Bladder Cancer Treatment
Treatment recommended by your
physician depends on the type of bladder cancer you have: transitional cell carcinoma (TCC), squamous cell
carcinoma or adenocarcinoma. The stage of the cancer is also related to the therapeutic method used. Usually,
the treatment of a bladder cancer diagnosed at early stages is less rigorous than that of a final stage bladder
cancer. However, whatever the type or the severity of the cancer, bladder cancer treatment always involves
surgery, radiotherapy, immunotherapy or chemotherapy; sometimes, a combination of those therapies can be
A less aggressive cancer
that is confined within the wall of the bladder can be treated by endoscopic resection. This method consists of
removing cancerous tissue from the bladder using an instrument called resector. A bladder cancer that has
already metastases can be treated with cystectomy associated with chemotherapy combining several drugs. Usually,
the surgery involves partial or total removal of the bladder.
Cystectomy – this is a segmental
resection of the bladder which allows you to get rid of the tumor while maintaining a normal natural urination.
After the operation, the bladder capacity is reduced, but a normal capacity is recovered in a few months. In
general, a partial cystectomy is indicated for bladder cancer located only on the bladder wall, which do not
affect surrounding organs or tissues. The partial cystectomy, however, is associated with risk of recurrence.
radiotherapy can be combined to reduce the risk of recurrence.
Total cystectomy (in men): this surgical procedure involving a complete removal of
the bladder and other tissues surrounding it: the fatty tissue around the bladder, prostate, seminal vesicles,
and possibly the urethra.
Total cystectomy (in women) – in women, a total cystectomy consists of removing the
bladder and urethra, the fatty tissue around the bladder, uterus and part of the anterior wall of the vagina.
The removal can be performed through the vaginal or abdominal area. In general, a reconstruction of the vagina
after a total cystectomy is necessary.
These operations may cause
a continual flow of urine which needs to be collected in a small plastic bag stuck to the skin of your abdomen.
the bag must be changed regularly. If you wear an artificial bladder, you must learn to hold urine and control
the discharge. Occasionally, you can experience some episodes of incontinence, which occurs mostly at night.
In addition, the removal of
the bladder almost always causes impotence in men and infertility in women.
is the use of high-energy beams to kill cancer cells. In general, two types of radiation are used in the
treatment of bladder cancer, internal radiation therapy and/or external radiotherapy.
radiation therapy – in external
beam radiotherapy, cancer cells of the bladder are exposed to the radiation source. The rays of the radiation
prevent the proliferation of the cancerous cells and cause their destruction. External radiation therapy can be
administered before surgery to reduce the size of the tumor or after surgery in combination with chemotherapy.
radiotherapy - during
internal radiation, a radiation therapist places radioactive implants directly into the bladder to destroy the
cancer cells. Unlike external beam radiation, internal radiation therapy requires a short hospitalization and
visits are often not allowed to protect visitors from the radiation. In some cases, your oncologist can use both
types of radiation: internal radiotherapy therapy and external radiotherapy.
internal or external, radiation always causes at least one of these side effects:
- loss of
and redness skin at the radiation site.
is a systemic treatment that affects the entire organism. Depending on the aggressiveness of the tumor, your
oncologist may use chemotherapy alone or in combination with radiation or surgery. The chemotherapy drugs can be
administered intravenously or as local treatment.
chemotherapy - this
therapy involves introducing chemotherapy drugs directly into the bladder, in order to destroy the cancer cells.
Local chemotherapy is less toxic, causing fewer side effects. However, it is only effective in less advanced
cancer or cancer that has been excised by a partial cystoscopy.
chemotherapy - this method
is systematic, drugs affect all organs of the body, thus causing more side effects. Systematic chemotherapy is
generally used in the treatment of advanced bladder cancers or cancers that are untreatable by local
chemotherapy increases your survival chance; however, it is still prone to side effects; the most common
- hair loss
also called biological therapy, immunotherapy is based on the iterative intravesical administration
(administered directly into the
Bacille Calmette-Guerin (
or interferon alpha 2a. These drugs are, most of the times, recommended in non-invasive cancers, after
surgery. The purpose of the immunotherapy is to fortify your immune system, and help your body to destroy the