Bladder cancer

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Cystoscopy

Female urinary tract

Male urinary tract

Transitional cell carcinoma of the bladder

The choice of an appropriate treatment is based on the stage of the tumor, the severity of the symptoms, and the presence of other medical conditions.

Generally, stage 0 and I tumors are treated by removing the tumor without removing the rest of the bladder. They sometimes may also be treated by administering chemotherapy or immunotherapy (see below) directly into the bladder. Because the risk of the cancer returning is so high, people with bladder cancer require constant follow-up for the rest of their lives.

The treatment for patients with stage II and stage III disease is changing. While the accepted treatment has been removing the entire bladder (in a surgery called radical cystectomy), there is growing interest in keeping as much of the bladder as possible. Some patients may be treated by removing only part of the bladder, and that procedure is followed by radiation and chemotherapy. Some patients may be treated with chemotherapy before surgery, to try and shrink their tumor down, so that they might be able to avoid having the entire bladder removed. However, many people with stage II and stage III tumors still require bladder removal. In some patients with stage III tumors who choose not to have surgery, or who cannot tolerate surgery, a combination of chemotherapy and radiation may be used.

Most patients with stage IV tumors cannot be cured and surgery is not indicated. In these patients, chemotherapy is often considered.

CHEMOTHERAPY

Chemotherapy for bladder cancer can be administered through a vein or into the bladder. For early disease (stages 0 and I), it is usually given directly into the bladder. For more advanced stages (II-IV), treatment is usually given by vein.

Chemotherapy may be given to patients with stage II and III disease either before or after surgery in an attempt to prevent the tumor from returning.

Chemotherapy may be given as a single drug or in different combinations of drugs. These drugs include: