Understanding advanced bladder cancer

Bladder cancer is one of the most common forms of cancer, especially in men. Though it mainly affects older people, young men and women aren’t immune to it. Approximately 68,000 men suffer from bladder cancer every year in the country. However, in most cases bladder cancer is treatable. This is because most of the bladder cancer cases involve the urothelial cells that line the interior walls of the bladder.

As this type of cancer takes time to develop and its different symptoms are noticeable, it is usually easy to detect it in its early stages and can be treated in a timely manner. However, if the cancer is not detected early, it is difficult to treat advanced bladder cancer like any other type of cancer. Patients may also suffer from squamous cell bladder carcinoma and adenocarcinoma of the bladder. However, such cancers are rare at least in the country. Having adequate information about advanced bladder cancer is crucial in understanding the disease, its stages, and the treatment options. Read on to understand advanced bladder cancer better.

How is bladder cancer diagnosed?

• To detect bladder cancer the doctor will take out a portion of the suspected tumor and examine it for signs of cancer. The doctor will insert a device known as a cystoscope into the bladder and take out the affected tissue.
• If this intervention is carried out in early stages, it may remove the carcinoma en bloc. This is possible as, in the early stages, the cancer does not spread to the muscles beneath the urothelial cells.
• In the case of advanced stages of bladder cancer, the cancer may have spread to the underlying muscle tissue. In such cases, one may need to undergo an invasive surgical procedure.

What are the different types of surgery options for bladder cancer?

• There are a number of different surgical interventions for bladder cancer. The basic objective of surgery is to remove the affected tissue along with some of the surrounding tissue.
• The doctor evaluates the condition of the patient’s bladder and suggests surgical intervention depending on the stage of the cancer.

What are the treatment options are available for advanced bladder cancer?

Advanced bladder cancer includes stages after stage 2, i.e., stage 3 and 4. At stage 3, the advanced bladder cancer has spread outside the bladder and grown to nearby organs and tissues. At stage 4, the cancer spreads to the pelvic and abdominal walls and/or to lymph nodes nearby or different parts of the body. The treatment options for advanced bladder cancer stages include:

• In stage 3 of advanced bladder cancer, the treatment options involve transurethral resection (TURBT), radical cystectomy, partial cystectomy, and neoadjuvant chemotherapy (chemo).
• In stage 4 of advanced bladder cancer, the treatment options are mainly aimed at slowing down the growth rate and spread of the cancer. Chemotherapy without radiation is used sometimes as a treatment option at this stage. As at this treatment options are less likely to cure the cancer, being a part of clinical trials can offer access to newer options for increasing longevity and/or relieve the symptoms.

What is the invasive procedure for the advanced stages of bladder cancer?

• Usually, invasive procedures are avoided in the early stages of cancer. However, in an advanced stage where it is the best treatment option, a doctor will opt for an invasive procedure.
• In such cases, the whole bladder may be surgically removed along with some of the surrounding tissues like the prostate and urethra in men, and ovaries, fallopian tubes, and a part of the vagina in women.
• Lymph nodes in the pelvis may also be removed if they seem to be affected.
• Depending on the severity and spread of the disease, the doctor may also opt for a partial cystectomy. In that case, only a part of the bladder may be resected out.

How can one survive if the bladder is removed?

• In case the doctor resects the whole bladder out, then he/she will create a urinary diversion to pass the urine.
• For this purpose, the doctor would most probably use a part of the patient’s colon or intestine to divert the urine to a bag kept outside the body through an opening on the abdominal wall. The patient would need to wear the bag at all times.

How can advanced bladder cancer be treated without surgery?

• Advanced bladder cancer can be treated without surgery with the help of a combination of chemotherapy and radiation therapy.
• In order to destroy the cancerous cells, the chemotherapy makes use of drugs meant for the same. The type of chemotherapy varies depending upon the mode of application. If the chemotherapy drug is applied locally, it is known as intravesical chemotherapy. If the drug is given orally as a general chemotherapy dosage it is known as systemic chemotherapy.
• In radiation therapy, the doctor would use high energy X-rays to destroy the cancerous cells.