Treating Bladder Cancer: What Patients Need to Know

The bladder refers to a hollow muscular lower abdominal organ that stores urine. Bladder cancer is a type of cancer that starts in the bladder cells and generally affects older adults. 

Most often, bladder cancer starts in the urothelial cells (cells lining your bladder’s inside part). Urothelial cells are also present in the ureters (the tubes that connect the bladder and the kidney) and the kidney itself. 

Most of the time, this disease is diagnosable in the beginning stages when bladder cancer treatment can be administered. However, since there are chances of recurrence, follow-up tests are generally recommended. This article discusses various things that patients need to know about treating bladder cancer. 

Bladder Cancer Treatment Options

The common treatment options for bladder cancer are:

• Surgery
• Bladder chemotherapy (intravesical chemotherapy)
• Whole body chemotherapy (systemic chemotherapy) 
• Radiation therapy
• Immunotherapy
• Targeted therapy

Depending on various factors, your doctor may recommend any one of the above-listed treatment methods or a combination of these. 

Factors That Decide Bladder Cancer Treatment

There are different treatment options for bladder cancer. However, your doctor is the only person who can decide the best course of treatment depending on many factors. Some of the factors that help the doctors devise a treatment plan include the type of bladder cancer, the stage and grade of the cancer, patient’s age, gender, overall health and the risks and benefits of each treatment. 

Surgery 

The goal of bladder cancer surgery is to remove the cancer cells. The different surgical approaches include:

• Transurethral Resection of Bladder Tumour (TURBT)
• Cystectomy
• Neobladder reconstruction
• Ileal conduit
• Continent urinary reservoir

Chemotherapy

Chemotherapy makes use of drugs for killing cancer cells. In this procedure, two or more drugs are generally used in combination. These drugs are administered either intravenously through a vein or by intravesical therapy directly into the bladder.

Radiation Therapy

In radiation therapy for bladder cancer, powerful energy beams such as protons and X-rays are used for destroying the cancer cells. This treatment is typically administered using a machine that moves around the patient’s body by directing the beams of energy to appropriate points. Sometimes, radiation therapy is given along with chemotherapy for treating bladder cancer in specific circumstances (for example, when surgery cannot be considered as a treatment option). 

Immunotherapy

Immunotherapy is a kind of drug treatment, which helps the body’s immune system in fighting bladder cancer. In this therapy, the drugs can either be given directly into the bladder through intravesical therapy or intravenously through a vein. 

Targeted Therapy

The drugs used in targeted therapy concentrate on particular weaknesses in the cancer cells. These drugs kill the cancer cells by targeting the weaknesses. Doctors may consider testing the bladder cancer cells to check if this therapy will be effective. Targeted therapy is considered as a treatment option for advanced bladder cancer when other treatment methods fail to help. 

Bladder Preservation

In some circumstances, patients suffering from muscle-invasive bladder cancer may not wish to go through surgical treatment involving removal of the bladder. Instead, doctors may recommend a combination of treatments for these patients. Referred to as trimodality therapy, this method is a combination of TURBT, radiation therapy and chemotherapy. 

To start with, the surgeon carries out TURBT treatment for removing as much of the tumour as possible from the bladder while preserving its functioning. Following this, patients go through chemotherapy and radiation therapy. Even after trimodality therapy, if all of the tumour is not gone and if muscle-invasive bladder cancer recurs in patients, doctors may suggest undergoing a radical cystectomy.  

After Successful Treatment

Some patients may experience a recurrence of bladder cancer even after successful treatment. Due to this, even after successful treatment, they should get follow-up tests done for a few years. Your doctor will prescribe the tests that need to be taken and the frequency of the tests depending on the kind of bladder cancer and what treatment was given among several other factors. 

Usually, doctors advise undergoing tests for examining the inside of your bladder and urethra (cystoscopy) once in 3-6 months for the initial few years following bladder cancer treatment. After these examinations for a few years without diagnosing a recurrence of cancer, you may have to undergo a cystoscopy just once in a year. Your doctor may also advise undergoing a few more tests regularly. You can consult oncologists from any good cancer hospital in India for bladder cancer treatment.