6 Dec 2023
Revolutionizing Recovery: Advances in Bladder Cancer Treatment
Bladder cancer, a condition affecting millions globally, requires a nuanced approach to treatment. However, the landscape for bladder cancer treatment worldwide has become dynamic and continually evolving, with healthcare systems and approaches varying across regions. The global effort to combat bladder cancer today involves a combination of conventional treatments and cutting-edge innovations.
In this article:
Conventional Bladder Cancer Treatment Modalities
The approach to treating bladder cancer depends on the specific characteristics and extent of the cancer. This ensures a targeted and effective intervention. The treatment modalities for bladder cancer are outlined below.
Transurethral bladder tumor resection (TURBT)
Transurethral bladder tumor resection (TURBT) is a multifaceted procedure employed for both diagnostic and staging purposes, along with therapeutic interventions. In this method, a cystoscope is skillfully inserted by the surgeon through the urethra into the bladder to excise the tumor.
Radical cystectomy and lymph node dissection
A radical cystectomy, coupled with lymph node dissection, is a comprehensive surgical approach that involves the complete removal of the bladder. This may include the prostate and a segment of the urethra in male patients or the uterus, fallopian tubes, ovaries, and a portion of the vagina in female patients. The procedure is an extensive intervention designed to address the advanced stages of bladder cancer.
In the case of all patients, the removal of pelvic lymph nodes, known as a pelvic lymph node dissection, is a standard procedure. For enhanced precision in detecting cancer that may have disseminated to the lymph nodes, an extended pelvic lymph node dissection is deemed the most accurate method. This meticulous approach aims to thoroughly investigate the presence of cancer beyond the bladder, aiding in a comprehensive assessment of the disease's extent.
BCG treatment for bladder cancer
BCG, short for Bacillus Calmette-Guérin, stands as an intravesical immunotherapy drug integral to the treatment of bladder cancer. This intravesical treatment involves the instillation of drugs directly into the bladder, effectively flushing it with agents designed to eliminate residual cancer cells post-surgery. This proactive approach significantly diminishes the likelihood of cancer recurrence.
It plays an important role in urothelial cancer treatment, a specific type of bladder cancer. This type of therapy includes avelumab, nivolumab, and pembrolizumab. The mechanism of action of these drugs is multifaceted, operating on various fronts to effectively eliminate cancer cells.
This type of therapy includes two treatment approaches: Systemic Chemotherapy and Intravesical Chemotherapy. In systemic chemotherapy for bladder cancer, drugs like carboplatin, cisplatin, doxorubicin, fluorouracil (5-FU), gemcitabine, methotrexate, mitomycin, paclitaxel, and vinblastine are injected into a vein. This allows the drugs to circulate in the bloodstream, reaching cancer cells in Intravesical Chemotherapy. Intravesical chemotherapy involves introducing drugs directly into the bladder. This targeted approach flushes the bladder with drugs to eradicate remaining cancer cells post-surgery, thereby reducing the risk of cancer recurrence.