Risks And Side Effects Of Cystectomy
The risks with any type of cystectomy are much like those with any major surgery. Problems during or shortly after surgery can include:
- Reactions to anesthesia
- Blood clots in the legs or lungs
- Damage to nearby organs
Most people will have at least some pain after the operation, which can be controlled with pain medicines.
Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place .
If a recurrence happens, a new cycle of testing will begin again to learn as much as possible about it. After this testing is done, you and your doctor will talk about the treatment options.
People with recurrent cancer sometimes experience emotions such as disbelief or fear. You are encouraged to talk with your health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.
Certain Factors Affect Prognosis And Treatment Options
The prognosis depends on the following:
- The stage of the cancer . Bladder cancer in the early stages can often be cured.
- The type of bladder cancer cells and how they look under a microscope.
- Whether there is carcinoma in situ in other parts of the bladder.
- The patients age and general health.
If the cancer is superficial, prognosis also depends on the following:
- How many tumors there are.
- The size of the tumors.
- Whether the tumor has recurred after treatment.
Treatment options depend on the stage of bladder cancer.
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What Does Your Bladder Do
Your bladder is part of your urinary system. The job of the urinary system is to filter waste products from your blood and transport the waste products or urine, out of your body. The diagram below shows the organs of the urinary system.
Most of the urinary tract is lined with a special layer of cells called transitional cells. The primary machines in the human filtering system are the two kidneys located close to the backbone and protected by the ribs. The kidneys work independently. They have the significant task of filtering approximately 20% of total blood volume each minute and removing the by-products of digestion and of other body functions.
Once produced, the urine is stored in the central part of the kidney called the renal pelvis. At regular intervals, the renal pelvis contracts and propels the urine through the ureters. These narrow, thin-walled tubes extend from inside the renal pelvis to the bladder. The bladder is a thick-walled structure, consisting of a relatively thin inner layer with a thick muscle covering.
If Treatment Does Not Work
Full recovery from bladder cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or metastatic.
This diagnosis is stressful, and for some people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, expertise, and knowledge to support patients and their families and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
People who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is a specific type of palliative care designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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Sexual Effects Of Urostomy
Its normal people to be concerned about having a sex life with a urostomy. Having your ostomy pouch fit correctly and emptying it before sex reduces the chances of a major leak. A pouch cover or small ostomy pouch can be worn with a sash to keep the pouch out of the way. Wearing a snug fitting shirt may be more comfortable. Choose sexual positions that keep your partners weight from rubbing against the pouch. For more tips, see Urostomy Guide.
Evaluation Of Upper Urinary Tract
Additional workup for all patients with bladder cancer includes evaluation of the upper urinary tract with intravenous urography , renal ultrasonography, computed tomography urography, or magnetic resonance urography.21,22 Renal ultrasonography alone is insufficient to complete the evaluation of hematuria in a patient with bladder cancer because it cannot delineate details of the urinary collecting system. Traditional IVU has been largely replaced by CT urography because of increased detail and data combined in the CT .
For patients unable to undergo contrast injection , magnetic resonance urography may be used to evaluate the upper urinary tract. These tests are useful for disease staging and excluding other causes of hematuria. Pelvic imaging should be performed before transurethral resection to improve staging accuracy because postoperative inflammation mimics the appearance of tumor infiltration.21 Pelvic imaging also may detect synchronous upper tract urothelial cancer, which can occur in 5 percent of patients with bladder cancer.22
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What Kind Of Treatment Will I Need
There are many ways to treat bladder cancer. You might want to get a second opinion about the best treatment plan for you.
Bladder cancer is most often treated with:
Sometimes more than one type is used. The treatment plan thats best for you depends on:
- The stage and grade of the cancer
- Whether the cancer has spread into the bladder wall
- The chance that a type of treatment will cure the cancer or help in some way
- Other health problems you have
- Your feelings about the treatment and the side effects that come with it
Transurethral Resection Of The Bladder Cancer Tumor
This is when the tumor is removed from the urinary tract through the urethra using an electrical force. Transurethral resection is an endoscopic or scope procedure that does not involve making an incision in the body.
Drug therapy after TUR is commonly prescribed for patients with large, multiple or high-grade tumors.
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Signs Of Bladder Cancer In Dogs
Dogs with urinary tract infections and tumors within the bladder, prostate, kidneys, or urethra may present with similar symptoms:
- Straining to urinate.
- Constipation as a result of dehydration.
- Loss of appetite and weight loss.
If your pets have abdominal pain or are straining to urinate, this is not to be ignoredseek veterinary advice. Straining to urinate and being unable to pass urine for more than 24 hours is a medical emergency. Consider arranging for the dog to have a test for cancer cells if you notice blood in the urine.
What Will Happen After Treatment
You’ll be glad when treatment is over. But its hard not to worry about cancer coming back. Even when cancer never comes back, people still worry about this. For years after treatment ends, you will see your cancer doctor. Be sure to go to all of your follow-up visits. People who have had bladder cancer are at high risk of having a second bladder cancer.
If you have no signs of cancer, most experts advise seeing with your doctor every 3 to 6 months. These visits might include urine tests, blood work, and other tests. If you still have your bladder, you will need regular exams of your bladder, too. The time between doctor visits may be longer after a few years if no new cancers are seen.
Having cancer and dealing with treatment can be hard, but it can also be a time to look at your life in new ways. You might be thinking about how to improve your health. Call us or talk to your doctor to find out what you can do to feel better.
You cant change the fact that you have cancer. What you can change is how you live the rest of your life making healthy choices and feeling as well as you can.
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Arsenic In Drinking Water
Drinking water containing arsenic is associated with a greater risk of bladder cancer. However, this is not a large concern in the U.S. Where you live, as well as if you drink well water, or public system water will determine your risk. Most public water systems meet standards for low arsenic content.
Intravesical Therapy For Bladder Cancer
With intravesical therapy, the doctor puts a liquid drug right into your bladder rather than giving it by mouth or injecting it into your blood. The drug is put in through a soft catheter that’s put into your bladder through your urethra. The drug stays in your bladder for up to 2 hours. This way, the drug can affect the cells lining the inside of your bladder without having major effects on other parts of your body.
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Muscle Invasive Vs Non
How quickly a cancer spreads is a concern, and bladder cancers are defined by how far they have spread, and whether they have reached deeper levels of the bladder and beyond.
Invasive bladder cancers are more difficult to treat, as they often grow further into the walls of the bladder and beyond.
Non-invasive bladder cancers are discovered in the inner layer of cells, and they have not grown further into the deep layers of the bladder. They are easier to treat because they havent spread.
Two other descriptors of bladder cancer are superficial, or non-muscle invasive. Both can be used to describe a cancer that is non-invasive, and one that is invasive, but hasnt spread into deeper layers of the bladder muscle yet.
Cancer May Spread From Where It Began To Other Parts Of The Body
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began and travel through the lymph system or blood.
- Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor in another part of the body.
- Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if bladder cancer spreads to the bone, the cancer cells in the bone are actually bladder cancer cells. The disease is metastatic bladder cancer, not bone cancer.
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Types Of Bladder Cancer
Bladder cancer can be described based on where it is found:
- non-muscle invasive the cancer has not spread to other layers of the bladder or muscle
- muscle-invasive the cancer has spread to other layers of the bladder, muscle or other parts of the body.
There are 3 main types of bladder cancer:
- urothelial carcinoma 80 to 90% of bladder cancers sometimes called transitional cell carcinoma
- squamous cell carcinoma 1 to 2% of all bladder cancers. It is more likely to be invasive
- adenocarcinoma 1 to 2% of all bladder cancers. It is more likely to be invasive .
There are other, less common types of bladder cancer. Treatment for these may be different. Speak to your doctor or nurse for information about these types of cancer.
Considering Complementary And Alternative Methods
You may hear about alternative or complementary methods that your doctor hasnt mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.
Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of a doctors medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.
Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known about the method, which can help you make an informed decision.
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Transurethral Resection Bladder Tumor
The first step in treating non-muscle invasive bladder cancermeaning the tumor is contained within the bladder and has not penetrated its thick muscular layeris a type of surgery called transurethral resection bladder tumor, or TURBT. This procedure removes the tumor from the bladder.
During a TURBT, a urologist places a rigid, thin instrument with a light and camera on it through a person’s urethra into his or her bladder. The resectoscope contains a wire loop that allows the doctor to remove the tumor.
This procedure is usually done in an operating room and sometimes a second TURBT is required weeks after the first to ensure that none of the tumor was missed.
Most people can go home the same day or the next day after TURBT. Also, side effects, like bleeding or discomfort when urinating, are typically short-lived and mild.
Other Treatments For Bladder Cancer
For many early-stage bladder cancers, BCG is the best option for treatment. Other treatments for bladder cancer include:
- Surgery to remove the tumor: Early cancers can be removed with TURBT surgery. More advanced cancers may require more extensive surgery, like removal of part or all of the bladder .
- Intravesical chemotherapy: This treats the inside of the bladder with chemotherapy drugs. Chemotherapy drugs commonly used for bladder cancer include Mutamycin , Gemzar , or Valstar .
- Radiation therapy
- Clinical trials
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What Are The Symptoms Of Bladder Cancer In A Dog
The common symptoms of bladder cancer are almost identical to those of bacterial infections of the urinary tract, and they include:
- Frequent urination in small amounts
- Painful urination
- Blood spots in the urine
- Persistent urinary tract or bladder infection even with treatment
- Urination accidents in the house.
Not all clinical signs of bladder cancer in dogs are related to the urinary tract. For example, bladder tumors can also cause some non-specific health problems such as:
Potential Risks Of Surgery
Radical cystectomy and creating a new bladder or pouch is a complex surgery. In other words, it is a big deal. So, it’s important you understand all the risks and benefits involvedthe good and the bad, so to speak.
With that, the likelihood of surgical complications depends on a number of factors, like the surgeon’s experience, the patient’s age, and whether the patient has any underlying medical problems. Still, examples of potential surgical complications include:
Another issue to address with your surgeon is the potential for sexual side effects, like erectile dysfunction or changes in sexual arousal, and how to cope with it.
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Patients Can Enter Clinical Trials Before During Or After Starting Their Cancer Treatment
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCIs clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
If Your Bladder Cancer Comes Back
The surgeon can remove the growths with cystoscopy again if stage Ta or T1 bladder cancer comes back after treatment.
Your specialist takes more biopsies to check that the cancer is still at an early stage. If it is, you usually have chemotherapy or BCG treatment into the bladder. You then go back to having regular cystoscopies to check your bladder.
Your doctor might suggest you have more intensive treatment such as surgery to remove your bladder . They might recommend this if your cancer is:
- at a more advanced stage than before
- carcinoma in situ that has come back after treatment into the bladder
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Treatments After Or Instead Of Surgery
Sometimes, doctors will use a mix of chemotherapy and radiation therapy to avoid surgery to remove the bladder. It can be a good option if youâre not healthy enough for surgery. In this case, you will likely take the chemo drug cisplatin by itself, cisplatin and fluorouracil, or mitomycin with fluorouracil.
You may also get chemotherapy and radiation together after surgery if your cancer has grown into the muscle layer of the bladder but hasnât spread elsewhere.
If your cancer spreads after chemo, you can try other chemotherapy drugs or other types of medicine, like immunotherapy.