander's death — the same caliber used to shoot him — but Arias insisted she didn't take it. Authorities believe she brought it with her to kill him. The coincidence of the same caliber gun stolen from the home also being used to shoot Alexander was never resolved.
Meanwhile, the entire case devolved into a circus-like spectacle attracting dozens of enthusiast each day to the courthouse as they lined up for a chance to score just a few open public seats in the gallery. One trial regular sold her spot in line to another person for $200. Both got reprimands from the court, and the money was returned.
Many people also gathered outside after trial for a chance to see Martinez, who had gained celebrity-like status for his firebrand tactics and unapologetically intimidating style of cross-examining defense witnesses.
The case grew into a worldwide sensation as thousands followed the trial via a live, unedited Web feed. Twitter filled with comments as spectators expressed their opinions on everything from Arias' wardrobe to Martinez's angry demeanor. For its fans, the Arias trial became a live daytime soap opera.


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Bladder Cancer
Topic Overview
What is bladder cancer?
Cancer is the growth of abnormal cells in the body. These extra cells grow together and form masses, called tumors. In bladder cancer, these growths happen in the bladder.
The bladder is the part of your urinary tract that stores your urine until you are ready to let it out. See a picture of the female urinary system or male urinary system.
Bladder cancer can often be successfully treated if it is found and treated early. And most bladder cancer is found early.
This topic is about the most common type of bladder cancer, called transitional cell cancer. This is cancer that starts in the inner layer of the bladder. It happens most often in people who are in their 60s or older.
What causes bladder cancer?
Experts don't know what causes bladder cancer. But smoking cigarettes or being exposed to certain chemicals raises your risk. And like other cancers, changes in the DNA of your cells seem to play a role.
What are the symptoms?
Blood in the urine is the main symptom. Other symptoms may include having to urinate often or feeling pain when you urinate.
These symptoms can be caused by other problems, including a urinary tract infection. Always call your doctor if you see blood in your urine.
How is bladder cancer diagnosed?
To diagnose bladder cancer, your doctor will:
- Ask about your medical history and do a physical exam, including a vaginal or rectal exam.
- Test your urine to look for blood or abnormal cells.
- Do a cystoscopy, a test that lets your doctor look into your bladder with a thin, lighted viewing tool. Small tissue samples (biopsies) are taken and looked at under a microscope to find out if there are cancer cells.
How is it treated?
Treatment choices for bladder cancer include:
- Surgery to remove any cancer. Sometimes lasers or other methods can be used to get rid of tumors.
- Chemotherapy, which uses medicine to destroy cancer cells.
- Immunotherapy, which causes your body's natural defense system to attack bladder cancer cells.
- Radiation therapy, which uses high-dose X-rays to kill cancer cells.
The treatment depends a lot on how much the cancer has grown. Most bladder cancers are treated without having to remove the bladder.
Sometimes doctors do have to remove the bladder. For some people, this means having urine flow into a bag outside of the body. But in many cases, doctors can make a new bladder—using other body tissue—that works very much like the old one.
Bladder cancer often comes back. The new tumors can often be treated successfully if they are caught early. So it's very important to have regular checkups after your treatment is done.
Finding out that you have cancer can change your life. You may feel like your world has turned upside down and you have lost all control. Talking with family, friends, or a counselor can really help. Ask your doctor about support groups. Or call the American Cancer Society (1-800-227-2345) or visit its website at www.cancer.org.
What increases your chances of getting bladder cancer?
Anything that increases your chances of getting a disease is called a risk factor. The main risk factors for bladder cancer include:
- Smoking. Cigarette smokers are much more likely than other people to get bladder cancer.
- Being older than 40, being male, or being white (Caucasian).
- Being exposed to cancer-causing chemicals, such as those used in the wood, rubber, and textile industries.
- What you eat. A diet high in fried meats and fats increases your risk for bladder cancer.
- Parasites. There is a parasite that causes schistosomiasis, which can increase your risk. This condition is sometimes found in developing countries and rarely occurs in North America.
Health Tools
Health Tools help you make wise health decisions or take action to improve your health.
The cause of bladder cancer is not known. Changes in the genetic material (DNA) of bladder cells may play a role. Chemicals in the environment and cigarette smoking also may play a role. And when the lining of the bladder is irritated for a long time, cell changes that lead to cancer may occur. Some things that cause this are radiation treatment, having catheters in place for a long time, or having the parasite that causes schistosomiasis.
Bladder cancer is twice as likely to develop in smokers than in nonsmokers. Experts believe that smoking causes about half of all bladder cancers in men and women.footnote 1
Exposure to chemicals and other substances at work—including dyes, paints, leather dust, and others—may also cause bladder cancer.
The most common symptoms of bladder cancer include:
- Blood or blood clots in the urine (hematuria). Hematuria occurs in 8 or 9 out of 10 people who have bladder cancer and is the most common symptom. Usually it isn't painful.
- Pain during urination (dysuria).
- Urinating small amounts frequently.
- Frequent urinary tract infections (UTIs).
Symptoms that may indicate more advanced bladder cancer include:
- Pain in the lower back around the kidneys (flank pain).
- Swelling in the lower legs.
- A growth in the pelvis near the bladder (pelvic mass).
Other symptoms that may develop when bladder cancer has spread include:
- Weight loss.
- Bone pain or pain in the rectal, anal, or pelvic area.
- Anemia.
The symptoms of bladder cancer may be similar to symptoms of other bladder conditions.
What Happens
Bladder cancer is the rapid, uncontrolled growth of abnormal cells in the bladder. Cancer usually begins in the lining of the bladder. The cancerous cells may spread through the lining into the muscular wall of the bladder.
Invasive bladder cancer may spread to lymph nodes, other organs in the pelvis (causing problems with kidney and bowel function), or other organs in the body, such as the liver and lungs.
Your treatment will depend on how far the cancer has spread.
Most bladder cancer is found early, before it has spread into the bladder wall. Surgery can usually remove these tumors. But bladder cancer often comes back, so you may also get other treatments, such as chemotherapy or immunotherapy, to lower the chances of that happening.
What Increases Your Risk
The main risk factors for bladder cancer include:
- Smoking. Cigarette smokers are much more likely than other people to get bladder cancer.
- Chemical exposure. Bladder cancer has been linked to chemicals called aromatic amines. These chemicals are found in many products, including dyes, paints, solvents, inks, and the dust from leather. This risk may also depend on how much and how often a person was exposed to these chemicals.
- Being older. Your risk goes up as you get older. Most people who get bladder cancer are close to their 70s.
- Being a white male. Men are 4 times more likely to get bladder cancer than women. And white men are twice as likely to get it as African-American men.footnote 1
- Some cancer treatments, such as radiation therapy to the belly or pelvis.
- Some chemotherapy medicines, such as cyclophosphamide.
- A diet that is high in nitrates or rich in meat and fatty foods.
- Schistosomiasis, which is an infection caused by a parasite. It's sometimes found in developing countries and rarely occurs in North America.
When should you call your doctor?
If you have been diagnosed with bladder cancer, be sure to follow your doctor's instructions about calling when you have problems, new symptoms, or symptoms that get worse.
Call your doctor if you:
- Have blood in your urine.
- Feel pain when you urinate.
- Are urinating small amounts frequently.
- Have back or flank pain.
Watchful waiting
If you are concerned about your symptoms or about your risk for bladder cancer, make an appointment with your doctor. Watchful waiting is not appropriate if you have symptoms that do not go away.
Who to see
Health professionals who can evaluate your symptoms and your risk for bladder cancer include:
- General practitioners.
- Family medicine doctors.
- Nurse practitioners.
- Physician assistants.
- Internists.
- Urologists.
Doctors who can manage your cancer treatment include:
Exams and Tests
To find out whether bladder cancer may be the cause of your urinary symptoms, your doctor will:
- Do a physical exam. This may include a rectal exam, a prostate exam for men, or a pelvic exam for women.
- Ask questions about your medical history, including:
- Your smoking history.
- Your possible exposure to cancer-causing chemicals.
- Your family history of cancer.
- Order a urine test and urine culture to check for the presence of blood, infection, and other abnormal cells. A urine test may also be done to look for tumor markers, which can be signs of cancer.
You will have a cystoscopy, a test that allows your doctor to look at your bladder with a thin, lighted tube. The doctor can use the same tube to take small tissue samples (biopsies) of any abnormal areas. The samples will be looked at under a microscope to find out whether cancer cells are present and what the cells look like.
Tests to determine stage and grade
Bladder cancer is classified by stage and grade. The stage is determined by the cancer growth in the bladder wall and how far it has spread to nearby tissues and other organs, such as the lungs, the liver, or the bones. The grade of bladder cancer is determined by how the cancer cells look in comparison with normal bladder cells.
Your doctor finds out the stage and grade of your bladder cancer by gathering information from several tests, including:
- Biopsies from the cystoscopy.
- An intravenous pyelogram or CT urogram to look for a mass near the kidneys, ureters, or bladder.
- Ultrasound or magnetic resonance imaging (MRI). These help find out if the cancer has spread to lymph nodes, the lungs, the liver, or other abdominal organs.
- CT scan. This finds out if the cancer has spread to other parts of the body.
- Chest X-ray. This finds out if the cancer has spread to the lungs.
- Bone scan. This finds out if the cancer has spread to the bones.
Knowing the stage and grade of your cancer is important in choosing the right treatments.
Other tests
Other diagnostic tests that may be done include:
- A complete blood count (CBC) to find out if you have anemia.
- A chemistry screen to evaluate kidney, liver, and bone functions.
Early detection of returning cancer
Bladder cancer often comes back, so it's important to have regular checkups. Then, if the cancer does come back, you have a better chance of finding it early enough for successful treatment.
Treatment Overview
The choice of treatment and the long-term outcome (prognosis) for people who have bladder cancer depend on the stage and grade of cancer. When deciding about your treatment, your doctor also considers your age, overall health, and quality of life.
Bladder cancer has a better chance of being treated successfully if it is found early.
Treatment choices for bladder cancer may include:
- Surgery to remove the cancer. Surgery, either alone or along with other treatments, is used in most cases.
- Chemotherapy to destroy cancer cells using medicines. Chemotherapy may be given before or after surgery.
- Radiation therapy to destroy cancer cells using high-dose X-rays or other high-energy rays. Radiation therapy may also be given before or after surgery and may be given at the same time as chemotherapy. For more information, see Other Treatment.
- Immunotherapy. This treatment causes your body's natural defenses, known as your immune system, to attack bladder cancer cells. For more information, see Medications.
Stages and grades of bladder cancer
There are five stages of bladder cancer, stages 0 to IV:footnote 2
- Stage 0: Cancer cells are only on the surface of the inner layer of the bladder. This may be called carcinoma in situ.
- Stage I: Cancer has grown deeper into the inner layer but not into the muscle layer.
- Stage II: Cancer has grown into the muscle layer of the bladder.
- Stage III: Cancer has grown through the muscle layer and into nearby organs, such as the prostate, uterus, or vagina.
- Stage IV: Cancer has grown into the wall of the pelvis or the belly but not into any lymph nodes. Or the cancer has spread into at least one lymph node or to another part of the body, such as the liver, lungs, or bones.
The grade of bladder cancer is usually either low-grade (LG) or high-grade (HG). High-grade tumors tend to grow faster. They are also more likely to spread than low-grade tumors. When your doctor knows the grade of your cancer, this information will help him or her choose the best treatment plan for you.
More information about bladder cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/bladder.
Bladder cancer that comes back
After initial treatment for bladder cancer, it is important to receive follow-up care, because bladder cancer often comes back (recurs). Your doctor will set up a regular schedule of checkups and tests.
Bladder cancer may recur in the bladder, or it may spread (metastasize) to other parts of the body. Recurrent bladder cancer may be treated with surgery or chemotherapy to slow cancer growth and relieve symptoms.
Participation in a clinical trial may be recommended if you have been diagnosed with recurrent bladder cancer.
Body image and sexual problems
Sexual problems can be caused by physical or psychological factors related to the cancer or its treatment. You may experience less sexual pleasure or lose your desire to be sexually intimate.
- Women who have their bladder removed (radical cystectomy) will also have their ovaries and uterus removed. They cannot become pregnant and may experience menopause soon after having this surgery.
- Men who have their prostate glands and seminal vesicles removed may have erection problems and will no longer produce semen.
Your feelings about your body may change after treatment for cancer. Managing your feelings about your body may involve talking openly about your concerns with your partner and discussing your feelings with your doctor. Your doctor may also be able to refer you to groups that can offer support and information.
Palliative care
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life—not just in your body but also in your mind and spirit. You can have this care along with treatment to cure your illness.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
For more information, see the topic Palliative Care.
End-of-life care
For some people who have advanced cancer, a time comes when treatment to cure the cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But you can still get treatment to make you as comfortable as possible during the time you have left. You and your doctor can decide when you may be ready for hospice care.
For more information, see the topics:
Bladder cancer cannot be prevented, but you may be able to reduce some of your risk for getting it.
- Stop smoking. Cigarette smokers are much more likely to get bladder cancer than nonsmokers. For help on how to quit smoking, see the topic Quitting Smoking.
- Avoid exposure to industrial chemicals, such as benzene substances and arylamines. Occupational exposure from working with dyes, rubbers, textiles, paints, leathers, and chemicals raises your risk for bladder cancer.
- Avoid exposure to arsenic. Have your drinking water tested. Drink bottled water if you think that your water is contaminated with arsenic.
- Eat healthy foods. Experts believe that what you eat and drink may help prevent bladder cancer.
- Choose a low-fat, low-cholesterol diet that includes plenty of fruits and vegetables. For more information, see the topic Weight Management.
- Avoid dehydration. Increase your fluid intake, particularly water. Water dilutes cancer-causing chemicals.
Home Treatment
The side effects of bladder cancer treatment can be serious. Healthy habits such as eating a balanced diet and getting enough sleep and exercise may help control your symptoms. Your doctor may also give you medicines to help you with certain side effects.
You can try home treatments:
- For nausea or vomiting, such as ginger or peppermint tea, gum, or candy.
- For diarrhea, such as small, frequent sips of water and bites of salty crackers.
- For constipation, such as plenty of water and fiber in your diet. Do not use a laxative without first talking to your doctor.
Other issues that can be treated at home include:
- Sleep problems. If you have trouble sleeping, try having a regular bedtime and getting exercise daily.
- Feeling very tired. If you lack energy or become weak easily, try to manage your energy and get extra rest.
- Hair loss. Hair loss may be unavoidable. But using mild shampoos and avoiding damaging hair products will reduce irritation of your scalp.
- Pain. Home treatment can help you manage pain. Be sure to talk with your doctor about any home treatment you use.
Handling the stress of having cancer
Having cancer can be very stressful, and it may feel overwhelming to face the challenges in front of you. Finding new ways of coping with the symptoms of stress may improve your overall quality of life.
These ideas may help:
- Get the support you need. Spend time with people who care about you, and let them help you.
- Take good care of yourself. Get plenty of rest, and eat nourishing foods.
- Talk about your feelings. Find a support group where you can share your experience.
- Try new ways to relax. And do things each day that help you stay calm and relaxed. Stress reduction techniques may help.
Having cancer can change your life in many ways. For support in managing these changes, see the topic Getting Support When You Have Cancer.
Medicines may be used to control the growth of bladder cancer cells and to relieve symptoms. These medicines may be taken by mouth, injected into a vein (intravenous, or IV), or delivered directly into the bladder using a catheter.
- Chemotherapy uses medicines to destroy cancer cells.
- Immunotherapy, also called biological therapy, uses medicines that cause your body's immune system to attack cancer cells in your bladder. It is most often used for early-stage bladder cancer. It may also be used after a transurethral resection (TUR) to help keep cancer from coming back.
Medicine choices
Examples of chemotherapy medicines used for bladder cancer include gemcitabine, mitomycin, and cisplatin.
Side effects of chemotherapy may include:
- Loss of appetite, nausea, or vomiting.
- Diarrhea.
- Hair loss.
- Mouth sores.
- An increased risk of infection.
- Skin peeling or a rash from mitomycin.
Some people may need medicines to control nausea and vomiting.
Examples of immunotherapy medicines used for bladder cancer include Bacillus Calmette-Guerin (BCG), nivolumab, and atezolizumab.
Side effects of immunotherapy medicines may include:
- Fatigue.
- Fever.
- Joint pain.
- Decreased appetite or nausea.
- Constipation.
- Disseminated tuberculosis from BCG.
- Immune-related problems (such as infections or skin reactions) from nivolumab and atezolizumab.
Surgery is used to treat most stages of bladder cancer.
- Transurethral resection (TUR) is surgery done through the urethra. A thin, lighted tube called a cystoscope is used to remove or destroy tumors in the bladder.
- Cystectomy is surgery to remove the bladder.
- Partial cystectomy removes only part of the bladder. It is used to treat cancer that has invaded the bladder wall in just one area.
- Radical cystectomy removes all of the bladder as well as nearby lymph nodes, part of the urethra, and nearby organs that may contain cancer cells.
- Urinary diversion is surgery that makes a new way for your body to store urine. This can be done with a pouch created inside your body from part of your intestines, called a continent reservoir. Or the surgeon may make an artificial opening, called an ileal conduit, and you will wear a flat bag to store urine outside your body.
The side effects of surgery may include:
- Bowel problems, such as constipation or diarrhea.
- Scar tissue that forms inside your body from having surgery (adhesions).
- A blockage in the intestines (bowel obstruction).
- In men, erection problems if the bladder was removed.
Other Treatment
Radiation treatment
Radiation treatment for bladder cancer uses high-energy X-rays to kill cancer cells and shrink tumors. It may be given after surgery. It may be used along with chemotherapy. Sometimes it is used instead of surgery or chemotherapy.
- External beam radiation comes from a machine outside the body. The machine aims radiation at the area where the cancer cells are found.
- Internal radiation uses needles, seeds, wires, or catheters that contain radioactive materials placed close to or directly into the bladder.
Which treatment you receive will depend on the type and stage of your cancer.
Side effects of radiation may include:
- Nausea, vomiting, or diarrhea.
- Pain or discomfort when you urinate.
- An increased risk for infection.
- In women, changes to the cells lining the vagina. These changes can make intercourse difficult or painful.
- In men, erection problems if the nerves that control erection were affected by radiation.
Clinical trials
Your doctor may talk to you about joining a research study called a clinical trial if one is available in your area. Clinical trials are research studies to look for ways to improve treatments for bladder cancer. Experts are doing studies on:
- Chemoprevention for early-stage bladder cancer. This is the use of medicines or vitamins to reduce the risk of getting cancer or having cancer come back.
- Photodynamic therapy. This uses medicine and a special light to treat the cancer.
For some people with bladder cancer, clinical trials may offer the best treatment available.
Complementary therapies
People sometimes use complementary therapies along with medical treatment to help relieve symptoms and side effects of cancer treatments. Some of the complementary therapies that may be helpful include:
- Acupuncture to relieve pain.
- Meditation or yoga to relieve stress.
- Massage and biofeedback to reduce pain and ease tension.
- Breathing exercises for relaxation.
These mind-body treatments may help you feel better. They can make it easier to cope with treatment. They also may reduce chronic low back pain, joint pain, headaches, and pain from treatments.
Before you try a complementary therapy, talk to your doctor about the possible value and potential side effects. Let your doctor know if you are already using any such therapies. They are not meant to take the place of standard medical treatment.
- American Cancer Society (2012). Cancer Facts and Figures 2012. Atlanta: American Cancer Society. Available online: http://www.cancer.org/Research/CancerFactsFigures/CancerFactsFigures/cancer-facts-figures-2012.
- National Cancer Institute (2010). What You Need To Know About Bladder Cancer (NIH Publication No. 10-1559). Available online: http://www.cancer.gov/cancertopics/wyntk/bladder.
Other Works Consulted
- American Cancer Society (2011). Lasers in cancer treatment. Available online: http://www.cancer.org/Treatment/TreatmentsandSideEffects/TreatmentTypes/lasers-in-cancer-treatment.
- American Cancer Society (2012). Bladder cancer. Available online: http://www.cancer.org/cancer/bladdercancer/detailedguide/index.
- American Joint Committee on Cancer (2010). Urinary bladder. In AJCC Cancer Staging Manual, 7th ed., pp. 497–505. New York: Springer-Verlag.
- National Cancer Institute (2012). Bladder Cancer Treatment (PDQ)—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/healthprofessional.
- National Cancer Institute (2012). Bladder Cancer Treatment (PDQ)—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/patient.
- National Cancer Institute (2012). SEER Fact Sheets: Bladder. Bethesda, MD: National Cancer Institute. Available online: http://seer.cancer.gov/statfacts/html/urinb.html.
- National Comprehensive Cancer Network (2013). Bladder Cancer. NCCN Clinical Practice Guidelines in Oncology, version 1.2013. Available online: http://www.nccn.org/professionals/physician_gls/pdf/bladder.pdf.
- U.S. Preventive Services Task Force (2011). Screening for bladder cancer: Recommendation statement. Available online: http://www.uspreventiveservicestaskforce.org/uspstf11/bladdercancer/bladcanrs.htm.
Current as of: December 19, 2018
Author: Healthwise Staff
Medical Review:E. Gregory Thompson, MD – Internal Medicine & Kathleen Romito, MD – Family Medicine & Christopher G. Wood, MD, FACS – Urology
This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. Learn how we develop our content.


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Mississippi Mud Cake ~ Anncoo Journal Turns Two Today!!
I am submitting this post to Aspiring Bakers #4: Love In The Air (Feb 2011) hosted by Cuisine Paradise.
- Here is the recipe
1/2 tbsp Baking soda
- In a pot melt butter, sugar, bitter chocolate, sugar, coffee liquid together. Still the mixture very well till sugar dissolved. Do not boil. Then add kahlua liqueur and vanilla extract.
- In a large bowl, sift self raising flour, baking soda and cocoa powder together, then pour chocolate mixture into flour. Use hand whisk to mix well till mixture becomes thick and lastly add in beaten eggs and mix till smooth batter.
- Pour batter in a 8 inch heart shaped (lined) pan or 8 inch round cake tin or a 7 inch round cake tin if you prefer a taller cake.
- Bake at preheated oven 170C for 30-35mins.
- Leave cake in mold till cool after baked.
Mix warm melted butter in chocolate cream with a hand whisk till smooth, add Kahlua liqueur ~mix well.
- Slice cake into two horizontally and sandwich the cake with chocolate cream. Then coat the whole cake with chocolate cream with a palette knife and decorate as desire.
- Serve the cake immediately or chill the cake before serve.
- Keep the remaining chocolate cream in fridge for other uses.


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Dangerously strong storms and tornadoes are possible Saturday and into Sunday from north central Texas up through Oklahoma, Kansas, Nebraska, Missouri and Iowa and as far east as Wisconsin, the National Weather Services's Storm Prediction Center is warning.
And according to the prediction center, "this is only the second time a high risk has been issued for the ["day two"] forecast, and the first time ever it has been issued for the initial D2 outlook." That's how unusual and how serious the situation appears to be.
The Weather Channel has applied its "TOR: CON Index" to the forecasts and says that these area have "an above-average threat of ... severe thunderstorms with damaging winds, hail, and/or tornadoes" on Saturday and through the night into Sunday:
Iowa — across its southwest, northwest, central and northeast sections.
Kansas — across its central and southeast sections.
Minnesota — across its southwest, south and east-central sections.
Missouri — in its northwest corner.
Nebraska — from the southeast across the central section and to the northeast.
Oklahoma — from the west to the north-central section (not including the panhandle), and through the center of the state to the northeast.
South Dakota — in its southeast corner.
Texas — in the northwest, "near Wichita Falls," and across the central section west of Interstate-35.
Wisconsin — in the west-central section.
Update Saturday at 7:05 a.m. ET. Tornado Sirens In Okla.:
"Pre-dawn tornado sirens have sounded in Oklahoma City," The Associated Press reports. Reporter Kurt Gwartney of member station KGOU tells our Newscast unit that storms Friday evening spawned at least one tornado and caused at least 10 injuries across central Oklahoma.
Update Saturday at 1:00 p.m. ET. Three Possible Tornadoes:
The National Weather Service is working to confirm three tornadoes that were reported west and north of Oklahoma City Saturday morning, the AP says.
The storms reportedly damaged some homes, but the worst of the severe weather is still expected to hit later this afternoon.
"We're quite sure [Saturday] will be a very busy and dangerous day in terms of large tornadoes in parts of the central and southern plains," National Weather Service Spokesperson Chris Vaccaro told the AP. "The ingredients are coming together."
Update Saturday at 7:05 p.m. Heavy Weather Overnight
Expected during the day, the National Weather Service is now issuing a stern warning for parts of the mid-U.S. to expect the most dangerous weather and possible fast-moving tornadoes overnight.
"The threat isn't over with tonight, unfortunately. Severe weather is possible again tomorrow from east Texas and Arkansas and up to into the Great Lakes," Bill Bunting, chief of operations at the Storm Prediction Center, which is part of the National Weather Service, told the AP.
Some homes have been damaged in Nebraska, Kansas and Oklahoma from hail and three reported tornadoes, but so far there were no injuries immediately reported in any of the states experiencing heavy severe weather.
Copyright 2021 NPR. To see more, visit https://www.npr.org.


text:
Plus Size Lovely Ladies 100% Polyester Made In U.S.A. Beautiful Brilliant Floral Print Oversize Flowy Dramatic Bell Sleeves Kimono (Off White)
Made In U.S.A
Plus Size Floral Printed Oversize Flowy and Airy Kimono with Dramatic Bell Sleeves
A rich, decadent, sumptuous vintage style! You can wear it as your unique style statement garment. pair it with your favorite accessories or go without any frills at all! It looks absolutely stunning! anyway and gives you instant standout status as a fashion diva in the midst of a crowd. It is completely luxurious with it's lavish embellished design exquisitely created by our skilled artisans who ply their unique art to create this truly remarkable masterpiece!
Care Instructions: Every garment in our collection is pre-washed so colors will not run. Hand wash in cold water with mild soap and hang dry. Do not use bleach or fabric softener as they can damage the fabric. Very light iron on low delicate setting or steam if needed.
One size fits all-Kaftan (Small to 8XL)
Quality: Excellent (Best Quality Of Our Stock)
Condition: Brand New
Brand: Silk Kaftan
Type: Kaftan
100% Polyester
Off White
Measurements: SIZE S
Length:30" Waist:50" Bust:50"
We will accept all authorized returns. All returns are accepted if the request is made to return the item within 30 days of receiving the merchandise. Once approved we will generate the FREE UPS prepaid return label and will email you with the label included within the attachment. Just print the label, attach it to any box / package put your item(s) inside and return the items. You will have 30 days to return the item(s) for a full refund once you receive the free return label. Once we receive the item(s) we will process the return and refund the balance back to your account. Please note free return labels are available for items that have shipped within 48 continental states only.
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To complete your return, we require a receipt or proof of purchase.
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We only replace item(s) if they are defective or damaged that have shipped within the 48 continental states. If you need to exchange it for the same item, kindly email us at firstname.lastname@example.com
If the item was marked as a gift when purchased and shipped directly to you, you'll receive a gift credit for the value of your return. Once the returned item is received, a gift certificate will be mailed to you. If the item wasn't marked as a gift when purchased, or the gift giver had the order shipped to themselves to give to you later, we will then send a refund to the gift giver, and they will be informed regarding your return.


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