Bladder Cancer Awareness Month: Recent advances in diagnosis, management

Bladder Cancer Awareness Month: Recent advances in diagnosis, management

In the detection and surveillance of bladder cancer, cystoscopy remains an important investigative technique

Dr Nikhil S GhadyalpatilUpdated: Saturday, May 21, 2022, 05:02 PM IST
article-image
Urinary bladder cancer is one of the most common urological malignancies breaking in to top 10 most prevalent cancers across the globe. /Representative image |

Surgery, chemotherapy, radiation therapy, combination therapy, and immunotherapy in advanced illness are the main therapeutic options for bladder cancer.

Urinary bladder cancer is one of the most common urological malignancies breaking in to top 10 most prevalent cancers across the globe. Its increasing incidence may reflect the latent effects of cigarette smoking and industrial carcinogens as well as the overall aging of the population. Despite this increase in incidence, mortality rates seem to be on a decline in the last few years. This can be mainly attributed to newer and better diagnostic techniques and advances in the treatment of Bladder Cancer.

Certain important modalities have been instrumental in getting an accurate diagnosis. These include cystoscopy and newer imaging techniques like MRI and PET scan which are useful staging modalities.

In the detection and surveillance of bladder cancer, cystoscopy remains an important investigative technique. Inconspicuous bladder cancer is better detected by photodynamic/blue-light cystoscopy. Recurrent bladder tumours are better detected using narrow-band imaging cystoscopy.

Following imaging tests may be used to find out if the bladder cancer has spread and to help with staging.

Computed Tomography Urography (CTU) is now the modality of choice for investigating patients at high risk for Bladder carcinoma. Magnetic resonance imaging (MRI) and Positron emission tomography (PET) or PET-CT scan aid in better visualization of tumor and their spread to other organs.

Surgery, chemotherapy, radiation therapy, combination therapy, and immunotherapy in advanced illness are the main therapeutic options for bladder cancer.

Bladder cancer surgery

In the early stages of bladder cancer, surgery is the primary therapy option. In many cases, surgeons are able to operate on bladder cancer patients with minimally invasive techniques, robotic surgery, and reconstruction procedures. Robotic surgery may offer shorter hospital stay with less blood loss and faster recovery time.

Bladder reconstruction surgery/Artificial bladder

When the bladder is removed to treat bladder cancer, surgical procedures known as urinary diversions are performed to give your body a way to store and remove urine. Urinary diversions are done at the same time as a cystectomy.

One way to do this is to use a section of the small intestine or colon to divert urine to a stoma or ostomy (an opening) on the outside of the body. The patient then must wear a bag attached to the stoma to collect and drain urine.

Surgeons can sometimes use part of the small or large intestine to make a urinary reservoir, which is a storage pouch that sits inside the body. With these procedures, the patient does not need a urinary bag. For some patients, the surgeon is able to connect the pouch to the urethra, creating what is called a Neobladder.

These procedures help substantially in improving the quality of life of patients.

Intravesical therapy

This treatment is used to treat superficial bladder cancer. Urologists use a catheter to fill the bladder with a solution containing Bacillus Calmette-Guérin (BCG), a bacterial organism. BCG stimulates an immune response within the bladder to destroy any remaining cancer cells. The success rate is approximately 70% in ideal circumstances.

Therapies using medication

Systemic therapy is the use of medication to destroy cancer cells. This type of medication is given through the bloodstream or from the mouth to reach cancer cells throughout the body (the "system" in "systemic therapy"). Systemic therapies are generally prescribed by a medical oncologist, a doctor who specializes in treating cancer with medication. These are used in combination with surgery to improve cure chances or single modality therapy in advanced disease.

Immunotherapy

These drugs work by improving the ability of the patient’s immune system to fight cancer. This is a more advanced form of treatment that may also be used as an adjunct with chemotherapy or alone in patients with long-term survival.

Radiation therapy

Although surgery is the most common treatment for bladder cancer, radiation therapy may be used in some cases. About 60% of optimum radiation therapy candidates are able to maintain their bladders and avoid cancer recurrence.

In conclusion, all of these modern developments in bladder cancer management aid in early detection, correct staging, improved management, and increased patient quality of life.

(Dr Nikhil S Ghadyalpatil is Senior Consultant Medical Oncologist & Hemato-Oncologist, Yashoda Hospitals, Hyderabad)

RECENT STORIES

Revolutionising Cancer Care: US & India Join Forces For Ground-breaking Collaboration

Revolutionising Cancer Care: US & India Join Forces For Ground-breaking Collaboration

Activists Write To PM Modi Over TB Drug Shortage Ahead Of World TB Day

Activists Write To PM Modi Over TB Drug Shortage Ahead Of World TB Day

Holi 2024: Say Bye-Bye To Skin Allergy With This Simple Home Remedy

Holi 2024: Say Bye-Bye To Skin Allergy With This Simple Home Remedy

Controversy Surrounds New Uniform Code For Pharmaceutical Marketing Practices

Controversy Surrounds New Uniform Code For Pharmaceutical Marketing Practices

Mumbai: Nepali Couple Turns To Wadia Hospital To Save Child's Arm From Amputation

Mumbai: Nepali Couple Turns To Wadia Hospital To Save Child's Arm From Amputation