Bladder Cancer Treatments
Most individuals with bladder cancer have superficial and noninvasive tumors. Treatment for these tumors is often very effective with an excellent prognosis. The remainder of bladder cancers invade deep into the bladder wall and muscle. There is a greater risk for metastasis into other tissues in these cases. Depending on the extent, bladder cancers may be managed with a single therapy or combination of treatments.
Specific treatment for bladder cancer will be determined by your physician and care team based on:
- Your age, overall health and medical history
- Extent of the disease
- Grade and stage of the cancer
- Your tolerance of specific medicines, procedures or therapies
- Expectations for the course of the disease
- Your opinion or preference
Treatments for bladder cancer may include surgery, therapy or a combination of both.
There are several surgical procedures used to treat bladder cancers. Usually, hospitalization and anesthesia are needed. Surgical procedures include:
- Transurethral resection: The surgeon inserts a cystoscope through the urethra into the bladder. Tissue containing cancer cells can be surgically removed or burned away with an electric current called fulguration.
- Segmental cystectomy: Removal of a small portion of the bladder that contains the cancerous tissue. This procedure is most effective when there is only a single site of cancer cells in the bladder.
- Radical cystectomy: Removal of the bladder, lymph nodes near the bladder, and any nearby organs that contain cancer cells. This procedure is usually used when there are multiple areas of cancerous cells in the bladder and there is metastasis to other sites. When the bladder is removed, a urostomy procedure is performed. This is a surgical procedure to create another opening for urine to drain. Women who have a radical cystectomy usually have their uterus, ovaries, and part of the vagina removed as well. The prostate gland and seminal vesicles are usually removed in men who have a radical cystectomy.
Radiation therapy uses high-energy rays to kill or shrink cancer cells. Internal or external radiation, or both, may be used in the treatment of bladder cancer. With internal radiation, a radiation implant is placed into the bladder for a direct effect on cancer cells. External radiation uses a machine outside the body to direct rays at a broader area. Radiation therapy for bladder cancer may have side effects including nausea, vomiting, diarrhea, and urinary discomfort, and may affect sexual function in both men and women.
Biological therapy uses the body's own immune system to fight cancer. In one form of this therapy, a solution called Bacillus Calmette-Guerin is placed in the bladder, where it stimulates the immune system to kill the cancer cells.