Bladder Cancer Clinical Trials
Major drug companies continually research and develop new medications and treatments for bladder cancer that must be shown to be safe and effective before doctors can prescribe them to patients. Through clinical trials, researchers test the effects of new drugs on a group of volunteers who have bladder cancer. Following a strict protocol and using carefully controlled conditions, researchers evaluate the investigational drugs under development and measure the ability of the new drug to treat bladder cancer, its safety, and any possible side effects.
Some patients are reluctant to take part in clinical trials for fear of getting no treatment at all. But patients who participate in clinical trials receive the most effective therapy currently available for the condition, or they may receive treatments that are being evaluated for future use. These bladder cancer drugs may be even more effective than current treatment. Comparing them in a clinical trial is the only way to find out.
Hereâs where to find information about whether a bladder cancer clinical trial is right for you.
This website lists industry-sponsored clinical trials that are actively recruiting patients.
American Cancer Society: âBladder Cancer Treatment,â âBladder Cancer Surgery,â âRadiation Therapy for Bladder Cancer,â âChemotherapy for bladder cancer,â âFDA Approves New Immunotherapy Drug for Bladder Cancer,â âImmunotherapy for bladder cancer.â
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.
What Are The Drains Needed For
To provide drainage of urine from your kidneys to the urinary diversion, you will have two temporary stents that will be visible on the outside of your body. With a neo-bladder or continent diversion, you will also have 1 to 2 catheters to drain the bladder until it heals. With an ileal conduit, you will have only an appliance over the stoma. All patients will usually also have a temporary drain connected to a bulb to collect extra fluid. This is usually removed before discharge.
Again, since the urinary diversion is constructed from the intestine, the presence of mucus in the urine is normal following this surgery. The mucus will decrease over a period of time. This is especially important for neo-bladders and continent diversions. Immediately after surgery, to prevent the catheters from becoming plugged, it is important that they be regularly flushed with sterile water. You will be given supplies and taught how to irrigate these catheters.
The stents and catheters may stay in place up to 2 to 4 weeks to allow adequate time to heal. The surgeon will let you know when they will be removed.
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Quality Of Life After Surgery
Since bladder removal surgery involves restructuring the way urine exits the body, a person may initially experience a decrease in their quality of life. However, managing urine secretion usually becomes easier as time goes on.
Immediately following surgery, doctors usually restrict what the person can do. This restriction, though temporary, may feel frustrating.
It is common for the new urinary system, such as urinary sacks or stomas, to feel uncomfortable at first. If the person has trouble adjusting, they may want to discuss their concerns and feelings with a doctor, social worker, or counselor. Joining a support group can also help.
The person should be able to return to all their normal life activities within 46 weeks following surgery.
During recovery, the person will be able to get used to their new means of urinating. As their familiarity with the new urinary system grows, any inconvenient symptoms should lessen.
Palliative Or Supportive Care
If your cancer is at an advanced stage and can’t be cured, your medical team should discuss how the cancer will progress and which treatments are available to ease the symptoms.
You can be referred to a palliative care team, who can provide support and practical help, including pain relief.
Page last reviewed: 01 July 2021 Next review due: 01 July 2024
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‘living With A Stoma’ Webinar Recording
At first, the thought of managing and caring for your stoma can be overwhelming. There is much information to take in at once and new things to learn. With experienced stoma nurse, Sharon Fillingham, answering common questions about stomas and two patients sharing their own experiences of getting and living with a stoma, we hope our webinar will help guide you.
It may not seem like it now, but please know that you should soon be able to do things youve always done, just a little differently.
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 Is The Main Function Of The Bladder
The urinary system, which includes the bladder, urethra, ureters, and kidneys, helps maintain stable chemical conditions in the body, stores and eliminates waste products. The bladder, a muscular chamber located in the lower abdomen, acts as a reservoir to collect urine. Two narrow tubes called ureters carry urine from the kidneys to the bladder. From the bladder, urine is empted through another tube, the urethra, during urination.
What Is The Recovery Time From Bladder Tumor Biopsy And Resection
Following the procedure, youll have a catheter inserted into the bladder to drain urine. It is normal for there to be blood in the urine at first. Drinking liquids will help flush out your bladder and help prevent infections. Your catheter will be removed when there is no more blood visible in the urine or when you go home.
Most people can have a simple bladder tumor biopsy and resection done as an outpatient procedure. However, your provider might suggest you stay overnight if you have other medical concerns or if you have had a large amount of tissue removed.
You should be able to drink and eat the way you normally do. Youll probably be told to make sure you drink adequate amounts of fluids.
You might have some discomfort when you urinate.
You should be able to return to normal activity in a few days.
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There Are Three Ways That Cancer Spreads In The Body
Cancer can spread through tissue, the lymph system, and the blood:
- Tissue. The cancer spreads from where it began by growing into nearby areas.
- Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
- Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
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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What Is The Outlook For Someone Who Has Had Bladder Tumor Biopsy And Resection
Bladder tumor biopsy and resection is a successful treatment for early stage bladder cancer. It can prevent cancer from spreading into the bladder muscle wall. Invasive bladder cancers that spread require more extensive treatment.
However, bladder cancer often comes back . More TURBT procedures may be needed. Your doctor will do frequent follow-up checkups with you to look for signs that the cancer has returned. The risks of repeated TURBT procedures is small.
Some providers might choose to burn off smaller tumors rather than remove them.
If the TURBT shows that you have a more advanced bladder cancer, youll probably need further treatment. This could include:
- A more extensive TURBT.
What About Other Treatments That I Hear About
When you have cancer you might hear about other ways to treat cancer or treat your symptoms. These may not always be standard medical treatments. These treatments can be vitamins, herbs, special diets, and other things. You may be curious about these treatments.
Some of these are known to help, but many have not been tested. Some have been shown not to be helpful. A few have even been found to be harmful. Talk to your doctor about anything you’re thinking about using, whether its a vitamin, a diet, or anything else.
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How Bladder Cancer Is Treated
Different people with bladder cancer have different needs that have to treated. The treatments that your doctor recommends in the treatment plan are chosen based on the characteristics of your diagnosis and your overall health, as well as other factors.
Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. These types of talks are called shared decision-making. Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is particularly important for bladder cancer because there are different treatment options. Learn more about making treatment decisions.
To read an overview of treatment options based on the extent of the bladder cancer, read the next section in this guide, Treatments by Stage.
The most common types of treatments used for bladder cancer are described below. Your care plan also includes treatment for symptoms and side effects, an important part of cancer care.
What Are The Urinary Diversion Options
There are three main types of urinary diversion surgeries:
- Ileal conduit urinary diversion.
- Indiana pouch reservoir.
- Neobladder-to-urethra diversion.
For all of these procedures, a portion of the small and/or large bowel is disconnected from the fecal stream and used for reconstruction.
Ileal conduit urinary diversion
Ileal conduit urinary diversion: A segment of the intestine directs urine through a stoma into an external collecting bag.
With this procedure, the ureters drain freely into part of the ileum . The end of the ileum into which the ureters drain is then brought out through an opening in the abdominal wall. This opening, called a stoma, is covered with a bag that gathers the urine as it drains from the ileal conduit.
Advantages and disadvantages
The advantages of the ileal conduit urinary diversion surgery are:
- It is a relatively simple surgery.
- It requires less surgical time .
- There is no need for occasional catheterization
The disadvantages of the ileal conduit urinary diversion are:
- Theres a change in body image.
- It uses an external bag to collect urine, which might leak or have odors.
Indiana pouch reservoir
Indiana pouch reservoir: A pouch is made out of portions of intestines stores urine until it is drained via a catheter inserted through the stoma.
Advantages and disadvantages
The advantages of the Indiana pouch reservoir surgery are:
The disadvantages of the Indiana pouch are:
Advantages and disadvantages
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Why Should You Have A Cystectomy
The benefits of this operation will be discussed with you in more detail, but your doctor may be recommending this surgery for you for the following reasons:
- you have cancer in your bladder that would be best managed by completely removing the bladder
- your bladder may have developed a tumour after radiation treatment
- your bladder may be bleeding after radiotherapy
- your bladder may be damaged or bleeding uncontrollably from other causes or treatments.
For more information on radical cystectomy including how to prepare for surgery and recovery afterwards, download or order a copy of our Muscle-invasive bladder cancer booklet .
Transurethral Resection Of Bladder Tumor
A transurethral resection of bladder tumor or a transurethral resection is often used to find out if someone has bladder cancer and, if so, whether the cancer has spread into the muscle layer of the bladder wall.
TURBT is also the most common treatment for early-stage or superficial bladder cancers. Most patients have superficial cancer when they’re first diagnosed, so this is usually their first treatment. Sometimes, a second, more extensive TURBT is done to better ensure that all the cancer has been removed. The goal is to take out the cancer cells and nearby tissues down to the muscle layer of the bladder wall.
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Surgery To Remove The Bladder
A cystectomy is an operation to remove your bladder. This is quite a big operation. You might be in hospital for a week or two.
After surgery to remove your bladder, you need another way to collect and pass your urine. Doctors call this urinary diversion. There are different types of urinary diversion. Your doctor will talk to you about the different types.
For some rarer types of bladder cancer, the surgeon might only remove part of your bladder. This is called a partial cystectomy.
Treating Stage Ii Bladder Cancer
These cancers have invaded the muscle layer of the bladder wall , but no farther. Transurethral resection is typically the first treatment for these cancers, but it’s done to help determine the extent of the cancer rather than to try to cure it.
When the cancer has invaded the muscle, radical cystectomy is the standard treatment. Lymph nodes near the bladder are often removed as well. If cancer is in only one part of the bladder, a partial cystectomy may be done instead. But this is possible in only a small number of patients.
Radical cystectomy may be the only treatment for people who are not well enough to get chemo. But most doctors prefer to give chemo before surgery because it’s been shown to help patients live longer than surgery alone. When chemo is given first, surgery is delayed. This is not a problem if the chemo shrinks the bladder cancer, but it might be harmful if the tumor continues to grow during chemo.
If cancer is found in nearby lymph nodes, radiation may be needed after surgery. Another option is chemo, but only if it wasn’t given before surgery.
For people who have had surgery, but the features of the tumor show it is at high risk of coming back, the immunotherapy drug, nivolumab, might be offered. When given after surgery, nivolumab is given for up to one year.
For patients who cant have surgery because of other serious health problems, TURBT, radiation, chemotherapy, or some combination of these may be options.
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Sexual Effects Of Radical Cystectomy In Women
If the surgeon takes out the end of the urethra where it opens outside the body, the clitoris can lose some of its blood supply, which might affect sexual arousal. Talk with your surgeon about whether the end of the urethra can be spared.
For more on ways to cope with these and other sexual issues, see Sex and the Woman With Cancer.
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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