Bladder Cancer Treatment at World Class Hospitals in India.
Bladder cancer is an uncontrolled abnormal growth and multiplication of cells in the urinary bladder, which have broken free from the normal mechanisms that keep uncontrolled cell growth in check.
Bladder cancer invariably starts from the innermost layer of the bladder (for example, the mucosa) and may invade into the deeper layers as it grows. Alternately, it may remain confined to the mucosa for a prolonged period of time. Visually, it may appear in various forms. Most common is a shrub-like appearance (papillary), but it may also appear as a nodule, an irregular solid growth or a flat, barely perceptible thickening of the inner bladder wall (see details in subsequent sections).
Key Points of Bladder Cancer Treatment:
- Bladder cancer is a disease in which malignant (cancer) cells form in the tissues of the bladder.
- Smoking can affect the risk of bladder cancer.
- Signs and symptoms of bladder cancer include blood in the urine and pain during urination.
- Tests that examine the urine and bladder are used to help detect (find) and diagnose bladder cancer.
- Certain factors affect prognosis (chance of recovery) and treatment options.
Bladder Cancer Grade
Bladder cancer tumors are further classified based on how the cancer cells appear when viewed through a microscope. This is known as tumor grade, and your doctor may describe bladder cancer as either low grade or high grade:
- Low-Grade Bladder Tumor. This type of tumor has cells that are closer in appearance and organization to normal cells (well-differentiated). A low-grade tumor usually grows more slowly and is less likely to invade the muscular wall of the bladder than is a high-grade tumor.
- High-Grade Bladder Tumor. This type of tumor has cells that are abnormal-looking and that lack any resemblance to normal-appearing tissues (poorly differentiated). A high-grade tumor tends to grow more aggressively than a low-grade tumor and may be more likely to spread to the muscular wall of the bladder and other tissues and organs.
Types of Bladder Cancer
The main types of bladder cancer are named for the type of cells that become cancerous. The most common is transitional cell carcinoma, which begins in the cells that line the inside of the bladder. Squamous cell carcinoma and adenocarcinoma are much less common.
- Stage 0: Cancer stays in the inner lining.
- Stage I: Cancer has spread to the bladder wall.
- Stage II: Cancer has reached the muscle of the bladder wall.
- Stage III: Cancer has spread to fatty tissue around the bladder.
- Stage IV: Cancer has spread to the pelvic or abdominal wall, lymph nodes, or distant sites such as bone, liver, or lungs.
Treatment Options available for Bladder Cancer Treatment at World Class Hospitals in India
Treatment options for bladder cancer depend on a number of factors, including the type of cancer, grade of the cancer and stage of the cancer, which are taken into consideration along with your overall health and your treatment preferences.
Surgery
Transurethral Surgery is most often done for early-stage cancers. If cancer has invaded more of the bladder, the surgeon will most likely perform either a partial cystectomy, removing a portion of the bladder, or a radical cystectomy, to remove the entire bladder. For men, the prostate and urethra may also be removed. For women, the uterus, fallopian tubes, ovaries, and part of the vagina may also be removed.
Cystectomy A radical cystectomy is the removal of the whole bladder and possibly nearby tissues and organs. For men, the prostate and urethra also may be removed. For women, the uterus, fallopian tubes, ovaries, and part of the vagina may be removed. In addition, lymph nodes in the pelvis are removed for both men and women. This is called a pelvic lymph node dissection. An extended pelvic lymph node dissection is the most accurate way to find cancer that has spread to the lymph nodes. Rarely, for some specific cancers, it may appropriate to remove only part of the bladder, which is called partial cystectomy.
Chemotherapy
Chemotherapy involves drugs designed to kill cancer cells. These drugs may be given before surgery to shrink tumors, making them easier to remove. Chemotherapy is also used to destroy any cancer cells left after surgery and to lower the chances that the cancer will return. Hair loss, nausea, loss of appetite, and fatigue are common side effects. The drugs can be given by vein or directly into the bladder.
Radiation therapy
Radiation therapy uses high-energy beams aimed at your cancer to destroy the cancer cells. Radiation therapy for bladder cancer usually is delivered from a machine that moves around your body, directing the energy beams to precise points.
In select cases, radiation therapy is sometimes combined with chemotherapy as an alternative to surgery or when surgery isn’t an option.
Immunotherapy
Immunotherapy, also called biological therapy, works by signaling your body’s immune system to help fight cancer cells.
Immunotherapy for bladder cancer often is administered through the urethra and directly into the bladder (intravesical therapy). One such immunotherapy drug used to treat bladder cancer is Bacillus Calmette-Guerin (BCG), which is a vaccine used to protect against tuberculosis. Another immunotherapy drug is a synthetic version of interferon, which is a protein your immune system makes to help fight infections. The synthetic version, called interferon alfa-2b (Intron A), is sometimes used in combination with BCG.
Atezolizumab (Tecentriq) is a new immunotherapy option for locally advanced or metastatic bladder cancer that didn’t respond to or got worse after chemotherapy. An intravenous (IV) medication, the drug works by triggering the body’s immune system to attack the cancerous tumor. Atezolizumab is also being studied as a possible first line therapy for people with bladder cancer who aren’t eligible for chemotherapy.
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