Bladder cancer: A patient's guide to the treatment options

In his latest online article, esteemed consultant urological surgeon Mr Dimitrios Moschonas delves into the intricacies of bladder cancer. He explains the diagnosis, the treatments options, and the latest developments in bladder cancer treatment.

How quickly does bladder cancer treatment start after a diagnosis?

Let's begin by discussing the most common symptoms of bladder cancer: blood in the urine, recurrent urinary infections, frequency of urination, urgency, or pain on passing urine, even when no infection is found in urine tests by your doctor. Therefore, it's crucial that if you experience any of these symptoms, you promptly see your doctor. They will organise some tests and then refer you to a specialist for further investigations.

This specialist, usually from a urology team, which may involve either a doctor or a specialist nurse, will arrange a couple of tests. These include a CT scan, a detailed scan of the urinary system that detects any abnormalities in the kidneys or bladder, as well as a flexible cystoscopy. This procedure allows for a telescopic examination of your bladder, revealing any abnormal growth in the lining of the urinary system.

As soon as a provisional diagnosis is made through these tests, treatment commences promptly. Time is of the essence in managing bladder cancer, with the principal treatment being transurethral resection of bladder tumor (TURBT). This is typically the first treatment most patients receive after a provisional diagnosis.

TURBT is a minor operation performed with a telescope, removing the cancerous growth and sealing the tissue around it, providing necessary information to understand the extent of the cancer. In patients where the disease is caught in its early stages, TURBT might be the only necessary treatment.

How is the treatment for bladder cancer decided?

The treatment for bladder cancer is determined by factors such as the cell type, grade, and stage of the cancer. The cell type, often transitional cell in around 90% of cases, and the stage, indicating the extent of the cancer within the body, play critical roles in deciding the appropriate treatment. Bladder cancer can either be non-muscle invasive, affecting the bladder lining in approximately 80% of cases, or muscle-invasive, affecting around 20% of patients.

What is the most common treatment for bladder cancer?

The most common treatment for bladder cancer is transurethral resection of bladder tumour (TURBT), a diagnostic and treatment procedure to remove cancer from the bladder lining. This procedure is performed with a camera within the urethra and the bladder, conducted by a specialist surgeon to ensure complete removal.

Depending on the extent and aggressiveness of the tumour, radical surgery may be necessary. Treatment is typically occurs as a day case in the hospital, and patients may undergo post-surgery chemotherapy to prevent cancer recurrence or progression.

What is the latest treatment for bladder cancer?

Recent advancements in bladder cancer treatment include improvements in surgical techniques, visual detection technologies enhancing diagnostic capabilities, and minimally invasive robotic surgery coupled with enhanced recovery protocols. These advancements aim to improve patient experiences, minimise surgical stress, shorten hospital stays, and reduce complication rates, ultimately leading to better functional outcomes and improved cancer prognosis.

What is the survival rate of cancer of the bladder?

The survival rate of bladder cancer in the UK has significantly increased over the past 40 years. Survival rates depend on various factors, with approximately 75% of patients surviving for one year or more after diagnosis. Moreover, more than half of patients survive for four to five years or longer after diagnosis.

Early-stage diagnosis significantly improves survival rates, with more than nine in ten patients surviving for one year or more compared to around one in three patients diagnosed at a later stage.

Who treats bladder cancer?

Bladder cancer is treated by a multidisciplinary team of healthcare professionals, including specialist urologists, oncologists, radiologists, and pathologists. This team provides comprehensive care tailored to the individual patient, emphasising a patient-centred approach and shared decision-making.

High-quality care involves prompt diagnosis, timely delivery of curative treatments, and excellent patient support to maximise quality of life throughout the treatment process, acknowledging the life-changing nature of bladder cancer treatment.

Mr Dimitrios Moschonas is a renowned consultant urological surgeon based in Surrey and London. If you would like to book a consultation with Mr Moschonas, you can do so today via his Top Doctors profile.