Bladder Cancer Treatment
What does Bladder Cancer Treatment Involve?
The treatment varies according to the size, extent and aggressivity of the cancer.
In some bladder cancers, treatments like chemotherapy, radiotherapy and palliative therapies may be necessary. However, the most common and most effective treatment is surgery.
There are two types of surgery: endoscopic for superficial cancers; laparoscopic, or open, for more aggressive cancers (this is increasingly replacing classical open surgery).
Both surgical techniques are minimally invasive which reduces hospitalisation, post-operative complications and recovery time.
Endoscopic surgery is performed on superficial cancers. It is much less aggressive and better tolerated.
Laparoscopic surgery (open surgery) is reserved for invasive cancers, so it is much more aggressive and radical – far more "mutilating" – as it involves the removal of the bladder.
What are the Treatments for Bladder Cancer?
The treatment depends heavily on assessment of the stage of the cancer which is generally determined by TNM ranking (the most common system for ranking malignant cancers). This ranking determines the best type of treatment.
Endoscopic and laparoscopic/open surgery are the most effective procedures to treat superficial and invasive (or more aggressive, even if superficial) cancers, respectively.
In the case of metastatic tumours, systemic therapies like chemotherapy and immunotherapy are used.
What is the Post-Treatment Patient Care?
Patient follow-up depends on the type of surgery performed. The patient’s clinical history, objective exam and imaging tests – generally ultrasound and CT scans – must be taken into account. When the patient undergoes endoscopic surgery – and therefore still has a bladder – follow-up is based on endoscopic exams (urethrocystoscopy) and urinary cytology.
The patient is usually observed every 3 months in the first year, every 4 months in the second year, and every 6 months until the fifth year. From then onwards, and if there is no recurrence, the assessment may become annual, with continued cystoscopies.
In these assessments, the following exams must be done:
- Bladder endoscopy;
- Urinary cytology;
- Possibly bladder, kidney or abdominal ultrasounds;
- Any other necessary exams such as CTs.
The patient must continue to undergo these exams periodically and to maintain their consultations, since bladder cancer has a high risk of recurrence.
Want to know more about bladder cancer treatments?
Dr. José Santos Dias
Clinical Director of the Instituto da Próstata
- Bacherlor's Degree from the Faculty of Medicine at the University of Lisbon
- Specialist in Urology
- Fellow of the European Board of Urology
- Autor dos livros "Tudo o que sempre quis saber Sobre Próstata", "Urologia fundamental na Prática Clínica", "Urologia em 10 minutos","Casos Clínicos de Urologia" e "Protocolos de Urgência em Urologia"
FAQs about Bladder Cancer Treatment
Are there different types of bladder cancer?
What surgical treatments are there for bladder cancer?
Does bladder cancer treatment have future consequences?
Can bladder cancer return after being treated?
References
- DIAS, José Santos. Urologia Fundamental: na prática clínica. Lisboa: Lidel - Edições Técnicas, Lda, 2010.
- Bladder Cancer - https://www.nm.org/conditions-and-care-areas/cancer-care/genitourinary-cancer-care/bladder-cancer
- Transurethal telescopic resection - https://www.baus.org.uk/_userfiles/pages/files/Patients/Leaflets/Bladder%20tumour%20resection.pdf