Bladder Cancer Treatment - GO.CARE Blog

Bladder Cancer Treatment

Author: Hào Nghiêm
Review Date: August 5, 2018 | Last Modified: September 25, 2019
Bladder Cancer Treatment

Definition

1. What is Bladder cancer treatment?

Bladder cancer is where a growth of abnormal tissue, known as a tumour, develops in the bladder lining. In some cases, the tumour spreads into the bladder muscle. Although it’s most common in the bladder, this same type of cancer can occur in other parts of the urinary tract drainage system.

Most of the time, bladder cancer treatment is based on the tumor’s clinical stage, which is how deep it is thought to have grown into the bladder wall and whether it has spread beyond the bladder. Other factors, such as the size and grade of the tumor and a person’s overall health, can also affect treatment options.

2. What is the purpose of Bladder cancer treatment?

The purpose of bladder cancer treatment is to remove cancer and reduce the risk of it spreading or coming back (in early stages) or to lengthen life and relieve symptoms and side effects.

Treatment option for bladder cancer varies and has different purpose:

  • Surgery to remove cancerous tissue
  • Chemotherapy in the bladder (intravesical chemotherapy), to treat tumors that are confined to the lining of the bladder but have a high risk of recurrence or progression to a higher stage
  • Reconstruction, to create a new way for urine to exit the body after bladder removal
  • Chemotherapy for the whole body (systemic chemotherapy), to increase the chance for a cure in a person having surgery to remove the bladder, or as a primary treatment in cases where surgery isn’t an option
  • Radiation therapy, to destroy cancer cells, often as a primary treatment in cases where surgery isn’t an option or isn’t desired
  • Immunotherapy, to trigger the body’s immune system to fight cancer cells, either in the bladder or throughout the body

Candidates

1. When is Bladder cancer treatment needed?

Once you are diagnosed with bladder cancer, usually, you should seek treatment as soon as possible.

2. Who are eligible for Bladder cancer treatment?

Treatment options for bladder cancer depend on a number of factors, including:

  • The type, stage, and grade of bladder cancer
  • Possible side effects
  • The patient’s preferences and overall health

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Cost

1. Cost of Bladder Cancer Treatment in Vietnam

The cost of Bladder Cancer Treatment in Vietnam varies based on the type of procedure chosen:

  • It will cost patient about 78 millions VND to cut or reconstruction the bladder by using robot-arms therapy.
  • Fill chemical in the bladder to treat cancer, how often of filling times depend on the general health of patients: it costs 372,000 VND each time.

Chemotherapy cost 8-10 millions VND once.

2. Cost of Bladder Cancer Treatment in other countries

Typically in Italy, the total cost related to a superficial tumour of the bladder treated with an endoscopic resection amounts to Euro 2,242.20, while in case of invasive bladder cancer treated with a radical cystectomy it comes to Euro 6,860.

For chemo-immunotherapy the costs in a day hospital regimen related to a 8-weekly session of mitomicin, 6-weekly session of epirubicin and BCG are Euro 1,420, Euro 1,037 and Euro 975, respectively.

Furthemore, the first year of follow-up for a patient with low risk of superficial bladder cancer without recurrence costs Euro 265.15. In case of high risk superficial bladder cancer the cost reaches Euro 321.75.

In case of a patient with invasive bladder cancer in the first year, when follow-up is more strict, expenses amount to Euro 548.90.

Preparation

1. What should I do before Bladder cancer treatment?

Bladder cancer treatment varies depending on many factors and each of treatment require specific preparation.

Usually, after a cancer diagnosis, people with cancer and their families have to make decisions about treatment. Here are some simple but important steps you can take as you start the decision-making process:

  • Understand your diagnosis
  • Know your options
  • Understand the goals of treatment
  • Ask about the side effects of each treatment option
  • Consider the risks and benefits of each treatment option
  • Get a second opinion
  • Discuss your decision with people you trust

2. What should I do after Bladder cancer treatment?

Bladder cancer may recur.

Because of this, people with bladder cancer need follow-up testing for years after successful treatment. What tests you’ll have and how often depends on your type of bladder cancer and how it was treated, among other factors.

Ask your doctor to create a follow-up plan for you.

In general, doctors recommend a test to examine the inside of your urethra and bladder (cystoscopy) every three to six months for the first few years after bladder cancer treatment. After a few years of surveillance without detecting cancer recurrence, you may need a cystoscopy exam only once a year. Your doctor may recommend other tests at regular intervals as well.

You may fear that cancer has come back or worry about the uncomfortable exam.

But don’t let this stop you from going to your appointment. Instead, plan ways to cope with your concerns. Write your thoughts in a journal, talk with a friend or use relaxation techniques, such as meditation. Talk with other bladder cancer survivors. Connect with bladder cancer survivors who are experiencing the same fears you’re feeling.

Take care of yourself so that you’re ready to fight cancer if it comes back.

Take care of yourself by adjusting your diet to include plenty of fruits, vegetables and whole grains. Exercise for at least 30 minutes most days of the week. Get enough sleep so that you wake feeling rested.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Procedure

1. How long does Bladder cancer treatment last?

Surgery:

  • Transurethral resection of bladder tumor (TURBT): The procedure may last 15 minutes to one and a half hours.
  • Cystectomy: for radical cystectomy, it usually takes 4 to 8 hours to complete this operation

Chemotherapy

Bladder Cancer Treatment using Chemotherapy is usually given once a week for 2 weeks followed by a week off. This cycle will be repeated for a few months.

Radiation therapy

Each session lasts for about 10 to 15 minutes. Doctors usually give sessions on a daily basis for 5 days a week over the course of 4 to 7 weeks.

Immunotherapy

Doctors pass the BCG vaccine into your bladder through a catheter and left for 2 hours before being drained away. Most people require weekly treatments over a 6-week period.

2. How is the procedure of Bladder cancer treatment?

SurgeryApproaches to bladder cancer surgery might include:

  • Transurethral resection of bladder tumor (TURBT).

TURBT is a procedure to remove bladder cancers confined to the inner layers of the bladder, those which aren’t yet muscle-invasive cancers. During the procedure, a surgeon passes a small wire loop through a cystoscope and into the bladder. The wire loop burns away cancer cells using an electric current. Alternatively, a high-energy laser may be used to destroy the cancer cells.

TURBT is performed under regional anesthesia — where medication given numbs only the lower part of your body — or general anesthesia — where medication puts you to sleep during the surgery. Because doctors perform the procedure through the urethra, you won’t have any cuts (incisions) in your abdomen.

As part of the TURBT procedure, your doctor may recommend a one-time injection of cancer-killing medication (chemotherapy) into your bladder to destroy any remaining cancer cells and to prevent a tumor from coming back. The medication remains in your bladder for up to an hour and then is drained.

  • Cystectomy

Cystectomy is surgery to remove all or part of the bladder. During a partial cystectomy, your surgeon removes only the portion of the bladder that contains a single cancerous tumor. Partial cystectomy may only be an option if cancer is limited to one area of the bladder that can easily be removed without harming bladder function.

A radical cystectomy is an operation to remove the entire bladder, part of the ureters and surrounding lymph nodes. In men, radical cystectomy typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy also involves removal of the uterus, ovaries and part of the vagina.

Radical cystectomy can be performed through a single incision on the lower portion of the belly or with multiple small incisions using robotic surgery. During robotic surgery, the surgeon sits at a nearby console and uses hand controls to precisely move robotic surgical instruments.

  • Neobladder reconstruction

After a radical cystectomy, your surgeon must create a new way for urine to leave your body (urinary diversion). One option for urinary diversion is neobladder reconstruction. Your surgeon creates a sphere-shaped reservoir out of a piece of your intestine. This reservoir, often called a neobladder, sits inside your body and is attached to your urethra. In most cases, the neobladder allows you to urinate normally. A small number of people with a neobladder have difficulty emptying the neobladder and may need to use a catheter periodically to drain all the urine from the neobladder.

  • Ileal conduit

For this type of urinary diversion, your surgeon creates a tube (ileal conduit) using a piece of your intestine. The tube runs from your ureters, which drain your kidneys, to the outside of your body, where urine empties into a pouch (urostomy bag) you wear on your abdomen.

  • Continent urinary reservoir

During this type of urinary diversion procedure, your surgeon uses a section of intestine to create a small pouch (reservoir) to hold urine, located inside your body. You drain urine from the reservoir through an opening in your abdomen using a catheter a few times each day.

Chemotherapy

Doctors may give chemotherapy drugs through:

  • A vein in your arm (intravenously)
  • A tube passed through your urethra directly to your bladder (intravesical therapy)

Chemotherapy is the use of drugs to destroy cancer cells, usually by ending the cancer cells’ ability to grow and divide. A chemotherapy regimen, or schedule, typically consists of a specific number of cycles given over a set period of time. A patient may receive 1 drug at a time or combinations of different drugs given at the same time.

There are 2 types of chemotherapy that doctors may use to treat bladder cancer. They will recommend a suitable treatment for you depending on the stage of the cancer. Patients should talk with their doctor about chemotherapy before surgery.

Intravesical chemotherapy

Intravesical, or local, chemotherapy is usually given by a urologist. During this type of therapy, your doctor deliver drugs into the bladder through a catheter that has been inserted through the urethra. Local treatment only destroys superficial tumor cells that come in contact with the chemotherapy solution. It cannot reach tumor cells in the bladder wall or tumor cells that have spread to other organs. Mitomycin (Mitozytrex, Mutamycin) and thiotepa (multiple brand names) are the drugs that doctors use most often for intravesical chemotherapy. Other drugs that doctors use include cisplatin (Platinol), doxorubicin (Adriamycin), gemcitabine (Gemzar), and valrubicin (Valstar).

Systemic chemotherapy

Systemic, or whole-body, chemotherapy is usually prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. This gets into the bloodstream to reach cancer cells throughout the body. Common ways to give chemotherapy include an intravenous (IV) tube placed into a vein using a needle or in a pill or capsule that is swallowed (orally).

The most common chemotherapy regimens for bladder cancer are:

  • Cisplatin and gemcitabine
  • Carboplatin (Paraplatin) and gemcitabine
  • MVAC, which combines 4 drugs: methotrexate (multiple brand names), vinblastine (Velban, Velsar), doxorubicin, and cisplatin
  • Dose dense (DD)-MVAC

You wil need many more systemic chemotherapies in clinical trials to help find out which drugs or combinations or drugs work best to treat bladder cancer. Usually a combination of drugs works better than 1 drug alone.

Radiation therapy

Radiation therapy uses high-energy beams aimed at your cancer to destroy the cancer cells. Your doctor usually delivers Bladder Cancer Treatment using Radiation therapy from a machine that moves around your body, directing the energy beams to precise points.

In select cases, the doctor may combine radiation therapy with chemotherapy as an alternative to surgery or when surgery isn’t an option.

Immunotherapy

Immunotherapy, also called biological therapy, works by signaling your body’s immune system to help fight cancer cells.

The doctor often administers Bladder Cancer Treatment using Immunotherapy through the urethra and directly into the bladder (intravesical therapy). One such immunotherapy drug thata doctors use to treat bladder cancer is Bacillus Calmette-Guerin (BCG), which is a vaccine to protect against tuberculosis. Another immunotherapy drug is a synthetic version of interferon, which is a protein your immune system makes to help fight infections. The synthetic version, called interferon alfa-2b (Intron A), is sometimes used in combination with BCG.

Atezolizumab (Tecentriq) is a new immunotherapy option for locally advanced or metastatic bladder cancer that didn’t respond to or got worse after chemotherapy. An intravenous (IV) medication, the drug works by triggering the body’s immune system to attack the cancerous tumor. Doctor is also studying Atezolizumab as a possible first line therapy for people with bladder cancer, who aren’t eligible for chemotherapy.

3. What happens after the procedure?

Bladder cancer may reoccur. Because of this, people with bladder cancer need follow-up testing for years after successful treatment. What tests you’ll have and how often depends on your type of bladder cancer and the type of treatment, among other factors.

Ask your doctor to create a follow-up plan for you. In general, doctors recommend a test to examine the inside of your urethra and bladder (cystoscopy) every three to six months for the first few years after bladder cancer treatment. After a few years of surveillance without detecting cancer recurrence, you may need a cystoscopy exam only once a year. Your doctor may recommend other tests at regular intervals as well.

People with aggressive cancers may undergo more-frequent testing. Those with less aggressive cancers may undergo testing less often.

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Complications & Side Effects

1. What complications could arise from Bladder cancer treatment?

Some treatments for the condition can have a significant impact on your life, including:

  • Emotional impact: This type of emotional disruption can sometimes trigger feelings of depression.
  • Urinary diversion
  • Sexual problems: Erectile dysfunction and narrowing of the vagina

2. What are the possible side effects of Bladder cancer treatment?

Side effects of surgery

  • Longer healing time
  • Infection
  • Mild bleeding and discomfort after surgery
  • Infections or urine leaks after cystectomy or a urinary diversion. After getting a neobladder, a patient may sometimes be unable to urinate or completely empty the bladder

Moreover, men may be unable to have an erection, called erectile dysfunction, after cystectomy. Sometimes, surgeon will perform a nerve-sparing cystectomy to correct it. After a successful cystectomy, men may be able to have a normal erection.

Damage to the nerves in the pelvis and loss of sexual feeling and orgasm for both men and women. Often, further treatment will fix these problems.

Side effects of chemotherapy

Generally, side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment.

Side effects of radiation therapy

Typically, side effects from radiation therapy may include fatigue, mild skin reactions, and loose bowel movements. For bladder cancer, side effects most commonly occur in the pelvic or abdominal area and may include bladder irritation, with the need to pass urine frequently during the treatment period, and bleeding from the bladder or rectum. Most side effects go away soon after treatment.

Side effects of immunotherapy

In general, different types of immunotherapy can cause different side effects. Talk with your doctor about possible side effects for the immunotherapy recommended for you.

Common side effects of BCG include:

  • A frequent need to urinate
  • Pain when urinating
  • Blood in your urine (haematuria)
  • Flu-like symptoms, such as tiredness, fever and aching
  • Urinary tract infections

Need further information? Contact GO.CARE manage team to get more details from expert doctors and medical specialists.

Please choose the best hospitals and clinics that provide Bladder cancer treatment in Asia to get the most suitable healthcare for your condition.

GO.CARE  does not provide medical advice, diagnosis or Bladder cancer treatment.

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