Bladder cancer surgery, treatments, diagnosis city of hope cancer center

Surgery is a common treatment option for most bladder cancer patients, particularly those with early-stage, localized cancer. Different procedures may be chosen based on the individual patient’s diagnosis. City of Hope surgeons are among the most experienced in the country and have excellent success rates using a range of advanced technologies.

• Transurethral resection – This minimally invasive surgical procedure, performed through the urethra, is most useful for removing those cancers that have not advanced beyond the lining of the bladder. In most low-grade, low-stage tumors, resection is all that is required. This procedure uses a thin, flexible tube (cystoscope) that is inserted into the urethra and guided into the bladder. After cancerous tissue is identified, tools inserted through the tube can surgically remove it or burn it off using an electric current.

• Segmental or partial cystectomy – In some cases, the doctor may remove only part of the bladder in a procedure called segmental cystectomy. The doctor often chooses this type of surgery when a patient has a low-grade cancer that has invaded the bladder wall in just one area. Because only part of the bladder is removed, the patient may urinate normally after recovery.

• Radical cystectomy – For invasive bladder cancer, the most common type of surgery is radical cystectomy. The doctor may also choose this type of surgery when superficial cancer involves a large part of the bladder. Radical cystectomy is the removal of the entire bladder, the nearby lymph nodes, part of the urethra and the nearby organs that may contain cancer cells. In men, the nearby organs that are removed are the prostate, seminal vesicles, and part of the vas deferens. In women, the uterus, ovaries, fallopian tubes and part of the vagina are removed. Because the entire bladder is removed, the surgeon will also need to perform a reconstructive procedure to divert urine flow.

• Neobladder: Some patients may be eligible for a neobladder procedure, which creates a pouch from the small intestine that is connected directly to the urethra. While this procedure allows patients to pass urine through the urethra, it may take a while to regain urinary control and patients may have to self-catheterize to drain urine from the neobladder.

In addition to oral and intravenous delivery, bladder cancer patients may also receive anti-cancer drugs intravesically. In intravesical therapy, a catheter is guided through the urethra and into the bladder, allowing for direct drug administration. By directly delivering and confining the drugs within the bladder, its effectiveness may be increased and side effects can be limited.

The drug or drug combination used depends on the type and stage of bladder cancer, previous treatments used, the patient’s health and overall treatment goals. This personalized medicine approach may be further enhanced by molecular or genetic testing of your cancer, which can help identify treatments that are more effective and with fewer side effects.

City of Hope offers a wide variety of leading-edge radiation therapy options to treat bladder cancer. These include image-guided external radiation systems (such as TomoTherapy or TrueBeam) that combine detailed imaging and radiation delivery technologies, allowing our care team to “sculpt” radiation beams to the tumor site while avoiding nearby healthy tissue. This maximizes radiation’s cancer fighting ability while minimizing exposure to the bladder, rectum and other nearby organs.