Rosalyn Carson-DeWitt, MD
Surgery is a common treatment for bladder cancer. The goal is to remove the tumor(s) and preserve as much bladder function as possible. The type of surgery depends on the stage of the cancer. The impact on bladder function depends on the stage, the type of surgery needed, and overall health.
This type of surgery is often used to treat forms of bladder cancer that have not invaded the muscle tissue. A transurethral resection (TUR) is done with a cystoscope. During cystoscopy, a tube is passed through the urethra and into the bladder. The scope allows the doctor to see inside the bladder and pass instruments through the tube. The tumor is removed with a wire loop, chemicals, or by laser. Tissue samples will also be taken so they can be examined under a microscope.
TUR can cure cancer in those with very superficial, early stage bladder cancer. For others, it may be used in combination with
chemo- or radiation
It is not unusual for bladder cancer to return even if all the tumors are removed. This procedure may need to be repeated multiple times.
If the cancer has spread beyond superficial surfaces of the bladder and into the muscle, a cystectomy may be needed. A cystectomy is the removal of part or all of the bladder. Early stage bladder cancer may only require a partial cystectomy which can leave a smaller but still functioning bladder.
This surgery removes tissue of the bladder through an incision in the abdomen. The doctor may also take out nearby lymph nodes to see if cancer has spread.
A radical cystectomy may be needed for more advanced cancers. A radical cystectomy involves removing the tumor, the entire bladder, and surrounding lymph nodes. In men, the prostate gland is also removed. In women, the ovaries, fallopian tubes, the uterus, and a small portion of the vagina are often also removed
along with the bladder. Cystectomy may provide a cure for some types of bladder cancer, but some may need additional therapies such as chemotherapy.
Since the bladder is removed, there is no way to store or eliminate urine from the body. A urinary diversion will be created to allow the urine to leave the body. Options include:
Bladder cancer. American Cancer Society website. Available at:
http://www.cancer.org/acs/groups/cid/documents/webcontent/003085-pdf.pdf. Accessed June 29, 2015.
Bladder cancer. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115106/Bladder-cancer. Updated May 6, 2016. Accessed October 6, 2016.
Cystectomy. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/Ce-Fi/Cystectomy.html. Accessed June 29, 2015.
Last reviewed June 2015 by Mohei Abouzied, MD
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