surgery

Surgery is by far the most commonly used to treat bladder cancer. It is used for all types and stages of bladder cancer. Several types of surgery are used. What is needed in any situation depends largely on the stage of cancer. Many surgical procedures are available today that has not been widely accepted. Can be difficult to perform, and results are best achieved by those who run many of these operations per year. Types of surgery include the following:

Transurethral resection with fulguration: In this operation, the instrument (resectoscope) is inserted through the urethra and bladder. A thin wire loop by instrument, then remove the tumor by cutting or burning is an electrical current (shock). This usually happens for the initial diagnosis of bladder cancer and the treatment of stage Ta and T1 tumors. Often, after transurethral resection, treatment is given (for example, intravesical therapy) to help treat cancer of the bladder.

Radical cystectomy: In this operation, the entire bladder is removed and nearby lymph nodes and other structures that may contain cancer. This is usually done for cancer that has invaded at least the muscular layer of the wall of the bladder or the most superficial cancers, which covers much of the bladder, or have not responded to more conservative treatments. Occasionally, the bladder is removed to relieve severe urinary symptoms.

Partial cystectomy or partial: In this operation is part of the bladder removed. This is usually done for solitary low-grade tumors that invaded the bladder wall, but it is limited to a small area of ​​the bladder.

As its name suggests, radical cystectomy is major surgery. Not only the entire bladder, but also other structures are removed.

For men, the prostate and seminal vesicles (small tubes that carry sperm to the prostate penis) is removed. This will stop the production of sperm and may affect sexual function. However, nerve sparing technique can save you an erection in some men after surgery.

In women, the uterus (womb), ovaries, and part of the vagina are removed. It ceases to menstruation, and you can not get pregnant. The transaction may also interfere with sexual function and urinary.

Removal of the bladder is complicated because it requires the creation of a new way for urine to leave the body. This is called urinary diversion. Some people use a bag outside the body to collect urine. Others have a small pocket inside the body to collect urine. The bag is usually performed by a surgeon for a small part of the intestine. Most patients (men and women) are candidates for reconstruction of the continent urinary tract so that voluntary (voluntary) voiding can be restored.

Surgeons and medical oncologists work together to find ways to avoid radical cystectomy. A combination of chemotherapy and radiation can cause some patients to preserve their bladder, but the toxicity of treatment is important, with many patients requiring surgery to remove the bladder at a later date.

If your urologist recommends surgery as a treatment for bladder cancer, make sure you understand the type of operation you want, and what effect the surgery will have on your life.

Even if the surgeon believes that all the cancer removed by surgery, many people who undergo surgery for bladder cancer receive chemotherapy after surgery. This "adjuvant" chemotherapy is designed to eliminate the remaining cancer cells after surgery and increase the chances of recovery.

Some patients may receive chemotherapy before radical cystectomy. This is called "neoadjuvant" chemotherapy and can be recommended by the surgeon and oncologist. Neoadjuvant chemotherapy can kill microscopic cancer cells have spread to other parts of the body and can also shrink the tumor in the bladder before surgery.

If you decide that you need chemotherapy, radical cystectomy with our own, the choice of adjuvant or neoadjuvant chemotherapy, the decision is made on a case by case basis with each patient case, the medical oncology, and urologic oncologist.