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.
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.
There are various types of bladder cancer.
What are the different types of bladder cancer?
There are four types of bladder cancer:
By far it is the most common bladder cancer. In this type of cancer, cancerous cells form tumors in the urothelial cell layer. The urothelial cell line is the inner line of the bladder. Urothelial cells are found in the bladder as well as in the kidneys and ureter inner line. This is the reason the whole urinary tract should be screened to find this type of cancer.
Squamous refers to flat cells located on the skin’s outer layer. The carcinoma of these cells is known to be highly malignant, but it makes up 1-2% of all forms of bladder cancer.
Sarcoma is a disease that affects very few people and is specifically present in the bladder.
In this stage cancer has spread to the fatty tissues of the bladder. It may be spread outside to the prostate, urethra, or vagina. But not to nearby lymph or distant organs.
Now it is the time to learn more about the stages of bladder cancer and the possible treatment measures.
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.
However, let’s switch gears a bit to find out the symptoms that are associated with bladder cancer.
What are the signs and symptoms of bladder cancer?
Bladder cancer has different symptoms:
The following are the signs to check with bladder cancer:
- While urinating one may get a burning sensation or feel pain.
- Uncontrolled and increased frequency of going to the bathroom without any signs of physical strain
- Having the urge to pass urine through the night multiple times
- Bloody or Blood clots in Urine
- A feeling that the bladder is full but the patient cannot discharge urine.
- Lower back pain
Anyone who has been suffering from these symptoms should go to the doctor.
Along with the symptoms, you should learn about various risk factors associated with bladder cancer.
What are the risk factors for bladder cancer?
Age: The likelihood of bladder cancer is higher in older people.
Gender: It is more common for men to have bladder cancer than women.
Smoking: If you do smoke your risk is about three times higher than if you don’t.
Workplace: People working with chemicals like aromatic amines and dyes are at higher risk of bladder cancer.
Arsenic in drinking water: Arsenic present in drinking water causes a higher risk of bladder cancer.
Drinking less fluid: Drinking less water causes toxic chemicals to be deposited in the bladder and it increases the risk of bladder cancer.
If you are having any of these risk factors and facing any symptoms, you should immediately book an appointment with a urologist. The Doctor will diagnose further to verify whether you have the cancer.
Now, let’s check what diagnostic tests are used to determine bladder cancer.
How is bladder cancer diagnosis carried out?
Given below are the points that describe the process of diagnosing bladder cancer:
The urine cytology test is used to detect abnormal cells in the urine. It is mainly used to detect cancers of the urinary system, especially bladder cancer. If blood in your urine is noticeable, your doctor might order a cytology test
This involves a doctor inserting a thin tube that has a camera on its end through the urethra to view and examine /the bladder carefully.
When doing a cystoscopy doctors use tools to get samples of the inner lines of the bladder for testing. This procedure is also known as TURBT (Transurethral resection of bladder tumor). TURBT is done to confirm if someone has bladder cancer and establish what type of tumor it is, and how far it has penetrated the layers of the bladder. Also, treatment can be done through this procedure.
Various imaging tests such as CT urogram, magnetic resonance imaging (MRI), positron emission tomography (PET), bone scan, and X-ray are conducted to identify the stage of the disease (0-4) Moreover, it assists in determining treatment options.
Bladder cancer treatment in India
The treatment of bladder cancer depends on the stage it is in and how much they have spread in the body
The methods of cancer treatment are surgery, chemotherapy, radiation therapy, immunotherapy, targeted drug therapy, and potentially many more.
This happens to be the primary line of treatment signifying the beginning phase where cancer is removed from an organ. Among bladder cancer surgery, transurethral resection of a bladder tumor (TURBT) tops the list. Surgeons insert electricity through a tube and burn out the cancer.
Chemotherapy is used by doctors to attack stage 3 and 4 cancers, they can either inject it through the vein or directly into the bladder. Just before a surgery which helps in effectiveness, usually chemotherapeutics are given via a vein.
Radiation therapies are usually scheduled daily for weeks and in most cases an off day during weekdays. The treatment is almost nothing, like getting an X-ray. It is just that the radiation is stronger. Radiation doesn’t hurt. Though each treatment takes only a few minutes, the setup time, which includes positioning you for treatment, may take longer.
Immunotherapy helps the immune system do its job. It helps the body to identify cancer cells.
Drugs zero in on the particular mutations that help propagate cancer. There are manifold targets in cancer cells that can be directed with various medications.
The year 2003 marked the introduction of a new method of surgery, robot-assisted laparoscopic radical cystectomy and this quickly became one of the most important developments in the surgical field affecting the outcomes of many patients.
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 ca