Non metastatic bladder cancer treatment explained by CancerBro

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06/19/23

Today, CancerBro will explain non metastatic bladder cancer treatment. Watch the video to know how non metastatic bladder cancer is treated by oncologists. Video Transcript: We will first discuss the treatment for Localised bladder cancer. In this technique, a hallow tube called as cystoscope which is fitter with a camera is inserted into urethera and is slowly advanced into bladder. It helps to confirm the presence of bladder tumor and see its location, number and extent. Also, it helps in transurethral resection of bladder tumor which is both diagnostic and therapeutic. As you can see in this figure, only the cancer containing superficial layers are removed, without damaging the deeper layers. After TURBT, the hispathology reports tells us whether the tumor is non muscle invasive or muscle invasive, i.e., whether it has infiltrated the muscle or not. We will first discuss the treatment for non muscle invasive bladder tumors. Tis is carcinoma in situ which is a flat tumor, limited to epitherlium. Intravesical chemotherapy should be given in all cases of Tis disease. As you can see in the figure, in this procedure the chemotherapy drug is directly instilled into the bladder, with the help of a catheter. And Ta is the papillary tumor which is limited to the epithelium. For Ta disease also, intravesical chemotherapy may be given. But in some cases, intravesical chemotherapy may not be required, when we can keep the patient under observation. When the tumor infiltrates into the lamina propria, it is called as T1. For T1 disease, the treatment depends on whether the tumor is low grade or high grade. Intravesical chemotherapy is the treatment of choice for low grade tumors. Whereas, for high grade tumors, the prefered modality of treatment is cystectomy or surgical resection of bladder. When it infiltrates into the inner muscle layer, it is called as T2a. And T2b, when it infiltrates the outer muscle layer. For T2 disease with nodes negative, the prefered modality of treatment is chemotherapy followed by cystectomy. Usually, the cystectomy is radical cystectomy in which whole bladder is removed. But in highly selected cases we can do partial cystectomy also. But for non cystectomy candidates in which we are not planning for surgery, a combination of chemotherapy and radiation therapy may be used. But the final decision whether to do surgery or not, or to do total or partial cystectomy will be taken by the oncologist, on an individual patient basis, depending upon exact stage of the disease, number and location of bladder tumors, and co-morbidities and performance status of the patient. With this we come to the end of the treatment of localised bladder tumors, now let's come to the treatment of locally advanced bladder tumors. Read full transcript here - https://youtu.be/TJyEC60K_EU