Bladder cancer treatment
A malignant tumour in the inner lining of the urinary bladder is called bladder cancer. Males are four times more prone to be diagnosed. Surgical removal is a primary treatment option that might require bladder reconstruction. Urologists treat bladder cancer with systemic or intravesical therapy (chemo-, immuno-, targeted drugs), bacillus Calmette-Guerin (BCG), and radiation.
Cancer in the bladder is characterized by the appearance of a tumour in the urothelial cells of the urinary bladder. According to morphological classification (examination under a microscope), doctors divide the disease into:
- Urothelial carcinoma - is the most common type of bladder malignant tumour. It is either superficial or, at worst, penetrates deep into the muscles.
- Squamous cell carcinoma - abnormal cells proliferate in the bladder lining in response to inflammation or lesion.
- Adenocarcinoma develops from the bladder's glandular cells.
In addition, urologists-oncologists classify bladder cancer according to its spread to the layers of the organ:
- Noninvasive is a small bump that is easy to remove. It corresponds to stages 0 and 1st.
- Non-muscle-invasive - superficial cancer that doesn't grow deep also matches stage 1st.
- Muscle-invasive - grows into the muscle of the bladder wall and, in advanced cases, into the fatty layers. It meets the second and third stages.
- Metastatic urothelial cancer - is the 4th stage, when metastases spread to other body parts and organs.
Bladder tumours are the most common in older people. As a rule, the disease happens after 55 years old. Often, the first symptoms of bladder cancer appear in the early stages. Warning signs include blood in the urine, frequent and painful urination, burning during urination, and a false urge to urinate.
Sometimes there are no symptoms in the first stages, but they appear later when cancer spreads throughout the body. In addition to weakness, loss of appetite, lower back pain, lung metastases cause cough or shortness of breath, and liver metastases cause abdominal pain or jaundice.
Transurethral bladder tumour resection is a modern minimally invasive operation. Urologists use this technique for diagnosis, staging, and removing noninvasive and non-muscle-invasive bladder cancer. After surgery, intravesical (into the bladder) or systemic chemotherapy (into the vein) and immunotherapy medicines are recommended to reduce the risk of recurrence. External-beam radiation therapy is given in combination with chemotherapy. Surgical treatment sometimes requires urinary bladder reconstruction that can be performed simultaneously during the main surgery. As a unique targeted option, urinary bladder cancer can be treated with bacillus Calmette-Guerin (BCG) injections into the bladder.
The prognosis for bladder cancer depends on the stage at which the disease is diagnosed. The 5-year survivorship for noninvasive tumours is good at 96%. However, invasive lumps reduce the survival rate by up to 70%. Muscle-invasive cancer has a poor prognosis. When metastases spread to lymph nodes, organs, or specific body parts, the 5-year survival rate varies from 6% to 38%.
Where can I get Bladder cancer treatment?
What are the best clinics for Bladder cancer treatment?
Who are the best doctors for Bladder cancer?
Prof. Dr. med. Jurgen Gschwend from University Hospital rechts der Isar Munich
Dr. med. Holger Heidenreich from Academic Hospital Bundeswehr Berlin
Prof. Dr. med. Martin Kriegmair from Urological Clinic Munich-Planegg
Dr. med. Nathan Kaminski from Urology Clinic Wiener Platz & Grunwald Munich
Prof. Dr. med Harald-Robert Bruch, MSc, PhD from Oncological and Haematological Praxis Clinic Bonn