Bladder cancer is a common type of cancer that begins in the cells of the bladder, a hollow organ in the lower abdomen that stores urine. It is often detected early when it is highly treatable, but it has a high recurrence rate.
Treatment Options
The choice of treatment depends on various factors, including the type and stage of the cancer, the patient’s overall health, and personal preferences.
Surgery: Surgery is often the first step in treating bladder cancer. The kind of surgery depends on how much the cancer has spread.
- Transurethral bladder tumour resection (TURBT): Used for early-stage bladder cancer. A thin tube with a camera on the end is inserted through the tube where urine exits the body (urethra) into the bladder. A special tool is used to remove the tumour or burn it away. This is done under anaesthesia and the patient doesn’t feel pain.
- Radical cystectomy: This surgery is used when the cancer has spread more deeply into the bladder. The entire bladder and possibly other nearby organs that might contain cancer cells is removed. For men, this might include the prostate, and for women, it might include the uterus and ovaries. The lymph nodes in the area might also be removed to check for cancer spread.
- Partial cystectomy: Only the part of the bladder that contains cancer cells is removed. This is usually done when the cancer is in a specific area that can be easily removed. The rest of the bladder is left intact to store urine.
- Urinary diversion: If the entire bladder is removed, the body needs a new way to store and get rid of urine. This is called urinary diversion. There are several methods, including:
- a method where urine flows into a bag outside of the body,
- a method where urine is stored inside the body and drained through a tube, and
- a method where a pouch is attached to the urethra to allow for more normal urination.
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Chemotherapy: Uses drugs to kill cancer cells or to stop them from dividing.
- Neoadjuvant chemotherapy: This is chemotherapy given before surgery. The goal is to shrink the cancer, making it easier to remove during surgery. It can also kill any tiny bits of cancer that may have spread but are too small to see.
- Adjuvant chemotherapy: This is chemotherapy given after surgery. The goal is to kill any cancer cells that might have been left behind. It can also help to stop the cancer from coming back.
There are two ways to give chemotherapy for bladder cancer:
- Intravesical chemotherapy: The medicines are put directly into the bladder through a tube. This mainly affects the cells in the bladder and usually has fewer side effects.
- Systemic chemotherapy: The medicines are given by injection into a vein or taken as a pill. They then travel through the body to kill cancer cells wherever they are. This can have more side effects, but it can also be more effective if the cancer has spread.
Immunotherapy: Stimulates the body’s immune system to fight cancer.
- Bacillus Calmette-Guérin (BCG) therapy: In BCG therapy, a weakened version of BCG bacteria is put directly into the bladder through a tube. BCG therapy is often used for early-stage bladder cancer and is good at stopping the cancer from coming back after surgery. BCG therapy is usually given once a week for six weeks, and then less often for up to a year. It’s a local treatment, which means it only affects the bladder and doesn’t have the same side effects as treatments like chemotherapy. But it can still cause side effects, like bladder irritation and flu-like symptoms.
Targeted Therapy: In targeted therapy, drugs block specific genes or proteins that promote cancer cell growth and survival. It’s commonly used for advanced or metastatic bladder cancer. These drugs, usually taken as pills, slow down cancer cell growth and can shrink tumours. Targeted therapy isn’t suitable for all bladder cancer patients. The decision to use it depends on factors like genetic changes in the tumour, cancer stage, and overall health.
Gene Therapy: Gene therapy is an innovative approach to treat cancer by modifying the genes inside a person’s cells. In gene therapy for bladder cancer, the genes in bladder cells are altered to slow down or prevent the growth of cancer cells. This can involve introducing new genes that produce proteins to fight cancer or deactivating genes that promote cancer growth. Gene therapy for bladder cancer is still being studied in clinical trials and is not widely available as a standard treatment.
Radiation Therapy: Uses high-energy radiation to kill cancer cells. It’s often used instead of surgery or after surgery to eliminate remaining cancer cells. This damages the DNA in cancer cells, stopping them from growing and causing them to die. It can be used as an alternative to surgery or after surgery to remove any remaining cancer cells. Radiation therapy is delivered over several weeks, with short and painless sessions. Side effects may include fatigue, skin changes, and urinary issues.
Conclusion
Bladder cancer has various treatment options based on the cancer’s stage, patient’s health, and personal preferences. Each treatment has its specific use, from removing tumours and killing cancer cells to stimulating the immune system or blocking cancer growth.
