Treating Bladder Cancer

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Treating Bladder Cancer

If you've been diagnosed with bladder cancer, you'll likely need more tests so your doctors can learn more about your cancer. Your treatment team will then discuss your options with you. It's important to weigh the benefits of each treatment option against the possible risks and side effects.

How is bladder cancer treated?

Depending on the stage of the cancer and other factors, treatment options for people with bladder cancer can include:

q Bladder Cancer Surgery q Intravesical Therapy for Bladder Cancer q Chemotherapy for Bladder Cancer q Radiation Therapy for Bladder Cancer q Immunotherapy for Bladder Cancer q Targeted Therapy Drugs for Bladder Cancer

Common treatment approaches

Surgery, alone or with other treatments, is used to treat most bladder cancers.

Early-stage bladder tumors can often be removed. But a major concern in people with early-stage bladder cancer is that new cancers often form in other parts of the bladder over time. Removing the entire bladder (with a radical cystectomy) is one way to lower the risk of the cancer coming back, but it causes major side effects. If the entire bladder is not removed, other treatments may be used to try to lower the risk of new cancers. Whether or not other treatments are given, close follow-up is needed to watch for signs of new cancers in the bladder.

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Surgery is also often part of the treatment for more advanced bladder cancers, although other treatments are typically used as well, sometimes even before surgery.

q Treatment of Bladder Cancer, Based on the Stage and Other Factors

Who treats bladder cancer?

Based on your treatment options, you might have different types of doctors on your treatment team. This might include:

q Urologist: A doctor who specializes in treating diseases and conditions of the urinary system and male reproductive system

q Radiation oncologist: A doctor who treats cancer with radiation therapy q Medical oncologist: A doctor who treat cancer with medicines such as

chemotherapy, immunotherapy, and targeted therapy

You might have many other specialists on your treatment team as well, including physician assistants (PAs), nurse practitioners (NPs), nurses, nutrition specialists, pharmacists, social workers, and other health professionals.

q Health Professionals Associated with Cancer Care

Making treatment decisions

It's important to discuss all of your treatment options, including goals and possible side effects, with your doctors to help make the decision that best fits your needs. Some important things to consider include:

q Your age and overall health q The stage and grade of your cancer q The likelihood that treatment will cure your cancer or help in some other way q Your feelings about the possible side effects from treatment

You may feel that you need to decide quickly, but it's important to give yourself time to absorb the information you have just learned. It's also very important to ask questions if there is anything you're not sure about.

It is often a good idea to seek a second opinion. A second opinion can give you more information and help you feel more confident about the treatment plan you choose.

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q Questions to Ask About Bladder Cancer q Seeking a Second Opinion

Thinking about taking part in a clinical trial

Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-ofthe art cancer treatment. In some cases they may be the only way to get access to newer treatments. They are also the best way for doctors to learn better methods to treat cancer. Still, they're not right for everyone.

If you would like to learn more about clinical trials that might be right for you, start by asking your doctor if your clinic or hospital conducts clinical trials.

q Clinical Trials

Considering complementary and alternative methods

You may hear about alternative or complementary methods that your doctor hasn't mentioned to treat your cancer or relieve symptoms. These methods can include vitamins, herbs, and special diets, or other methods such as acupuncture or massage, to name a few.

Complementary methods refer to treatments that are used along with your regular medical care. Alternative treatments are used instead of standard medical treatment. Although some of these methods might be helpful in relieving symptoms or helping you feel better, many have not been proven to work. Some might even be harmful.

Be sure to talk to your cancer care team about any method you are thinking about using. They can help you learn what is known (or not known) about the method, which can help you make an informed decision.

q Complementary and Integrative Medicine

Help getting through cancer treatment

People with cancer need support and information, no matter what stage of illness they may be in. Knowing all of your options and finding the resources you need will help you make informed decisions about your care.

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Whether you are thinking about treatment, getting treatment, or not being treated at all, you can still get supportive care to help with pain or other symptoms. Communicating with your cancer care team is important so you understand your diagnosis, what treatment is recommended, and ways to maintain or improve your quality of life.

Different types of programs and support services may be helpful, and they can be an important part of your care. These might include nursing or social work services, financial aid, nutritional advice, rehab, or spiritual help.

The American Cancer Society also has programs and services to help you get through treatment. Options include rides to treatment, lodging, and more. Call us at 1-800-2272345 and speak with one of our caring, trained specialists.

q Palliative Care q Programs & Services

Choosing to stop treatment or choosing no treatment at all

For some people, when treatments have been tried and are no longer controlling the cancer, it could be time to weigh the benefits and risks of continuing to try new treatments. Whether or not you continue treatment, there are still things you can do to help maintain or improve your quality of life.

Some people, especially if the cancer is advanced, might not want to be treated at all. There are many reasons you might decide not to get cancer treatment, but it's important to talk to your doctors before you make that decision. Remember that even if you choose not to treat the cancer, you can still get supportive care to help with pain or other symptoms.

q If Cancer Treatments Stop Working

The treatment information given here is not official policy of the American Cancer Society and is not intended as medical advice to replace the expertise and judgment of your cancer care team. It is intended to help you and your family make informed decisions, together with your doctor. Your doctor may have reasons for suggesting a treatment plan different from these general treatment options. Don't hesitate to ask your cancer care team any questions you may have about your treatment options.

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Bladder Cancer Surgery

Surgery is part of the treatment for most bladder cancers. Different types of surgery might be done, depending on the stage1 (extent) of the cancer, as well as a person's overall health and preferences.

q Transurethral resection of bladder tumor (TURBT) q Cystectomy q More information about Surgery

Transurethral resection of bladder tumor (TURBT)

During a transurethral resection of bladder tumor (TURBT), or transurethral resection (TUR), the doctor removes any tumors from the inner lining of the bladder, as well as some of the muscle layer of the bladder wall around the tumors.

TURBT is often used to find out if someone has bladder cancer and, if so, whether the cancer has grown into (invaded) the muscle layer.

TURBT is also the most common treatment for superficial bladder cancer, also known as non-muscle invasive bladder cancer (NMIBC). Most people with bladder cancer have NMIBC when they're first diagnosed, so this is usually their first treatment. Sometimes, a second, more extensive TURBT is done, usually a few weeks later, to help ensure that all the cancer has been removed. The goal is to take out the cancer cells and nearby tissues down to the muscle layer of the bladder wall.

How a TURBT is done

This procedure is done using a long, thin instrument put in through your urethra, so there's no cutting into the skin. You'll get either general anesthesia, which puts you into a deep sleep so you don't feel pain, or regional anesthesia, which numbs the lower part of your body .

A type of thin, rigid cystoscope called a resectoscope is put into your bladder through your urethra. The resectoscope has a small telescope the doctor can see through and a wire loop at the end that's used to remove any abnormal tissues or tumors. The removed tissue is sent to a lab for testing2.

After the tumor is removed, more steps may be taken to try to ensure that there is no more cancer in the bladder wall. For instance, the tissue in the area where the tumor

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