Bladder Cancer Treatments
Following a bladder cancer diagnosis, the most important first step is to determine the best course of treatment. In most cases, doctors will choose the standard treatments, which include surgery, chemotherapy and radiation, because these have been found to be most effective in fighting the cancer.
Before deciding on your best treatment, your oncologist will look at a number of circumstances, including your age and overall health. In some cases, some types of treatment are not appropriate, so only one or two treatments are used. In other cases, all three treatments used in succession is the best approach.
Bladder cancer surgery can be used in all stages of the disease because there are different types of surgery that are performed.
Transurethral surgery (TURBT)
For the early stages of the disease, this is the most common type of treatment. In this operation, a rigid scope is passed through the urethra into the bladder. This scope has a heated wire loop at the end to remove tumors or abnormal tissue. The samples are sent to a lab for further review.
Used in the later stages of bladder cancer, this surgery removes some or the entire muscular organ. In a partial cystectomy, the diseased part of the organ and some nearby lymph nodes are removed. This allows patients to keep their bladder without being forced to undergo reconstructive surgery. In a radical cystectomy, the entire urinary bladder is removed as are nearby lymph nodes. Also, in men, the prostate is removed, and in women, the ovaries, fallopian tubes and part of the vagina are removed.
Patients who undergo a radical cystectomy must undergo surgery that creates a new way for urine to leave the body. There are several options including creating a new bladder from existing intestines.
Chemotherapy is a drug that is given to cancer patients to shrink tumors and kill cancer cells. It is used in all stages of the disease. There are several types of chemotherapy:
- Intravesical Therapy -- This type of chemotherapy is inserted directly into the bladder through a long, narrow tube. The goal is to kill cancer cells inside the bladder.
- Neoadjuvant Therapy --When chemotherapy is given before surgery, the goal is to shrink the tumors so they can be removed.
- Adjuvant Therapy -- This chemotherapy is given after surgery to kill the remaining cancer cells.
Often, chemotherapy is associated with side effects that include nausea and vomiting, but there are effective drugs to help.
Radiation uses high-energy beams to kill cancer cells. There are two common types used in bladder cancer patients:
External Bean Radiation
This type of radiation treatment uses beams that are projected from a large machine to specific areas of the body. It is the most commonly used type of radiation for bladder cancer.
Also called seeding, this utilizes tiny canisters of radioactive materials that are placed inside the bladder. In some cases, the canisters stay in place for weeks.
Radiation therapy is used in all bladder cancer patients as well, for either treatment or palliative measures.
American Cancer Society. Chemotherapy for bladder cancer. Retrieved from http://www.cancer.org/cancer/bladdercancer/detailedguide/bladder-cancer-treating-chemotherapy
Mayo Clinic. Brachytherapy. Retrieved from http://www.mayoclinic.com/health/brachytherapy/MY00323