Invasive Bladder Cancer

Invasive bladder cancer is a condition when cancer spread throughout your bladder or even further into nearby organs. 

Though it is a more devastating type of bladder cancer, there are two types of treatments that can be helpful. These treatments are radiotherapy and chemotherapy.

Removal of bladder

The removal of bladder along with the prostate in men, cervix in women, portions of the urethra is called radical cystectomy (RC). It’s major surgery and takes at least six hours, but it’s a good opportunity to wipe out cancer forever. Nowadays robotic surgery has been introduced but there is no evidence of whether it is successful or not. You will feel very weak after the surgery, it's normal. You will be discharged from the hospital after 10 days following the surgery.

RC has a major disadvantage in that you will lose your bladder permanently. An alternation will be created that will help you to pass out your urine. This process is called urine diversion. There is a total of three types of urine diversion; you can choose one of them. These are:

• A urostomy

• Bladder reconstruction

• Continent urinary diversion

A urostomy is the most common and most successful urinary diversion in medical history. Typically, this hole is called a stoma. During the surgery, a hole will be created in your abdomen. Then a small part of the ileum (small bowel)will be removed and the surgeon will connect it with the ureters. And then he connects the other terminal of the bowel to the abdomen, which enables you to pass out the pee through the stoma.

You will be habitual to urinate in this way and the urine will be collected outside the body in a bag or pouch called an Ostomy bag. You can empty that bag when it gets full. To avoid inconvenience at night you can use a night Ostomy bag that can hold a lot more urine.

Your Ostomy nurse can guide you in a very well manner. He or she can help you to choose the best Ostomy products for you. Initially, you will feel awkward and embarrassed using an Ostomy bag all the time, but with time you will learn to live with it.

Neobladder (Bladder reconstruction)

There are some situations in which a new bladder can be constructed, termed as a neobladder. In this procedure, a portion of the bowel is removed and is rebuilt into a balloon shape sack. This sack is then connected with the urethra at one terminal and the other terminal is connected with the ureters. This procedure does not work for everyone but it might be given as an option.

After the surgery, you will learn how to relax your pelvic muscles and tighten your abdominal muscles at the same time to empty your neobladder. This seems very difficult but doesn’t worry you will learn it shortly. There are no nerves present in the neobladder that’s why you don’t feel any urge to urinate. According to some people, they feel pressure and weight, and others feel like they need to pass out air. Your body will give indications when you need to pee.

As you know there is no nerve functioning, almost 25 % of people experience incontinence in the early stages, especially during the night when they are asleep. You can set times for urinating during the day and before going to bed. You should use incontinence pants until you can control your new bladder.

Continent urinary diversion

A continent diversion is the same as a urostomy except for an external Ostomy appliance. Despite that, the surgeon creates an internal pouch using your intestines that is used for the collection of the urine. This is very rare in the UK, less than five percentage patients undergo this procedure.

The surgeon connects one end of the internal pouch with the ureters and the other with the abdominal walls. A catheter is used for emptying the pouch. A catheter is inserted into the stoma to drain out urine. Typically, it is advised to empty the pouch four to five times throughout the day.

Sexual issues following the surgery

Erectile dysfunction is observed in men after the surgery. It is a condition when they lose the capability to acquire or maintain an erection. You can ask your surgeon he will refer you to any GP. This is not a big issue there are a lot of medicines and injections that can help you to overcome this issue shortly. There are many treatments; you just need to find the best one for you.

In women, the vagina gets narrow and shortens after the surgery. This can make it hard for them to have normal sex. There are two basic treatments. Either you can use a cream for lubrication that has natural hormones stimulating power or you can use a vaginal dilator. Don’t hesitate to ask for help.

Radiotherapy

Radiotherapy is also used for treating invasive bladder cancer. In this method, radiations are used for destroying cancerous or malignant cells. Radiotherapy for treating bladder cancer is done in three ways.

It can be a primary option for the cure of bladder cancer, it is the best option if you are so weak and your condition is very poor.

It is also used for controlling the symptoms in some situations such as palliative treatment, it is an incurable disease.

Radiotherapy session continues almost 5 days a week and for four to seven weeks. Each session is about ten to fifteen minutes long. Besides killing cancer cells it can also destroy healthy cells. It has other side effects such as:

• Diarrhea

• Inflammation in the bladder, leading to difficulty in urinating

• Vaginal shortening in women and erectile dysfunction in men

• Infertility

These side effects may lessen after a few weeks of radiotherapy, except infertility.

Sexual issues after radiotherapy

Radiotherapy can cause intimacy problems for both men and women.

Some men complain about weak erections or erectile dysfunction. And women experience vaginal dryness. It can be treated by using lubricants and medical gels.

Chemotherapy for invasive bladder cancer

Chemotherapy can be used for the treatment of invasive bladder cancer in three ways:

• It can be used before radiotherapy for shrinking the size of any present tumor

• It can be combined with radiotherapy, termed chemoradiation

• To slow down the irredeemable cancer

In chemotherapy, many chemo medicines are introduced in the body through veins. It continues for at least 28 days and lasts according to your stage and condition.

Side effects of direct chemotherapy are:

• Feeling ill

• Hair loss

• Loss of appetite

• Tiredness

These signs must diminish after the treatment. Chemotherapy can also weaken your immune system and you are an easy target for infections to attack. You should call your doctor if you experience high temperature, red skin, and a non-stop cough.

Living and persisting invasive bladder cancer

Despite the all treatments, there are a lot of chances for cancer cells to come back and attack any other part of your body. For example: lungs, abdomen, and pelvis. That’s why you need to keep a regular follow-up. Your body will be scanned every three to six months.

These follow-ups are very important to diagnose cancer at an early stage.