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Friday, June 6, 2008

Treatment for invasive bladder cancer

Surgery or radiotherapy

Surgery or radiotherapy may be used to treat invasive bladder cancers.

Surgery Some, or all, of the bladder may need to be removed. If the whole bladder is removed, you may need to have a new bladder made.

Radiotherapy may be used instead of surgery to try to avoid having to remove the bladder.

Some people may be offered a choice of having surgery or radiotherapy. This is because in some situations each treatment has the same chance of curing the cancer, but the benefits and disadvantages of the treatments are different.

Chemotherapy may be given into the vein to shrink the tumour before surgery or radiotherapy treatment. In some situations, the chemotherapy is given and the person is then monitored to see how well the treatment works, before deciding whether radiotherapy or surgery should be used.

Chemotherapy is also sometimes given into the vein after surgery, to reduce the risk of the tumour coming back.

Benefits and disadvantages of treatments

Surgery (total cystectomy)

  • Benefits:
    • The cancer may be completely cured
    • Does not involve radiation, so avoids the side effects of radiotherapy, e.g. diarrhoea and cystitis
    • There is no need for follow-up cystoscopies
  • Disadvantages:
    • Need 7–14 days in hospital for the operation and up to 3 months recovery time
    • Needs an anaesthetic
    • Need to wear a urostomy bag, learn to self-catheterise or learn to pass urine again
    • Tiredness after the operation
    • High risk of impotence in men and changes in sexual sensation in women.
    • Risk of death related to the surgery (2 in 100)

Radiotherapy

  • Benefits:
    • Does not involve an operation
    • No anaesthetic needed
    • After treatment it is possible to pass urine normally
  • Disadvantages:
    • Need to attend hospital each weekday for 4-7 weeks for treatment
    • Tiredness during and after treatment (may last some months)
    • Diarrhoea may occur and cystitis is common during treatment (approximately 7 in 10)
    • Possible long-term damage to bladder and rectum (2-8 in every 100)
    • Risk of impotence in men (up to 3 in 10)

Just can't wait card

Some treatments for bladder cancer can make you want to go to the toilet more often. You may also feel that you can’t wait when you do want to go. A card is available that you can show to staff in shops or pubs etc. The card allows you to use their loos, without them asking awkward questions. You can get the cards from Incontact.

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