- The different stages of bladder cancer
- What treatment is most appropriate at what stage
Treatment Options for Bladder Cancer
For a doctor to decide the best treatment for your bladder cancer, he or she has to look at the progression of the disease and what stage it's at. As stages of bladder cancer are very crucial before making treatment decisions, your doctor will perform different tests to evaluate the stage of your bladder cancer.
Every stage of bladder cancer requires different treatment methods that we have to view in detail:
Early bladder cancer is also known as non-muscle invasive or superficial bladder cancer. It is called so because the cancerous cells are located only in the bladder inner lining. Following are 3 stages of early bladder cancer:
- Stage T - also called carcinoma in situ
- Stage T1
- Stage Ta
Early bladder cancer can also be subdivided into 3 risk groups. The risk groups denote the likelihood of your bladder cancer spreading further or recurrence after treatment. The three risk groups are as follows:
- Low risk
- Intermediate or moderate risk
- High risk
These groups are very important to determine your best treatment option.
- Low Risk Bladder Cancer Treatment: The commonly used and the best treatment for low risk bladder cancer is surgery. The surgery is aimed at removing the cancerous cells from the bladder inner lining. This is done through a procedure known as TURBT.
- Intermediate Risk Bladder Cancer Treatment: In case you are diagnosed with intermediate early bladder cancer, chemotherapy is the best treatment for you. This chemotherapy should be done immediately after TURBT and should be continued for 6 weeks.
- High Risk Bladder Cancer Treatment: The recommended treatment for bladder cancer at this stage is TURBT operation. You should have 2 TURBT procedures at intervals 6 weeks. The second TURBT is used to double check how far your bladder cancer has spread or grown.
You can also undertake the following treatments for high risk early bladder cancer:
- Cystectomy: This is an operation aimed at removing the whole bladder
- BCG treatment: A BCG vaccine injected directly into the bladder can help treat this stage of bladder cancer.
Invasive Bladder Cancer
Invasive bladder cancer is a type of cancer which has spread from the bladder inner lining to the muscle layer. This type of cancer has a high probability of spreading to other body parts if not treated.
- Chemotherapy Combined with Radiotherapy: If you have a muscle invasive bladder cancer, you can have the following combination of treatment:
- Chemotherapy offered before radiotherapy (neoadjuvant chemotherapy). This helps the treatment work more effectively.
- Chemotherapy combined with radiotherapy - a procedure known as chemo-radiation.
- Chemotherapy after radiotherapy or surgery - this treatment is done to a type of cancer which has high chances of recurrence
The above combination depends on your doctor’s decision. For example, if you’re administered with radiotherapy and your body is responding well, your doctor is likely to recommend chemo-radiation.
For some stages of invasive bladder cancer, such as T2a, where cancerous cells are on the surface layer of your muscle, your doctor will perform a TURBT operation. This operation can also combined with both chemotherapy and radiation therapy, a process known as multi-modality bladder preserving medication.
The Best Treatment For Invasive Bladder Cancer
Radiotherapy works the same way when it comes to this stage of cancer treatment. However, radiotherapy is not the best in the following conditions:
- If you have squamous cell bladder cancer
- If your bladder cancer is not responsive to chemotherapy
- If there is invasive bladder cancer as well as carcinoma in situ
- In case your bladder cancer is blocking any of the tubes that carry urine from your kidneys to the bladder.
You have to see your doctor for advice on any advantages and disadvantages of surgery and chemotherapy as treatment options for bladder cancer. The final decision on the treatment to have is up to you.
Surgery performed for invasive type of bladder cancer means that a big operation has to be done. You will have your entire bladder removed in a partial cystectomy. After your bladder is removed, you will have another operation to insert a new one. Some doctors will insert a waterproof bag - known as urostomy bag - to replace your bladder.
In radiotherapy administration you are required to go to hospital for 6 to 7 weeks to undergo treatment, which tends to be more tiring. Radiotherapy has a number of side effects - such as bowel inflammation - which can lead to long-term diarrhea. During radiotherapy treatment you can also experience inflammation of the bladder, which makes it difficult to pass urine. When the inflammation is over, your bladder may shrink, causing frequent urination. The only advantage of radiotherapy over surgery in treatment of invasive cancer is that you don't have to remove your bladder.
Advanced Bladder Cancer
The advanced stage of bladder cancer is when the cancer has spread to different parts of the body. The treatment you may undergo for this type of bladder cancer depends on:
- Your general health
- Your age
- Previous treatments for any cancer
- How far the cancer has spread
Locally Advanced Bladder Cancer
This type of bladder cancer has grown though your bladder wall and spread to the lymph nodes. Removal of your bladder and radiotherapy can work to treat this type of bladder cancer. All the nearby lymph nodes should be treated with radiotherapy and after that, an intravenous chemotherapy, to prevent recurrence.
Bladder Cancer That Has Spread to Other Body Parts
If your bladder cancer has spread to other organs, there is no possible treatment to cure the cancer. However, you can control the cancer by using some medications tor reduce symptoms. The treatment may include:
- Surgery to remove the entire bladder
- Intravenous chemotherapy
- Radiotherapy to any body part with the cancer
- Drugs aimed at strengthening your bones in case the cancer has reached the bones.
- Unblocking the urethra and ureters
Talk to your doctor before any treatment for the best medication routine.
The Bottom Line
Bladder cancer can be treated using different medications at different stages. The early stages of your bladder cancer are not very serious, hence they may need a little medication. In case of late stages of bladder cancer, such as muscle invasive and non-muscle invasive cancers, the medications should be stronger, even if it means you need to take a combination of more than one drug. Combination of therapies is also common in treatment of late stages of your bladder cancer. At any stage of your bladder cancer you should first seek your doctor's advice to get the best medication.