Bladder Cancer
The types of bladder cancer are: non-muscle-invasive bladder cancer (NMIBC) or muscle-invasive bladder cancer (MIBC), and most newly diagnosed patients have NMIBC (70% to 85%). This is an important distinction, as NMIBC allows the patient bladder-sparing options for the treatment of bladder tumors. To help clarify between the two categories of bladder cancer, it is important to review the three histologic layers of the bladder.
The first layer of the bladder is the urothelium, the second layer is the lamina propria (suburethral loose connective tissue), and the third layer is the muscularis propria. Cancers that affect the urothelium or lamina propria are NMIBC and those that invade the muscularis propria are MIBC.
Almost 80% of patients with bladder cancer present with non-muscle invasive disease at the time of diagnosis. Characteristics of this cancer are high recurrence rates after transurethral resection and high risk of progression to muscle-invasive disease.
Signs and Symptoms
Bladder cancer can often be detected early as the signs and symptoms are more obvious than in other types of cancer.
- Blood in urine
- Changes in urinary habits or symptoms of irritation
Symptoms of advanced bladder cancer:
- Not being able to urinate
- Pain on one side of the lower back (bladder pain)
- Loss of appetite and weight loss.
- Tiredness or weakness.
- Swelling in the feet
- Bone pain
If you notice any of the symptoms, see a health professional.
Treatments
Although intravesical chemotherapy and immunotherapy can significantly decrease recurrence and progression rates, they still represent the main challenge in this field and more effective therapies are needed.
Particularly challenging is the bladder cancer treatment of patients with high-risk tumors according to the European Organization for Research and Treatment of Cancer (EORTC) scoring system.
Many approaches have been used to enhance the antitumor effects of intravesical chemotherapy. Several studies have shown promising results combining intravesical mitomycin-C (MMC) with hyperthermia (intravesical thermochemotherapy treatment). Bladder wall hyperthermia has been shown to enhance the penetration of MMC into the deep bladder wall and may offer anticancer advantages over chemotherapy instillation alone.
Thermal ablation is primarily used for the treatment of small, unresectable tumors, for patients who have been resistant to chemo/radiotherapy treatment or who are NOT surgical candidates, such as:
- Obese patients
- Patients with chronic diseases (diabetes, hypertension, cirrhosis, etc.)
- Patients who cannot have general anesthesia
- Patients with severe heart disease
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