Bladder Cancer
Bladder cancer can strike any person of any gender at any age, but is most common in people in their 50’s-70’s who have had some exposure to tobacco. In general, bladder cancer comes in two varieties. The most common type of bladder cancer is considered "superficial." Superficial bladder cancer is generally not life threatening and generally does not spread to other areas of the body. This type of bladder cancer, however, is prone to re-occur. Even when the tumor has been removed, there is a greater than 50% chance it will recur somewhere else in the bladder. In general, the treatment for superficial bladder cancer is looking inside the bladder with a small scope and removing the tumors by using tools that pass through this scope. There is no need for an incision through the skin for superficial bladder cancer. If superficial bladder cancers are large, multiple, or recur frequently, treatments are placed into the bladder to help prevent recurrences.
The other type of bladder cancer is called "invasive." This cancer is represents a serious condition, as patients with invasive bladder cancer who are not treated have a mean survival of only 9 months. In general, the earlier a patient with invasive bladder cancer has the bladder removed, the more likely he or she will have a good outcome. For the best survival, this cancer should not be treated with anything besides removal of the bladder. Radiation is being investigated, but preliminary data show it is not as effective as surgery. Chemotherapy, if necessary, can be given before or after surgery.
Bladder Cancer Treatment: Radical Cystectomy
The procedure to remove the bladder is referred to as "radical cystectomy." The reason it is referred to as radical is because it implies removing the bladder, and any other adjacent structures where the bladder cancer may have spread. This includes surrounding lymph nodes, occasionally the urethra, the prostate in males, and a portion of the vagina (plus or minus the uterus) in females. Although this sounds like a lot, control of the cancer is of the utmost importance in bladder cancer, which can be deadly if not controlled properly at the time of initial diagnosis. Cystectomy in the 21 st century is a safe, effective procedure with many ways of dealing with the urinary system after bladder removal. Most patients opt for the creation for a new bladder using bowel once the bladder is removed, but other systems of draining the urine (a bag to the skin or new bladder hooked up to the skin that is catheterized to release urine) do exist.