Bladder cancer is a malignancy that occurs in the muscular, hollow organ that holds urine until it is expelled from the body. Bladder cancer happens when the bladder cells incur damage to the part of their DNA that dictates cellular growth, replication, and apoptosis. Tobacco use, chemical exposure, radiation exposure, chronic bladder lining irritation, and parasitic infections can all cause bladder cancer to develop. An individual affected by bladder cancer can experience symptoms of pelvic pain, hematuria, frequent urination, and back pain. There are a few classifications of bladder cancer. Urothelial carcinoma happens in the cells that form the bladder lining that stretches when filling with urine. Squamous cell carcinoma often occurs as a result of chronic bladder irritation. Adenocarcinoma develops in mucus-secreting bladder gland cells. Bladder cancer may be diagnosed with biopsy, cystoscopy, urine cytology, x-rays, and CT urogram.
Bladder cancer in an affected individual may be treated through the use of radiation therapy. Radiation therapy utilizes rays of high energy that cause irreversible damage to malignant cells. This damage inhibits the cancerous cells from growing and multiplying further. The malignancy has to be contained within a localized region for radiation therapy to be effective in treating bladder cancer. Radiation therapy may be delivered externally or internally. Internal radiation therapy is performed by implanting a nominal quantity of radioactive material in the body close to the malignancy. External radiation therapy utilizes a machine called a linear accelerator that produces beams of high energy radiation. The machine is located outside of the patient's body and delivers the high energy rays through the skin to the cancerous area. The most common use of radiation therapy in bladder cancer patients occurs alongside chemotherapy as primary stage II or III bladder cancer treatment. In cases where the patient is unable to undergo surgical excision of cancer, radiation therapy may be used as a primary treatment method. Radiation therapy may be geared toward treating painful symptoms of bladder cancer rather than curing it in some patients.
An individual who has bladder cancer may be treated with methods involving the use of chemotherapy drugs. Chemotherapy for bladder cancer can be performed as intravesical chemotherapy, or as systemic chemotherapy. Chemotherapy may also be used in combination with surgery, before or following the procedure. Chemotherapy drugs work by targeting and destroying any cells in the process of reproduction or cell division. Since cancerous cells multiply rapidly and uncontrollably, chemotherapy can be highly effective to eradicate them from the patient's body. However, this type of treatment not only targets cancerous cells in any stage of the cell division process but healthy cells also undergoing cell division. Systemic chemotherapy or chemotherapy administered to the entire body can be useful in treating cases of bladder cancer that are not eligible for surgical cancer removal. Systemic chemotherapy is also used in cases where the patient has a total bladder removal to ensure all cancerous cells are destroyed. Intravesical chemotherapy works by placing the chemotherapy drugs directly into the bladder with a catheter. This method can be used because the bladder is a hollow organ, allowing for minimal damage to neighboring tissues from the chemotherapy drugs. Intravesical chemotherapy is used in cases where cancer has not spread past the bladder lining but are at an elevated risk of progression or recurrence.
Partial Or Radical Cystectomy
An individual who has bladder cancer may need to undergo a partial or radical cystectomy to treat their disease. A partial cystectomy is when part of the bladder is surgically removed. The partial removal is only effective for cases of bladder cancer where there is a single malignant tumor. The single tumor must be located in part of the bladder that can be removed without interfering with the normal functions of the bladder. A radical cystectomy is a surgical procedure where the bladder is entirely removed. Additionally, neighboring lymph nodes and a part of the ureters are also removed. When a radical cystectomy is performed in females, it also includes the excision of the ovaries, uterus, and part of the vagina. A radical cystectomy in males includes the excision of the seminal vesicles and prostate. This procedure is performed under general anesthesia using either a single lower abdominal incision or a series of several small incisions through which robotics are utilized to remove all or part of the bladder.
A transurethral resection is a type of surgical procedure that may be used in the treatment of some cases of bladder cancer. A transurethral resection is only suitable for individuals who have bladder cancer that has not spread beyond the inner bladder layers and has not breached into muscular tissues. During this procedure, a cystoscope or long surgical instrument is inserted into the urethra and into the bladder after general anesthesia has been administered. The instrument contains a tiny loop of wire on the end that utilizes an electric current to solder the tissues. The surgeon uses this tool to wipe out all of the cancer cells in the bladder lining. The cancer cells may also be destroyed via this method through the use of a high energy laser.
Transurethral resection is minimally invasive, and it does not require the making of any abdominal incisions. It is common for the surgeon to recommend a single dose of chemotherapy through an injection into the bladder at the end of the procedure. This is a precaution to ensure all cancerous cells are eliminated.
After an individual affected by bladder cancer has a radical cystectomy to remove the bladder because of malignancy, a new path or mechanism has to be created for the urine to be able to leave their body. There are three ways this can be accomplished or three types of urinary diversion. Neobladder reconstruction is a method that involves using a piece of the patient's intestine to make a sphere shaped reservoir referred to as a neobladder. This method allows the patient to urinate normally because the neobladder is placed inside of the body and is directly attached to their urethra. An ileal conduit is a method of urinary diversion that involves using a piece of the patient's intestine to create a tube structure. The tube structure attaches to the patient's ureters and runs to the exterior of their body. This mechanism allows the urine to flow out of the kidneys, into the ureters, and through the tube structure into an external pouch called a urostomy bag. This urostomy bag is worn on the abdomen and emptied several times a day. A continent urinary reservoir is a type of urinary diversion that involves creating a small pouch to hold urine out of the patient's intestine that stays inside of the body. This pouch has a direct opening to the outside of the abdomen where a catheter is used to drain it several times a day.