Treatment of bladder cancer

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Treatment of bladder cancer

Treatment of bladder cancer

Treatment of bladder cancer

Treatment of bladder cancers will depend upon the stage of the disease and the patient’s fitness. The different modalities may be – surgery, chemotherapy, radiotherapy, immunotherapy.

Surgery

TURBT

The most common surgical procedure is transurethral resection of bladder tumor (TURBT). In this procedure, the tumor is removed using a device that cuts the tumor using an electric current. For superficial bladder tumour, this is the treatment of choice.

The tissue removed is sent for pathological examination to get further details. Usually, after the procedure, you will have a tube in your bladder maybe for a few days.

Cystectomy

In this procedure, either part of the bladder ( partial cystectomy) or complete bladder (total cystectomy) is removed. Sometimes other adjacent organs may be removed as well called a radical cystectomy.

Intravesical Therapy

This treatment is also used for early-stage cancers. Your doctor uses a catheter to inject a liquid medication right into your bladder. They will choose between two types of medications: immunotherapy or chemotherapy (“chemo”). cancer cells. Your doctor will inject a germ called Bacillus Calmette-Guerin (BCG) into

  • Immunotherapy. In this therapy BCG is instilled in the bladder through the catheter, BCJ stimulates patients immune cells and that kills the cancer cells.
  • Intravesical chemotherapy (“chemo”). Chemotherapy drug can be instilled through the catheter in the bladder which kills the tumor cells

Systemic Chemotherapy

The most common chemotherapy agent used is Cisplatin, it is given through IV and it attacks wherever cancer cells are. It may be given before surgery on the bladder so that the risk of cancer coming back is less.

The cisplatin can cause damage to the kidney so in patients with kidney injury other chemotherapy will be used.

Radiation Therapy

Radiation is given focused on bladder and that kills bladder cancer cells. Radiation therapy will be used -

  • You have early-stage bladder cancer
  • You have early-stage cancer but can’t have surgery
  • As a follow-up to TURBT or partial bladder removal surgery
  • To prevent or treat symptoms of advanced bladder cancer

Treatments After or Instead of Surgery

Chemotherapy can be combined after surgery to decrease the chance of recurrence. Chemotherapy, radiation, and surgery may be combined in the same patient.

Immunotherapy

The FDA has approved several immunotherapy drugs for people who have metastatic bladder cancer that got worse during chemo. These medications are atezolizumab, avelumab, durvaluma, enfortumab vedotin-ejf, nivolumab , and pembrolizumab .