Bladder Cancer in Men - Treatment

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We use four types of treatment for bladder cancer

Surgery

  • Transurethral resection (TUR) with fulguration: surgery in which a cystoscope (a thin lighted tube) is inserted into your bladder through the urethra. We then use a tool with a small wire loop on the end to remove the cancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
  • Radical cystectomy: surgery to remove the bladder and any lymph nodes and nearby organs that contain cancer. We prescribe this surgery when the bladder cancer invades the muscle wall, or when superficial cancer involves a large part of the bladder. We remove the prostate and the seminal vesicles. Sometimes when the cancer has spread outside the bladder and cannot be completely removed, we may remove only the bladder to reduce urinary symptoms caused by the cancer. When we must remove the bladder, we create another way for urine to leave the body.
  • Partial cystectomy: surgery to remove part of the bladder. We may do this surgery if you have a low-grade tumor that has invaded the wall of the bladder but is limited to one area of the bladder. Because we remove only a part of the bladder, you are able to urinate normally after recovering from this surgery. 
  • Urinary diversion: surgery to make a new way for the body to store and pass urine.

Our surgeons are experienced with robotic-assisted laparoscopy for cystectomy and urinary diversion. Dr. Schanne is one of a select few robotic surgeons in the region to offer robotic cystectomy with robotic ileal loop urinary diversion for bladder cancer. Robotic surgery has advantages over traditional open surgery that include less pain and faster recovery.

Even if we remove all the cancer that can be seen at the time of the surgery, you may be given chemotherapy to kill any cancer cells that are left. Treatment given after surgery to lower the risk that the cancer will come back is called adjuvant therapy.

Radiation therapy

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells or keep them from growing. The way radiation therapy is given depends on the type and stage of the cancer being treated. There are different types of radiation therapy:

  • External radiation therapy uses a machine outside the body to send radiation toward the cancer. Conformal radiation is a type of external radiation therapy that uses a computer to create a 3-dimensional picture of the tumor. The radiation beams are shaped to fit the tumor.
  • Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires or catheters that are placed directly into or near the cancer. 

Our freestanding Philadelphia Treatment Radiation Oncology Center offers advanced technology and academic research excellence in a uniquely comfortable and supportive environment.

Chemotherapy

Chemotherapy uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. You can take it by mouth or it can be injected into the bloodstream to reach cancer cells throughout your body (systemic chemotherapy), or be placed directly into a specific area to kill cancer cells (regional chemotherapy). The way chemotherapy is given depends on the type and stage of your cancer. Regional chemotherapy may be put into the bladder through a tube inserted into the urethra. We may use more than one anticancer drug.

Biologic or immunotherapy

Biologic or immunotherapy uses your immune system to fight cancer. Substances made by the body or in a laboratory are used to boost, direct or restore the body’s natural defenses against cancer. We may be able to treat your cancer with a biologic therapy called BCG (bacillus Calmette-Guérin), which is placed directly into the bladder using a catheter.

Clinical trials

A clinical trial is a research study to help improve current treatments or obtain information on new treatments for patients with cancer. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment. Some clinical trials are open only to patients who have not started treatment, while others are open to patients in active treatment or with recurrent cancer. There are also clinical trials that test new ways to reduce the side effects of cancer treatment.

Urologic Consultants is actively involved with clinical trials, and many of today’s standard treatments were investigated through our practice. We can talk with you about clinical trials that may be appropriate for you.

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