Treatment
The choice of treatment for patients suffering from urinary bladder cancer depends on the degree of progression according to TNM classification, the level of tumor’s histological malignancy and the general state of the patient.Surgical treatment
Transurethral resection of tumor (TURT)
This method is used in the case of surface changes (Ta, T1, T2, as well as the multiple ones and when treating preinvasive tumor Tis, if the number of focuses is low and the atypy insignificant). TURT may be done also in the case of T3a tumors if the diameter of the base does not exceed 2 cm. In the case of advanced stages (T3, T4 ) it is sometimes used as paliative treatment.Partial resection of urinary bladder
It is applied when a 3 cm microscope margin of healthy tissue is possible in big, individual focuses of T2 tumor and in the early period of T3.Complete resection of urinary bladder (cystectomy)
A two-stage surgery which consists in cutting out a bladder together with lymph nodes and recreating the possibility to drain the urine from the upper urinary tracts. The operation concerns patients suffering from:- poorly differentiated cancer (G3)
- early recurrence after treatment using other methods
- tumors invading the neck of urinary bladder, prostate urethra, bladder triangle when urine flow from kidneys is impeded extended and multifocal pre-invasive tumors
- bleeding from the bladder impossible to control
Radiotherapy
It is applied among patients who do not give their consent to the treatment or when a radical cystectomy is often impossible in their cases. Radiotherapy among patients in T2 to T4 progression stage creates a possibility of attaining a 5-year survival without disease recurrence among 35 to 45% of patients and a 5-year complete survival among 23-40%. A 45 Gy dose is given for the pelvis and then a boost for bladder tumor is done up to 65 Gy dose. The introduction of conformal radiotherapy which consists in 3-dimensional planning system (3D CRT) into clinical practice in the recent years enables more effective application of radiotherapy in the radical treatment of urinary bladder cancer.Chemotherapy
In the case of urinary bladder cancer it is applied mainly as palliative treatment or together with surgical methods or radiotherapy. Inductive chemotherapy aims at reducing the size of tumor most often before the radiation.Prognosis
In the case of urinary bladder cancer the prognosis depends on the level of progression as well as the choice of optimal treatment and the internal state of patients. A percentage of 5-year cure most often oscillates around 50-70% as for the I and the II degree, and 20-30% as for the III degree. Longer survival periods are rarely reported in the IV degree.(published with permission in writing from:http://www.articlealley.com/)
