BLADDER CANCER TREATMENT :INTRAVESICAL THERAPY

INTRAVESICAL  THERAPY

intravesical  therapy is basically  used to treat the bladder cancer with the help of  drug . in intravesical    therapy drugs are directly inserted into the bladder with the help of  a catheter.  

 the benefit of  intravesical  therapy is that the drug is directly  insert into the bladder  instead of mouthstream. because  during the mouth streaming the drug can affect the other part of the body.intravesical therapy is mainly used to treat the early stage or non-invasive  bladder cancer.

TYPES OF INTRAVESICAL  THERAPY

1. intravenous chemotherapy

2. immunotherapy

 INTRAVENOUS CHEMOTHERAPY

intravenous chemotherapy  is the way to deactivate the cancer cells  by using drugs like mitomycin, valrubicin , docetaxel , gemcitabine , thiotepa. in intravenous chemotherapy mitomycin or other  drugs are injected directly into the bladder with the help of catheter. intravenous chemotherapy is only used to treat the normal type of cancer (non-invasive cancer).but there is systemic chemotherapy is also use for standard treatment of bladder cancer.

                                                                A  combination of the drugs used to treat the standard type of  bladder cancer. MVAC  is the cancer medication which is the combination of the 4 different types of drugs.methotrexate, vinblastine (Velban, Velsar), and cisplatin (Platinol)  ,doxorubicin. the people who suffering from the metastatic disease (disease which is due to bladder cancer) are thrated by MVAC.MVAC can extend life and cure patients.

INTRAVESICAL MITOMYCIN SIDE EFFECTS 

 1. irritation of the bladder.

 2. painful urination.

 3. skin rash on the palm of the hand, sole of the feet, genitals

 4. frequently urination.

 

IMMUNOTHERAPY (bladder cancer treatment with tuberculosis bacteria)

immunotherapy is  basically used to increase the body's immune power to  protect the body from the disease like  bladder cancer. immunotherapy is also known as biological therapy. the standard drug that is used for this therapy is named as BCG(bacillus Calmette-Guerin ). BCG is a type of drug which also causes tubercolusis(TB) . BCG is directly put into the bladder with the help of  catheter.  the main function of the BCG drug is to activate the body's system immune cells.these immune cells 

destroy the tumor spread inside the bladder.

 

BCG BACTERIA SIDE EFFECTS

1. fever 

2. fatigue

3. it also causes of burning feeling into the bladder.

 

BLADDER CANCER TREATMENT : surgery

TREATMENT FOR BLADDER CANCER

bladder cancer is very risky so it is more important to treat the bladder cancer.there are many ways to treat the bladder cancer like surgery, chemotherapy , radiation therapy etc......

                      

SURGERY 

surgery is mostly used to treat the early-stage cancer because in this condition tumor does not spread  through the bladder wall and also other parts of the body. so it is  more easy to  treat this type of cancer by surgery.

depending upon the stage of the cancer disease following procedure is recommend by the doctors.

  TURBT FOR BLADDER CANCER

 

TURBT for bladder cancer is also known as transurethral resection (TUR). this procedure is used to treat the early stage or superficial bladder cancer. AS we know that in superficial bladder cancer the cancer tumor does not spread through the bladder wall or other part of the body.To perform this procedure a instrument is put up through the urethra. the instrument is named as resectoscope.their is no need to cut the abdomen.at the end of the resectoscope a loop is provided to remove the tumor  or abnormal tissues.
                    after the whole process of the surgery it is also require to ensure that the tumor of the cancer are rootly destroyed. TO remove the all tumor of the cancer rootly ,a high-energy laser may be used to burn the root of the tumor. A cytoscope is used to view inside of the bladder.

SIDE EFFECTS

when the treatment is done then after  few days cancer again comes and again it is require to treat it by same procedure but due to the number of treatments the bladder become scarred  and it has no capacity to store much urine in it so due to this reason some people feel painful and frequent urination.  

CYSTECTOMY SURGERY

this type of surgery process is used to treat the invasive type of bladder cancer.
there are two types of cystectomy surgery process 
1. partial cystectomy
2.radical cystectomy

PARTIAL CYSTECTOMY

 this is used when cancer is invaded over the muscle layer of the bladder wall.it has only small part of bladder have cancer tumor. in this type of bladder treatment surgery the tumors are removed along with the bladder wall without removal of whole bladder.Nearby lymph nodes are also removed and examined for cancer spread.

                this types of surgery has an advantage that their is no need of reconstructive surgery.but it has a disadvantage is that the treated bladder have no capacity to store the more urine which also affect the painful and frequent urination.

RADICAL CYSTECTOMY

 this type of surgery is used when the cancer is more serious than in the case of partial cystectomy. when the cancer is spread out through the muscle layer or also other parts of the body then it is require to remove the entire bladder also nearby nodes.

               for the male patient  the prostate and seminal vesicles are also removed. for female patient, the ovaries, fallopian tubes (tubes that connect the ovaries and uterus), the uterus (womb), cervix, and a small portion of the vagina are often removed along with the bladder.

              this type of procedure are done through a incision (cut) in the abdomen. their are number of cuts are done in the abdomen which are produced with the help of an instrument, has a small camera at the one end to view the pelvis.this type of process is known as laparoscopic or keyhole surgery. this surgery some time called the robotic cystectomy surgery because surgeon can do the  surgey by robotic arm .it takes less time to recovery due to the small incision. 

               

 

URINARY DIVERSION

in most of the cases it is required to remove the whole bladder because cancerious bladder has no capacity to hold or store the sufficient amount of urine.in that case doctors will create new way to pass the urine out of the body.doctors use a small part intestine to divert the urine outside of the body.

                   A urinary reservoir also provided by the surgeon .this reservoir made up of part of intestine.it gives the batter life to the patient.surgeon can also able to connect a pouch to the urethra which is also known as neobladder.   

                   A neobladder is a type of bladder which is made up of intestine.the ureters are connected to the neobladder.

  SIDE EFFECT OF THE CYSTECTOMY

1.their is a risk of infection due to the surgery.

2. the main side effect of this surgery is bleeding.

3.patient feels discomfort after surgery.

4.neobladder is not very comfort to the patient because some time patient is unable to remove the whole urine from the neobladder.

5.their is also loss of sexual feeling both men and women because of damage to nearby organs.

6. it also affect the urination.

7.blocking of the flow of urine.

8.urine may also be leak through the bladder due to surgery infection.       

 

TYPES OF CANCER : BLADDER CANCER

TYPES OF CANCER 

There are some of common types of cancer

1. bladder cancer

2.leukemia cancer

3.Asbestos causes lung cancer

4.lymphoma cancer

5. breast cancer

6.renal cell cancer Or  kidney cancer

7.pancreatic cancer

8. skin cancer

9.thyroid cancer

10.Uterine cancer

11. colorectal cancer

12.prostate cancer

TYPE OF CANCER : BLADDER CANCER

before discuss about the cancer first i want to make you very familiar with the bladder

WHAT IS BLADDER

bladder is the type of flexible hollow bag. it is situated in the pelvis (it is funnel type structure at the outlet of the kidney). the main function of the bladder is to store the urine which is coming out from the kidney.the shape of the bladder is adjusted accordingly. when the bladder is empty then the shape of the bladder is like a pear.As we know that the main function of the kidney is to filter the blood and produce the urine. urine is then further pass through the tubes called ureters to the bladder.

        

LAYERS OF THE BLADDER WALL

1.flat layer

2.muscle layer

3.lamina propria or connective tissue

4.urothelium or transitional cell layer

  

BLADDER CANCER 

bladder cancer is the type of cancer in which the painless blood is involved in the urine and also frequent or painful urination is takes place.according to the layers of the bladder wall their are some types of bladder cancer

1.urothelial carcinoma (transitional cells carcinoma)

  + Non muscle invasive (superficial) bladder cancer

  + invasive bladder cancer

2. squamous cell bladder cancer.

3. adenocarcinoma bladder cancer

1.UROTHELIAL CARCINOMA 

 this cancer is also known as transitional cell carcinoma.transitional cells are shown in figure above. according to the figure these cells are inner layer of the bladder. the development of the cancer is started from here.this is most common  type of cancer 90 out of 100 cases are of it in uk. urothelial cells or transitional cells  can expand or contract accordingly. these cells are directly come into contact with the waste product of urine stored in the  bladder. 

•        Non muscle invasive (superficial) bladder cancer

  this is the early stage urothelial cell bladder cancer.this cancer does not spread deeper into the layer of the bladder. this can easily be treated by the doctor.
  
  

    

•     invasive bladder cancer

  this is the most hazardious type of cancer . it may spread inside the layer of the bladder(muscle layer ) and also spread out through the layer of the bladder wall.this type of bladder cancer can not be easily treated. it is more expensive than the superficial bladder cancer.  

2. squamous cell bladder cancer

squamous cell bladder cancer is grown in the flat cells of the bladder.this is rare type type of cancer which is develop 5% out of 100% population of the uk. this is most wide in developing countries  where a worm infection is called bilhazia or schistosomiasis is widespread. 

adenocarcinoma bladder cancer

 this is the cancer that develop from the cells of the lining  of the bladder that produce mucus(the fluid from the nose ,All the moist, skin like, tissues lining the body have some gland cells that produce mucus.).this is very rare type of bladder cancer about 1 - 2% out of 100% population of the uk.