Bladder cancer Q&A

How likely am I to survive bladder cancer?

Many patients ask about their prognosis (how likely they are to survive the cancer) and the news a consultant can give will vary from individual to individual, depending on how advanced the cancer is and how they have responded to treatment.

Your prognosis depends on the type of tumour and how far the tumour has spread. It ranges (for cancers confined to the pelvis) from having a roughly 90 per cent chance of surviving five years with a non aggressive (low grade) superficial cancer to a little as 10 per cent, if it has spread into other pelvic organs/lymph glands (1).

How much chemotherapy and radiotherapy will I have?

Other questions patients ask about bladder cancer are the treatments, specifically radiotherapy and chemotherapy.

In terms of radiotherapy (treatment with radiation), some patients will be treated with six-and-a-half weeks of daily radiotherapy (1).

If you need to have chemotherapy beforehand, the course would typically consist of three cycles of treatment that involve two or three sets of chemotherapy injections, with each cycle taking three or four weeks (1).

Shorter courses of radiotherapy are also used to help symptoms related to the bladder cancer, such as bleeding.

Side-effects of chemotherapy and radiotherapy also concern patients.

The following list is not exhaustive and all patients should discuss their side-effects (if any) on an individual basis with their own specialist oncologist:

Radiotherapy side-effects (1):

  • Tiredness
  • Bladder irritation (cystitis)
  • Diarrhoea
  • Skin reaction, like a mild sunburn
  • Effects on sexual function
  • Nausea
  • Bleeding from bowel or bladder (can be months or years after radiotherapy) - a medical review is required for these symptoms

While many side-effects settle within weeks or a few months after radiotherapy, there is a risk that some of them may become permanent symptoms (1).

Chemotherapy side-effects (1):

  • Risk of serious infections. You must seek medical attention immediately if you are on chemotherapy and have a raised temperature (38°C or above) or feel unwell
  • Tiredness
  • Nausea and vomiting
  • Bruising or bleeding
  • Anaemia
  • Affects on the kidneys
  • Altered taste and sore mouth
  • Changes in hearing
  • Flu like symptoms
  • Skin rash
  • Numbness or tingling in the hands or feet
  • Rarely hair loss

I have to have my bladder removed, how will I go to the toilet?

In some cases, people with invasive bladder cancer may need to have their bladder entirely removed (radical cystectomy) to stop the cancer spreading to other parts of the body.

Partial bladder removal may be performed in some patients and is usually followed by radiation therapy and chemotherapy to help decrease the chances of the cancer returning.

Different types of bladder removal surgery:

  1. Ileal Conduit - a small urine reservoir is surgically created from a small segment of bowel. The ureters are attached to one end of the reservoir, while the other end is brought out through an opening in the skin (stoma). Urine drains from the stoma into a bag.
  2. Continent Urinary Reservoir - a segment of colon is removed and is used to create an internal pouch to store urine. A small stoma is placed against the skin, which allows patients to insert a catheter periodically to drain the urine.
  3. Orthotopic Neobladder - a segment of bowel is folded over to make a pouch (neobladder), which is attached to the place in the urethra where the urine normally empties from the bladder. This procedure allows patients to maintain some urinary control, but urination may not be the same as it was before surgery.

Which type of bladder reconstruction or urine collection method will depend on to what extent your cancer has spread, your personal preference and the type of surgery available at your hospital. You should talk to your cancer multidisciplinary team representative about your options.

Infolinks

References:

  1. Alastair Thomson (consultant oncologist Royal Cornwall Hospital Trust) | Bladder cancer | Email communication (May 2009)

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