Bladder Cancer Treatment

Your team of specialists in urology, medical oncology, surgery, radiation oncology, radiology and pathology will work together to assess your best course of bladder cancer treatment. Your treatment will be tailored to your specific type of bladder cancer, and it may involve a combination of surgery, radiation and chemotherapy.

Bladder Cancer Surgery

If you are diagnosed with early-stage bladder cancer and it has not invaded the wall of the bladder, your doctors might recommend:

• TURBT (transurethral resection of bladder tumor): This procedure is often used to remove bladder cancers that are confined to the inner layers of the bladder. During TURBT, a doctor passes a small wire loop through the urethra and into the bladder. The loop is used to remove cancer cells with an electric current. In some cases, a high-energy laser may be used instead of electric current

If your cancer has invaded the deeper layers of the bladder wall, your surgeon might recommend:

• Segmental cystectomy or partial cystectomy: In this procedure, a surgeon removes only the portion of the bladder that contains cancer cells. Segmental cystectomy may be an option if your cancer is limited to one area of the bladder that can easily be removed without harming bladder function.
• Radical cystectomy: A procedure to remove the entire bladder, as well as surrounding lymph nodes. In men, radical cystectomy typically includes removal of the prostate and seminal vesicles. In women, radical cystectomy involves removal of the uterus, ovaries, and part of the vagina.

Medical Oncology/Chemotherapy

Chemotherapy is the use of drugs given by mouth or injection to destroy cancer cells. It can be used to assist in the cure of cancer patients or to prolong life or the quality of life. Adjuvant chemotherapy (after surgery) is administered in certain circumstances when the patient is at high risk for recurrence. Neoadjuvant therapy (before surgery) is also an accepted approach to delivering chemotherapy.

Instillation of the chemotherapy drug, mitomycin, or the immunotherapy drug, BCG, into the bladder can reduce the incidence of superficial cancer recurrences, but no single drug has been confirmed to reduce progression of superficial cancer to invasive bladder cancer. This means that multiple small new cancers can be prevented but progression to a more invasive bladder cancer may occur despite treatment.

Radiation

Radiation therapy in bladder cancer is used for cure and improving symptoms. Patients who are not surgical candidates can still potentially be cured through radiation and chemotherapy.

At WellStar, radiation is administered by radiation oncologists in consultation with medical oncologists and surgeons.