There are many different treatments available for people diagnosed with bladder cancer. Treatment depends mainly on the stage of cancer. A cancer caught early enough will require less dramatic measures than more advanced cancers. The most common treatment options are surgery, radiation therapy, chemotherapy and immunotherapy. In certain cases, your doctor may combine two or more treatment options, most commonly combining surgery with chemotherapy or radiation therapy.
Surgery may be performed with both early and advanced bladder cancers. When bladder cancer is caught early on, the tumor may be removed through the urinary opening, or urethra. This involves inserting small surgical instruments and a laparoscope through the urethra. The laparoscope is like a small telescope and is used to find the tumor and successfully remove it. This type of surgery is called a transurethral resection and rarely results in the patient requiring an external urine collecting method.
Once bladder cancer has spread, the surgical treatment usually involves complete or partial bladder removal. A partial bladder removal (cystectomy) is often reserved for patients with less invasive types of bladder cancer (usually cancers that start in cells associated with frequent infections or irritations) that occur near the top of the bladder. A complete, or radical, cystectomy may also involve removal of nearby tissues. For men, a radical cystectomy often includes removal of the prostate, the lymph nodes near the hip and the semen conducting tubes. For a woman, a radical cystectomy also includes removing the reproductive organs (uterus, ovaries and fallopian tubes), part of the vagina and the urethra. If you do undergo surgery to remove your bladder cancer, you may require an opening for urine discharge (urostomy). Recent advances in surgical procedures are decreasing the number of people with urostomies.
Chemotherapy can also be used to treat bladder cancer, often in combination with surgery. Chemotherapy is a whole body treatment, meaning it affects the entire body not just the bladder. This is why many chemotherapy patients experience side effects such as nausea, bruising, headache and fatigue. Chemotherapy uses drugs (for example valrubicin, thiotepa and doxorubicin) to kill cancer cells. These drugs can be given either in the form of a pill to be swallowed or injected into a vein. If your bladder cancer is caught early enough, you may have the choice of receiving chemotherapy directly into your bladder through the urethra.
Radiation therapy can also be used to treat bladder cancer. This may be used after surgery to kill any cancer cells that may have been missed by the surgeon. There are two ways radiation therapy may be performed, you may either receive a dose of radiation from a machine, or your tumor is planted with radioactive 'seeds' that slowly release their radiation. The side effects of radiation therapy can be an inflamed rectum, inability to control your bladder muscles, rash, or impotence (in men).
Immunotherapy, also called biological therapy, is a treatment designed to boost a person's immune system so the body can rid itself of the cancer. This is accomplished by injecting a vaccine derived from the tuberculosis bacteria into the urethra. This vaccine puts the immune system on high alert and causes it to kill the cancer cells. Common side effects to this treatment option are an inflamed bladder or prostate and flu-like symptoms.
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