EN
Bladder cancer is a malignancy that grows from bladder tissue. More than 1.6 million people around the world suffer from this disease. Every year, about 550,000 new cases and 200,000 deaths from this cancer occur. Treatment depends on the stage of the malignant process. Find out more about bladder cancer treatment abroad.
Bladder tumour
Bladder tumours are more common in men. The disease develops at the age of 65 years and older. 95% of patients are diagnosed with transitional cell cancer. These neoplasms develop from urothelial cells that line the inner bladder.
Urothelial cells are also lining the urinary tract, renal pelvis and urethra. People with bladder cancer have tumours in these areas. It is, therefore, necessary to check all urinary tract for cancer cells.
The remaining 5% of bladder cancers are flat cell tumours, adenocarcinomas, sarcomas, small cell cancer and secondary tumours in other parts of the body.
Tobacco is the main cause of bladder cancer. About half of all cases of this disease in men and a third in women are caused by smoking cigarettes. Passive smoking also increases the risk of developing cancer.
In 30% of patients, a tumour appears due to carcinogens. For example, hairdressers are at high risk due to the frequent use of resistant hair dyes.
Bladder cancer can be invasive or non-invasive. Non-invasive tumours spread within the mucous membrane of the organ, while invasive tumours spread beyond their original place of origin. The latter is difficult to treat and often relapse.
Methods of bladder cancer diagnostics
| Urine test | If there’s blood in the urine, a cytological test is prescribed. It allows you to know if there are tumour cells in your urine. It is also possible to perform an additional test, which includes rinsing the bladder and collecting fluid through a cystoscope or another small tube. |
| Computer tomography | CTs are used to measure tumour size and detect enlarged lymph nodes. Sometimes a special dye is injected into the patient before scanning. This provides a more accurate image detail. This dye can be injected into the patient’s vein or swallowed. |
| Cystoscopy | Cystoscopy is a key diagnostic procedure for bladder cancer. The examination is performed without anaesthesia. This procedure makes it possible to detect bladder tumours and determine whether a biopsy or surgery is necessary. |
| Magnetic Resonance Imaging | MRI uses magnetic fields rather than X-rays to produce detailed images of the body. The test determines the location, size and prevalence of the bladder tumour. |
| Biopsy | If cystoscopy shows abnormal tissue, a biopsy is performed. The procedure involves removing a small amount of tumour tissue for microscopic examination. |
| Ultrasound | The procedure helps to identify kidney dysfunction and ureteral blockage. This test does not require the use of a contrast agent. |
How does bladder cancer manifest itself?
Urine with blood is the most common symptom. But the patient does not always notice this. In 20% of cases, blood in urine can only be detected under a microscope.
Other symptoms of this pathology include pain during urination, frequent urination or the feeling of having to urinate without being able to do so. These signs are not specific. They also occur in prostate infection or cystitis.
Some rare forms of bladder cancer, such as carcinoma, produce mucin. It is released with the urine and causes it to thicken. People with advanced bladder cancer develop pelvic pain, leg swelling or pain in the side.
How fast does bladder cancer develop?
In 90% of cases, the disease progresses slowly. In the first stages, it can be treated without serious surgical intervention. Timely detection and regular check-ups are the keys to successful control of this pathology.
Urinary bladder tumor treatment abroad
Treatment of bladder cancer at stage 0
Bladder cancer at stage 0 is non-invasive papillary carcinoma and flat non-invasive carcinoma. Such tumours grow in the inner layer of the bladder shell and do not penetrate its wall. Transurethral resection is used for treatment. The operation is performed using the endoscopic technique.
To remove a bladder tumour through the urethra, a cystoscope or resectoscope is inserted. The bladder is filled with a sterile saline solution. The tumour is dissected using electrocoagulation or laser technology. It is possible to remove the neoplasm and coagulate vessels at the same time. Sometimes further treatment is not necessary. After surgery, a cystoscopy is performed every 3-6 months. This makes it possible to detect a recurrence of cancer in time.
For slowly growing non-invasive tumours, weekly intravesical chemotherapy is indicated. The procedure is performed a few weeks after the operation. If cancer returns, the treatment is repeated. Sometimes intravesical chemotherapy is repeated within a year. This prevents the recurrence of cancer.
Rapidly growing non-invasive tumours often relapse. Therefore, doctors use intravesical BCG therapy after surgery. The procedure is prescribed a few weeks after surgery and is done every week for a month or longer. This significantly reduces the risk of relapse.
Intravesical BCG therapy is more effective than intravesical chemotherapy for aggressive cancer. It stimulates the immune system and has antitumor activity. BCG vaccine is injected into the bladder at low pressure. The procedure is performed with an elastic urethral catheter. This drug should stay in the bladder for at least 2 hours.
Stage 0 bladder cancer rarely requires extensive surgery. A partial or complete cystectomy (bladder removal) is considered:
when a lot of surface cancer cells have been detected;
when cancer continues to spread despite treatment.
After the treatment of cancer of any stage, careful observation with cystoscopy is necessary approximately every 3 months. The prospects for people with stage 0 bladder cancer are good. These cancers are rarely invasive or life-threatening.
Treatment of stage 1 bladder cancer
During the first stage of bladder cancer, the tumour grows into the layer of connective tissue of the bladder. The neoplasm does not affect the muscular layer. At this stage, transurethral resection is the main treatment. Even if cancer has a low level of malignancy, a repeated operation is recommended after a few weeks. Then, doctors perform intravesical chemotherapy. If it is impossible to remove the entire tumour, they perform an intravesical BCG or cystectomy.
Oncologists use radiotherapy and chemotherapy if the patient can’t have full or partial bladder resection. The chances of remission after these methods are low.
Treatment of stage 2 bladder cancer
At stage 2, the tumour grows into the muscular layer of the bladder. Transurethral resection is the first stage of treatment.
If the tumour has germinated into the muscle, the primary treatment is radical cystectomy. It’s the full bladder removal, including the neighbouring lymph nodes. A partial cystectomy can be performed when the cancer is in only one area of the organ.
Chemotherapy is possible before the operation. If after the surgery cancer cells remain in lymph nodes, doctors prescribe radiation exposure.
Patients with other severe disorders can’t have cystectomy. In their case, doctors use TURBT, radiotherapy, chemotherapy or a combination of these methods.
Some patients undergo transurethral re-resection followed by radiation and chemotherapy. This preserves the bladder, but the risk of relapse after such treatment is higher than after a cystectomy.
Treatment of stage 3 bladder cancer
At stage 3, the tumours reach the external part of the organ. They grow into nearby tissues and/or lymph nodes. However, the cancerous cells do not spread to the remote parts of the body.
Transurethral resection shows how deep cancer has spread. Chemistry followed by a radical cystectomy (removal of the bladder and the surrounding lymph nodes) is a priority treatment. Partial cystectomies are rare.
Radiotherapy, immunotherapy and chemotherapy follow the surgery. This makes it possible to destroy residual cancer cells and reduce the risk of tumour recurrence.
For patients with single, small tumours, transurethral resection is combined with chemotherapy and radiotherapy. If a second cystoscopy does detect cancer, bladder removal surgery is unavoidable.
Treatment of stage 4 bladder cancer
At this stage, the tumour reaches the pelvic or abdominal wall. It extends to nearby lymph nodes and other organs. Stage 4 bladder cancer is very difficult to get rid of completely. Chemotherapy and radiotherapy are the first stages of treatment for metastatic cancer. This reduces the number of pathological foci and the primary tumour. Immunotherapy is also possible. Then a cystectomy is performed. In most cases, the entire bladder is removed.
In stage 4 oncology, even a radical cystectomy cannot remove entire cancer. Usually, the treatment is aimed at slowing down the growth and spread of the tumour.
Treatment of progressive or recurrent bladder cancer
If cancer continues to grow during treatment or relapses, the options for further treatment depend on:
where and how common the malignant process is;
what types of treatments have been used;
what is the patient’s general state of health;
whether the patient has a desire to continue treatment.
It is important to understand that the purpose of further therapy is to try to get rid of cancer, to slow down its growth or to relieve symptoms. For example, invasive tumours often return. They appear in the same place as before or in other parts of the bladder. These tumours are treated as primary neoplasms.
Immunotherapy is recommended for some non-invasive tumours after BCG therapy. If cancer returns, the bladder is removed.
Recurrent neoplasms, which are difficult to remove by surgery, are treated with:
chemotherapy;
immunotherapy;
target therapy;
radiotherapy.
Abroad, some patients may be recommended to take part in clinical trials of new treatment methods. This is not always the best option for the patient. However, clinical trials may benefit current cancer patients in the future.
Prognosis
According to the American Cancer Society, the 5-year survival rate of patients with bladder cancer is about 77%. Survival rates depend on the type and stage of oncology.
Where do you treat bladder cancer?
Liv Hospital Network (Turkey)
Souraski Medical Center (Ikhilov)
Teknon Clinic (Spain)
Urology Hospital Munich-Planegg (Germany)
Medical Center Memorial (Turkey)
Vienna Private Clinic (Austria)
Koç University Hospital (Turkey)
Soon Chun Hyang Hospital (South Korea)
Resume
95% of bladder cancer patients have a transitional cell type. These neoplasms develop in urothelial cells in the inner part of the organ. About 5% of cases are related to adenocarcinomas and flat cell cancer.
More than 50% of all oncological cases are caused by cigarette smoking.
The initial treatment of a bladder tumour is transurethral resection. During the operation, the neoplasm is removed through the urinary tract.
The 5-year survival rate of patients is about 77%.
To go to a foreign clinic for bladder cancer treatment, please contact our platform coordinators. We will help you choose a medical centre and organize your trip. Leave your application!
