• Understanding bladder cancer and your treatment
  • 1.What is bladder cancer?
  • 2.Diagnosing and treating non-muscle invasive(superficial) bladder cancer
  • 3.Your Mitomycin-C treatment
  • 4.What are the side effects?
  • 5.What else should I know?
  • 6.What happens next?
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  3. 2.Diagnosing and treating non-muscle invasive (superficial) bladder cancer

2 Diagnosing and treating non-muscle invasive (superficial) bladder cancer

Diagnosing

Specialist doctors, called urologists, diagnose bladder cancer. The doctors diagnose bladder cancer by reviewing your medical history, inspecting the bladder with a cystoscope and with diagnostic tests.
If your bladder cancer is diagnosed as non-muscle invasive (superficial), you will need an operation and additional treatment shown below.

Operation for non-muscle invasive bladder cancer

After a suspected bladder cancer is found, you’ll need an operation to remove the tumour. This will also help your doctor find out whether the tumour is malignant (cancerous) and what stage and grade it is. This type of operation is called a TransUrethral Resection of Bladder Tumour or TURBT.

A small tube-like instrument (resectoscope) will be inserted through your urethra (the tube you pass urine through) and into your bladder. The outside end of this is attached to a telescope and lightsource so that the surgeon can look inside your bladder. The surgeon will then guide a heated wire loop up through the other end of the instrument to cut away the tumour and seal (cauterise) the blood vessels from where the tissue has been removed.

You’re likely to have a temporary tube (catheter) in your urethra to drain urine from your bladder into a bag. Your urine may be blood-stained at first, but don’t worry, this is perfectly normal. The catheter will stay in place until your urine has returned to its ‘normal’ colour which is usually the following day. Fluid, called irrigant, may also be flushed through the tube to wash it out and stop blood clots clogging it up.

Other treatment after the operation for non-muscle invasive bladder cancer

Your operation will remove the visible tumour, but it’s important to make sure that no cancer cells have been left behind. So, afterwards, your bladder may be treated with a chemotherapy drug to destroy any remaining tumour cells. If these cells are left untreated they have the potential to re-grow and form another tumour. Bladder cancer recurrences can affect around 70% of patients who receive no further treatment but follow-up chemotherapy can significantly reduce the risk.

According to the guidelines of the EAU (European Association of Urology), it’s recommended that the majority of patients receive a single dose of chemotherapy within 24 hours of their operation. Mitomycin-C is one of the most commonly used drugs for this treatment.

Mitomycin-C is an ‘intravesical’ therapy which means that the drug is given directly into your bladder and stays there. It doesn’t go into your bloodstream and around your body, so it’s unlikely to cause the unpleasant side effects often associated with chemotherapy such as hair loss, nausea and vomiting.

Depending upon the stage and grade of your tumour, your doctor may decide that you also need additional doses of intravesical chemotherapy. These may be given as once-weekly instillations over several weeks or once-monthly over several months.

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