Urinary Bladder Cancer – Treatment

Today, bladder cancer is divided into two major categories.

• Surface cancer – i.e. found in bladder mucosa.
• Filtrated cancer – i.e. penetrates the bladder muscular wall and may be extended beyond it.

This categorisation important since based on the cancer type, treatment and prognosis is differentiated.
Treatment will also depend on the type of cancer e.g. surfacial or filtrated cancer.

i. Treatment of Surface Cancer

This type of bladder cancer appears to be relapsing in a great percentage (about 80% of cases). Thus, treatment aims at removing initially the tumor and then shift the risk relapsing to filtrated cancer.

Transurethral resection of the tumor is performed and cytostatic drug injections are performed at regular intervals – which, vary depending on tumor aggressiveness – as subsequent prophylaxis measures against patient relapsing. The patient undergoes cystoscopic check every three months during the first two years, every 6 months for 1-2 years and annually.

This is done in order to prevent possible relapses since there is 60-80% risk of relapsing and 10-15% risk of transforming to filtrated type of cancer.

ii. Treatment of fintrated bladder cancer

This is a more aggressive type of cancer, requiring immediate and radical treatment.

Currently, the best results are achieved by surgical treatment, in which bladder is removed along with prostate and seminal vesicles (radical cystectomy). Then, the bladder is either replaced by creating a new bladder from gut segment with which the patient may urinate normally; or urine is collected via a special bag. The results are very promising if the surgery is done in the early stages.

In advanced stages, or in cases the patient refuses surgery or is unable to perform surgery for other reasons (older age, presence of diseases that prohibit surgery), radiation or chemotherapy treatment may be chosen with less promising results.