Bladder Cancer Treatment In India With Advanced Technological Facilities
You can have bladder cancer with persistent lower abdominal pain.
However, with the introduction of new technology and protocols, the chances of quality of life have improved for bladder cancer treatment in India.
Though the detection of bladder cancer itself is a matter of concern, with the right treatment and the doctor at the right time, you can beat bladder cancer.
KEY TAKEAWAYS
- In this article, the different symptoms, types, risk factors, diagnosis, staging, and stage-specific treatment for bladder cancer are discussed.
- The reasons for choosing the best hospital and best oncologist are noted
- The cost of treatment and factors affecting the treatment costs are mentioned
- The survival chance of patients at different stages of bladder cancer is spoken about.
What is Bladder Cancer?
To comprehend this cancer, one has to learn how this bladder works. The main purpose of the bladder is to hold urine which is produced by the kidneys.
The kidney also produces urine that flows through the ureter tubes to this organ known as the bladder.
When you urinate, the bladder contacts and forces urine out of it to urethra tubes.
Now coming back to bladder cancer, cells that form the bladder start to grow uncontrollably and form tumors. With time, the tumor spread to the other body parts.
What are the Different Stages of Bladder Cancer?
There are 5 stages of bladder cancer from stage 0 to stage 4.
TNM staging is therefore a method used in staging cancer. TNM stands for Tumour, Node, and Metastases.
T: Doctors get all the scopes to predict the size of the tumor
N: Whether cancer has spread into the Lymph node.
M: Where cancer extends and invades other parts of the body.
In this stage, cancer has grown in the center of the bladder. Cancer has not even reached the tissues and muscle walls of the bladder.
In stage 1 cancer has grown to the inner lining of the bladder. It has not reached muscle walls or lymph nodes near the bladder.
The cancer has grown through the inner tissue of the bladder and possibly to the muscle layer of it.
It may have had a local extension to the nearby structures but does not affect the lymph or distant organs.
Lymph nodes in the vicinity may be affected, as may bone, liver, or lung tissue far away from the original tumor.
Recognizing the stages of bladder cancer is vital for someone to know the kind of treatment to be administered.
Stage-Specific Treatment of Bladder Cancer in India
You may also develop bladder cancer which is often localized to the inner layer of the bladder lining. The bladder wall muscles are not invaded (the tumor has not extended to this level deeper into the wall).
Stage I bladder cancer is a condition whereby the malignancy is constrained to the internal lining of the bladder without affecting the muscular layer of the organ. TURBT is the surgery that is mainly used.
Intravesical chemotherapy
Intravesical treatments are employed in superficial cancer diseases of the bladder as well as in diseases that originate in the layer of the bladder only.
Drugs introduced to the bladder area act on the cell lining of the bladder but it has almost no impact on cells all over the body. This means that intravesical therapy is not going to be beneficial, where the tumors have grown right through the depth of the bladder wall, or are present in any organ of the body.
Immunotherapy for bladder cancer
Immunotherapy has shown an increased level of success in reducing the chances of recurrence of bladder cancer and has also increased the percentage of patients who experienced complete response after surgeries were performed.
New experimental immunotherapy may offer even better options for patients suffering from this disease.
Stage 2 is characterized by cancer invasion of the bladder muscle but not the fibrous layer. The primary treatment of these cancers is TURBT, but it is carried out not with the intention of cure in view but with the purpose of staging the disease.
If this time the cancer has reached muscle then the necessity arises to perform the radical cystectomy which means the bladder must be removed.
Lymph nodes adjacent to the bladder are often resected as well. Lymph nodes in the vicinity of the bladder are often involved and resected. A partial cystectomy may therefore be considered if the disease is confined to only one sector of the bladder.
To lessen the spread of cancer cells before surgery, doctors recommend chemotherapy be conducted before surgeries. Cancer in lymph nodes may be prescribed radiation following surgery.
Neoadjuvant Chemotherapy
The neoadjuvant cisplatin-based chemotherapy is the standard of care in bladder cancer, with a two-drug regimen being preferred in this case. It has been linked with an improved five-year survival of 5% as well as a 14% decrease in mortality. However, there have been some questions regarding the use of Pre-operative administration of Chemotherapy.
Radical Cystectomy
The process of surgical removal of the urinary bladder is called radical cystectomy, and this process also involves the removal of the prostate gland and seminal vesicles in men. In women, radical cystectomy involves the removal of the uterus, both ovaries, both fallopian tubes, and a part of the vagina along with the bladder.
Radical cystectomy is done when cancer infiltrates part of the bladder wall muscles or when the disease recurs in a non-muscle invasive form. In certain circumstances, a partial cystectomy is employed to remove a malignant lesion that is localized to an area of the bladder only.
Urinary Diversion
Urinary diversion involves bypassing the normal structures and creating an exit somewhere else in the urinary tract. This may have to be done if the bladder no longer functions properly or if it has to be done because of cancer or an injury. Urine is passed through a new bladder built in the same surgery (neobladder) or through an opening, called a stoma, in the abdominal wall.
There is an extension of the tumor to the prostate (T3) or beyond the mucosa into the muscular wall (T3) or to adjacent Structures/Tissues (T4) or even to lymph nodes (N1 or N2 or N3). Here they have not affected any other body part or different region of the body.
When assessing the involvement of the bladder wall and surrounding tissue, the initial treatment for carcinoma is transurethral resection or TURBT. The primary conventional therapy for bladder cancer is systemic chemotherapy with or without radiation therapy, and then neoadjuvant cystectomy (surgical resection of the bladder, plus the regional lymph nodes).
Tumors involve the pelvic or abdominal wall to invade other structures (T4b), have extended to regional nodes (any N), and/or affected other sites of the body (M1).
If cancer has not metastasized to other organs or body parts, the process involves the administration of the first course of chemotherapy with or without radiation and the tumor is reassessed. If it seems to be missing, one has cystectomy or chemo with or without radiation as a course of action. In case of continued manifestation of symptoms of bladder cancer, some of the treatments that are done include Chemo with or without radio, switching to another type of chemo, using an immunotherapy drug, or cystectomy.
Palliative Radiation Therapy
This treatment is needed if the bladder cancer is extensive, or if the disorder has spread to organs/tissues in the body too.
In advanced cases, palliative radiation treatment has been used to shrink the tumor that is within the bladder, to arrest bleeding from the lining of the bladder, or to address pain.
It can also be directed at the other parts of the body for symptoms such as pain caused by cancer that has spread to the bones.
The sessions of radiation therapy depend on the type of cancer and the stage, it could be just one session or even up to several sessions in a week for several weeks. These treatment sessions do not take a lot of time in total and usually last roughly between 10 and 15 minutes.
Palliative Chemotherapy
The median survival in the context of palliative chemotherapy of bladder cancer in routine practice is a little lower than that of the result from clinical trials. However, according to the clinical trial outcomes, a percentage of patients with palliative chemotherapy will live for a long time.
Frequently Asked Questions (FAQs):
Q1. Where does bladder cancer usually spread first?
Indeed bladder cancer typically initiates in lymph nodes surrounding the bladder in the pelvis (perivascular lymph nodes) and then migrates to those around major blood vessels branching in the leg and pelvis.
Q2. How long will you be in the hospital after your bladder has been removed?
Postoperatively, you will possibly be inpatient for three to seven days. Your doctor and surgeon will observe how the new urine removal system works through this time.
Q3. How do you go about peeing after your bladder has been removed?
Your pee is directly diverted from your kidneys to the outside of your body through a duct made by a part of your small intestine. The open end of your small intestine drains urine into a small, flat pouch through a surgical hole in your belly.
Q4. How long does it take to recover from bladder cancer surgery?
It will take 6 weeks from the date of surgery for you to fully recover. Lifting and straining should be avoided at all costs, as this will lead to constipation.
You may resume regular activity during the second four weeks of your recovery, but only gradually. You might feel well enough to return to work, but it might be easier to start on a half-day basis. It’s common to feel tired in the afternoon, and if this happens to you, it’s best to take a nap! You may also start driving and lifting objects such as a briefcase.
Q5. Is it possible to lead a normal life after bladder cancer treatment?
If there is one major point that applies to the majority of patients, this is the fact that the cancer journey does not simply conclude when treatment is completed. Life after cancer treatment can be as difficult as the treatment itself.
It is necessary to give oneself a chance to adapt both to the physical and the emotional changes and to take some time to create the new daily routine slowly and comfortably. Your family and friends may require equal or more time to adapt to the changed situations.
Q6. What's the typical treatment time frame for bladder cancer in Mumbai?
The duration of treatment depends on the type of cancer and its stage together with the chosen course of treatment. Specifically, treatments vary in duration from several weeks to several months, and often, complex protocols such as surgery, chemotherapy, and radiation require multiple cycles at different times.
Q7. Is bladder cancer curable?
Bladder cancer is treatable. It can be completely cured in the early stages of cancer. In advanced stages of cancer, it may not be completely cured but treatments are available to manage the symptoms.
Q8. How fast does bladder cancer spread?
High-grade bladder cancer spreads fast in the early stages. Doctors will start treatment immediately even for stage 0 cancer if it is high-grade bladder cancer. In high-grade bladder cancer, cancer cells look different from normal bladder cancer and spread fast.
In Low-grade, bladder cancer tends to spread slowly.
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Next in Bladder Cancer
Author Bio:
Dr. Yashashree Joshi – MBBS, MD (Philippines)
Dr. Yashashree Joshi, MD, is a globally-trained oncologist with a robust academic background and extensive experience in pioneering cancer treatments. Dedicated to patient-centered care, she continually integrates the latest advancements in oncology to provide her patients with innovative and personalized treatment plans.
Content Medically Reviewed By MedicoExperts Editorial & Clinically Review Board
