Bladder cancer is the fourth most common cancer in men, but considerably less common in women. It is generally a disease of older people - 9 out of 10 sufferers are over 55, and the average age is 73 at time of diagnosis. The chance is about 1 in 26 for men and 1 in 88 for women. Risk factors include smoking, chemical exposure and consistently not drinking enough fluids. It is also more common in whites. The survival rates for bladder cancer are fairly high, fortunately, and there are a number of treatment options. There are four standard treatment options for bladder cancer, which may be used in combination: Surgery, radiation therapy, chemotherapy and biologic therapy.
Top 4 Treatment Options for Bladder Cancer
- Radiation Therapy
- Biologic Therapy
There are basically three kinds of surgery performed for bladder cancer. For early stage cancer, a transurethral resection might be employed. A thin tube is inserted into the bladder through the urethra, and then a tool is used to cut out the cancer or burn it out with electricity. For later stages, it may be necessary to remove all or part of the bladder - in men this often involves also removing the prostate and seminal vesicles, in women it means the loss of the uterus, ovaries, and part of the vagina. In some cases, only part of the bladder can be removed. When the bladder is removed, it is replaced by using part of the small intestine or colon to divert urine into either an internal reservoir or an external bag which has to be drained. Most surgeons try to avoid removal of the entire bladder.
- entire bladder may be removed
- external bladder storage bag sometimes necessary
- early stage cancer surgery involves transurethral resection
Radiation therapy is a standard cancer therapy that is not generally used as a standalone treatment for bladder cancer, but is used in combination with chemotherapy. It is resorted to alone only when the patient cannot receive chemotherapy for some reason. Radiation therapy for bladder cancer often causes frequent urination and may cause bleeding from the bladder or rectum - these side effects go away after treatment is finished. Because surgeons want to avoid removing the entire bladder, they generally use radiation therapy and chemotherapy after minor surgery.
- not generally used alone
- often causes frequent urination
- used after tumor removal
Chemotherapy may be systemic or intravesical (local). Local chemotherapy is generally preferred for cancer that is localized to the bladder. It does not have as many side effects as systemic chemotherapy and works only for early stage cancers. Systemic chemotherapy causes fatigue, hair loss, nausea, whilst intravesical chemotherapy can give side effects that are limited to frequent and painful urination, mild flu-like symptoms and a rash - which is still bad, but much better than systemic chemothrapy. In some cases, intravesical chemotherapy may be repeated as a maintenance treatment.
- may be intravesical (local)
- has unpleasant side effects
- local chemotherapy can be used as a maintenance treatment
Biologic therapy is also called immunotherapy. It involves using drugs that encourage the body’s immune system to attack the cancer. For bladder cancer, the standard drug used is BCG - which is actually a weakened and “domesticated” bacteria similar to the one that causes tuberculosis. It is inserted through a catheter. If BCG alone does not work, then Interferon is sometimes used. This therapy can cause flu-like symptoms, fatigue and bleeding from the bladder, but there are other approaches showing a lot of promise.
- used a weakened bacterium
- can cause flu-like symptom
- still an area of research
Bladder cancer is definitely not a death sentence, but it can leave you without a bladder and with major reduction in quality of life. Only your doctor knows what the best treatments are, but this overview can give an idea of what to expect.