Bladder Cancer is where a growth of abnormal tissue, known as a tumour, develops in the bladder lining. In some cases, the tumor spreads into the bladder muscle.
The most common symptom of bladder cancer is blood in urine, which is usually painless. If you notice blood in your urine, even if it comes and goes, you should visit your GP, so the cause can be investigated.

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Bladder cancer

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The treatment options for this type of cancer largely depend on how advanced the cancer is.

Treatment approaches differ between early-stage, non-muscle-invasive bladder cancer and more advanced muscle-invasive bladder cancer.

Treatment for Non-Muscle-Invasive Bladder Cancer:

For individuals diagnosed with non-muscle-invasive bladder cancer (stages CIS, Ta, and T1), the recommended treatment plan depends on the risk of cancer recurrence or spreading beyond the bladder lining. Factors such as the number of tumors, tumor size, history of this type of cancer, and cancer cell grade are considered.

Low-Risk Early Cancer:

Treated with transurethral resection of a bladder tumor (TURBT). This involves removing visible tumors using a cystoscope under general anesthesia. Post-surgery, a single dose of chemotherapy is administered directly into the bladder. Follow-up appointments are scheduled at 3 and 9 months.

Intermediate (Moderate) Risk Early Cancer:

Involves at least 6 doses of chemotherapy directly into the bladder. Follow-up appointments are at 3, 9, and 18 months, with potential referrals back to a specialist urology team if cancer recurs.

High-Risk Early Cancer:

Requires a second TURBT operation or a course of Bacillus Calmette-Guérin (BCG) treatment. BCG treatment involves instilling the vaccine into the bladder through a catheter over six weeks. Follow-up appointments are scheduled every 3 months for the first 2 years and then at increasing intervals. Referral for further treatments may occur if BCG is ineffective.

Treatment for Muscle-Invasive Bladder Cancer:

The treatment plan depends on the cancer’s spread, and options include:

Operation to Remove Bladder (Cystectomy):

Surgical removal is considered a primary treatment, and potential complications and recovery time are discussed. Follow-up appointments and checks are essential post-cystectomy.

Radiotherapy with a Radiosensitizer:

External radiotherapy sessions are administered daily over 4 to 7 weeks, alongside a radiosensitizer to enhance the treatment’s effectiveness. Side effects may include diarrhea, cystitis, erectile dysfunction, and fatigue. Follow-up appointments involve regular checks using cystoscopy and periodic CT scans.

Surgery and Radiotherapy:

Pros and cons of both approaches are discussed based on individual circumstances, with considerations for the impact on fertility, recovery time, and potential complications.

Chemotherapy:

Administered intravenously before radiotherapy and surgery, in combination with radiotherapy before surgery (chemoradiation), or as palliative chemotherapy for advanced bladder cancer. Follow-up appointments are crucial, and side effects such as nausea, vomiting, and hair loss should be monitored.

Treatment for Advanced or Metastatic Bladder Cancer:

Treatment options for locally advanced or metastatic bladder cancer include chemotherapy, immunotherapy, and symptom-relieving treatments. Follow-up appointments and discussions about the effectiveness of treatments are crucial in managing advanced-stage bladder cancer. Immunotherapy aims to enhance the immune system’s ability to recognize and combat cancer cells. Additionally, treatments addressing specific cancer symptoms, such as radiotherapy for painful urination, blood in urine, or pelvic pain, may be recommended. The treatment plan is individualized based on the extent of cancer spread and the patient’s overall health.

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