Bladder Cancer : In Depth - Deciding on T...
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Researchers are always finding new treatments for bladder cancer. People with cancer now have more hope for survival than ever before. In this section we will cover the details of different treatments.
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You may feel overwhelmed at first with all the information about treatment options. Give yourself time to gather as much information as you can. Learn about your disease and the treatments. Discuss the issues with your doctors, nurses, and loved ones.
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The type of treatment your doctor recommends for you depends on the type of cancer you have and its stage--that is, how invasive it is.
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Surgery is the most common treatment for bladder cancer. Its goal is to remove the tumor, while preserving as much of the bladder as possible. Several types of surgery can be used. Your doctor will help you understand the risks and benefits of each type. You may have surgery alone or with another type of treatment.
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You have to be healthy for surgery to be a good choice. Before surgery, you'll meet with your surgeon, who is a urologist, which is a doctor who specializes in problems with the urinary tract, including the bladder. In this meeting, you will talk about the procedure. You'll also be able to ask questions and address concerns you may have. You may want to ask about the possible side effects of the surgery and talk about its risks. You may also want to ask your doctor when you can expect to return to your normal activities. You may want to ask where the scars will be and what they will look like.
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This type of surgery is usually done for early-stage, superficial bladder cancers. So you may have this surgery if you have stage 0 or stage I bladder cancer. This means that the cancer hasn't spread beyond the bladder's lining.
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During your evaluation, your doctor uses cystoscopy to look inside your bladder. If the cancer is in an early stage (superficial) and growing slowly (low grade), it may be removed using cystoscopy. Removal of a tumor during cystoscopy is known as transurethral resection (TUR). Most of the time, tissue removed during TUR can be studied to see if more treatment is needed.
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You'll probably stay in the hospital 1 to 2 days after transurethral resection. A tube called a catheter is usually left in the urethra after the procedure. The tube prevents blockage of the urethra. It also helps stop the bleeding. Your doctor will remove the catheter when the bleeding stops.
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This type of surgery may be necessary if you have invasive bladder cancer. That means you may have this type of surgery if you have stage II or stage III bladder cancer. This means the cancer has spread to at least the muscular wall of the bladder (stage II) and may have spread to the fatty layer or to the prostate (in men) or uterus or vagina (in women). For this surgery, the surgeon takes out part, or all, of your bladder. If your whole bladder is removed, it's called a radical cystectomy. If only some of the bladder is removed, it's called a partial cystectomy.
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The night before the surgery, you will need to drink liquid medicine that empties your bowels. You will also need to have a liquid-only dinner. And you may take an antibiotic to reduce the chance of infection. If you are healthy, you can check into the hospital on the same day of your surgery.
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Cystectomy is the surgical removal of the entire bladder. This surgery may be suggested in certain cases of bladder cancer, especially high-grade, high-stage cancer. Your doctor can discuss the risks and benefits of cystectomy with you. If you decide to have surgery, the surgeon can explain the procedure and answer your questions.
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You'll stay in the hospital 5 to 7 days after having cystectomy. You may have pain where the surgeon cut into your abdomen. You may be nauseated from the anesthesia. You'll be given medications to ease pain. You may be given medications to ease nausea as well. You'll probably be able to resume your normal activities in 4 to 6 weeks. In some cases, you may go home with a catheter in place for you to urinate through. If only part of your bladder was removed, called partial cystectomy, you'll notice that you can't hold as much urine in the bladder as you used to. You'll have to urinate more often at first. This problem may go away after the bladder stretches. Or you may find that you always have to urinate more often than you did before.
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If your whole bladder is removed, you will need another way to store and eliminate urine. The creation of a new place for urine to be stored and a way for it to leave your body is called reconstructive surgery. Your surgeon performs reconstructive surgery at the same time that you have your bladder removed. There are 2 main types of reconstructive surgery that can be performed.
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It takes time to get used to the changes in your body when you've had reconstructive surgery. Depending on the type of surgery you had, you may not urinate the way you used to. You may have an abdominal opening and an external urine bag to cope with. You're going to have to deal with changes in the way you view your body. You'll want to talk with your healthcare team about any questions and concerns you may have.
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This treatment is sometimes called biological therapy. Immunotherapy is when drugs are used to make the body's own immune system fight cancer. Its goal is to kill cancer cells without having to remove the bladder. It can also help keep the bladder cancer from coming back.
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Your doctor may recommend immunotherapy if you have early-stage, superficial bladder cancer. This means the cancer has not spread beyond the lining of your bladder. Immunotherapy may be used alone to treat bladder cancer.
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The most common way to give immunotherapy for bladder cancer is intravesically. That means the drugs are placed directly into your bladder instead of injected into your blood or taken as pills. Early-stage bladder cancer can often be successfully treated with the drug BCG (bacillus Calmette-Guerin). The doctor puts BCG directly into your bladder by inserting it through a catheter in your urethra. Your body's immune system responds to the presence of BCG, and the bladder cancer cells are destroyed.
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Here are some of the side effects that are common with immunotherapy for bladder cancer.
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Chemotherapy uses drugs to kill cancer cells. The drugs used in chemotherapy are designed to attack and kill cells that divide quickly. Cancer cells divide more quickly than most cells in the body. This means that the drugs used in chemotherapy mainly affect cancer cells. However, they can also affect fast-growing normal cells, such as cells in the digestive tract or cells in the hair roots. This is why chemotherapy causes some side effects.
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Your doctor may recommend chemotherapy to treat bladder cancer if any of these cases apply to you.
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Chemotherapy is given in cycles. A person with bladder cancer will get chemotherapy treatment for a certain length of time and then get a rest period. Then treatment will begin again. Each treatment and rest period makes up one cycle. Most people have chemotherapy in an outpatient clinic in their local hospital, at their doctor's office, or in their home. Sometimes, they may go to a special chemotherapy-only clinic.
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For this treatment, chemotherapy drugs are placed directly into your bladder. The doctor does this with a catheter inserted through your urethra. When you get chemotherapy in this manner, the drugs affect only the cancer cells in your bladder. The drugs do not do anything to cancerous cells outside the bladder. For this reason, this kind of chemotherapy is only used for stage 0 or stage I bladder cancer. These are stages where the cancer hasn't spread past the bladder lining. These are the most common intravesical chemotherapy drugs.
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Bladder infection Bladder irritation (burning, need to urinate frequently, pain on urination)
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For systemic chemotherapy, your doctor or nurse injects anticancer drugs into your vein. The benefit of systemic treatment is that the drugs can attack cancer cells throughout your body, not just in your bladder. It's used to treat cancers that may have spread.
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Ask your oncologist and chemotherapy nurse for the details on each drug's side effects. Side effects of chemotherapy are different for everyone and vary based on the types of drugs you receive.
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Radiation therapy is also called radiotherapy. It is one way to treat bladder cancer. Radiation uses high-energy X-ray beams to kill cancer cells. Radiation that comes from a machine outside the body is called external beam radiation therapy (EBRT).
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Your doctor may recommend radiation for you in any of the following situations.
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External radiation therapy is usually given on an outpatient basis in a hospital or a clinic. This type of radiation usually comes from a machine called a linear accelerator.
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Radiation is a way of treating cancer. Radiation uses beams of energy to destroy cancer cells. With each dose, the tumor gets smaller. The cancer cells die and healthy cells take their place. Radiation may be used alone or with chemotherapy, and may be done before or after surgery.
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Radiation therapy can help you in your fight against cancer. Your radiation therapy team will work with you. Together you will set treatment goals, make a plan, and carry out the treatment. To be an active member of this team, ask questions when you don't understand what is happening. And let your team know how you're doing.
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Radiation therapy can help you in your fight against cancer. To feel better, get plenty of rest, exercise, and eat well. This will give your body the extra strength it needs right now. Also, look to family and friends for support and comfort.
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Because radiation affects normal cells as well as cancer cells, you may have some side effects from this treatment. Usually, the risk of side effects is far less than the benefit of killing cancer cells. Many people have no side effects at all. If you do have them, they relate to the dose of radiation you get and the area of your cancer, and they are generally limited to the area that's been treated.
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According to the American Cancer Society, these are facts about bladder cancer.
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