Bladder cancer is the commonest cancer seen in amongst the urological cancers. Smoking, tobacco, recurrent stone disease, recurrent urinary tract infections, aging are the main etiological factors for the developing these cancers. Hematuria with clots is the commonest presentation.
Bladder cancer is of mainly two types – non muscle invasive (NMIBC) or muscle invasive (MIBC). Cysoscopic assessment (Bladder tumor resection through endoscopic route) is the first step to decide which type they belong to. In case of NMIBC, we completely remove the tumor endoscopically and treat them with intravesical instillation of BCG to prevent further recurrences.
The 10 year survival in case of NMIBC is around 75%. Those who have muscle invasion (MIBC), bladder needs to be removed (Radical cystectomy) and urinary diversion is performed. Nowadays rather than doing the urinary diversion, we create a new bladder from small intestine and join it to the native urethra, so that patient can void urine naturally without the need of bag of the tummy. This is a major revolution in the treatment of bladder cancer. This has given a new lease of life to the patients of bladder cancer. The 10 year survival of MIBC is around 55-60%. Recently use of cisplatin based chemotherapy in high risk and lymph node positive patients has shown better outcomes and survival benefit.