Treating Bladder Cancer

There is a lot for you to think about when choosing the best way to treat or manage your cancer. There may be more than one treatment to choose from. You may feel that you need to make a decision quickly. But give yourself time to absorb the information you have learned. Talk to your doctor. Look at the list of questions at the end of this article to get some ideas. Then add your own.

The main types of treatment for bladder cancer are surgery, radiation therapy, immunotherapy, and chemotherapy. Based on the stage of your cancer, your doctor may recommend one or more of these.

Surgery
There are several kinds of surgery for bladder cancer depending on how invasive or how spread the cancer is. Some types of surgery involve removing the entire bladder, prostate, and nearby lymph nodes and others do not. The type of surgery will depend on the stage of the cancer. The most common types of surgery are explained below.

• Transurethral surgery: This surgery is done through a slender tube with a lens and a light that is placed into the bladder through the urethra. With this approach it is not necessary to cut into the abdomen. This operation is used as the initial treatment of bladder cancer, and may be adequate treatment for early stage bladder cancer.
• Cystectomy: This surgery is used only for the more advanced cancers, when the tumor has invaded into the deeper layers of the bladder. It is necessary to cut into the abdomen. When only part of the bladder is removed, it is called a partial cystectomy. If the entire bladder is removed it is a radical cystectomy; nearby lymph nodes are also removed. In men, the prostate is removed as well. In women, if the entire bladder is taken out, then the womb (uterus), ovaries, fallopian tubes, and a small part of the vagina are usually removed as well.

When the entire bladder is removed, another way to store and remove urine from the body is needed. Options include a urostomy or a continent diversion. For a urostomy, a short segment taken from the small intestine is attached to the ureters. A bag is worn outside the body to catch the urine.

Continent diversions do not require a bag outside the body. Instead, the surgeon will create a sac from a piece of small intestine and attach it to the ureters. Urine is emptied when the person places a drainage tube into the hole of the diversion. Newer methods of surgery can route the urine into the urethra, making urination nearly normal.

Some problems from these methods could include wound infections, urine leaks, pouch stones, and blockage of urine flow.

Talk to your doctor before surgery to learn what to expect afterwards. This will help you be prepared to handle any side effects or problems. The United Ostomy Association (UOA) has programs and information to help people who have had a urostomy.