bladder%20cancer
BLADDER CANCER

Bladder cancer is a heterogenous neoplasm that ranges from non-life-threatening, low-grade, superficial papillary lesions to high-grade invasive tumors that often metastasizes at the presentation.

It is the most common cancer involving the urinary system and it is the 11th most commonly diagnosed in the world.

Microscopic or gross painless hematuria is the most common presenting complaint.

Chemoradiotherapy

  • Alternative treatment in patients unfit for or opposed to radical surgery
  • May consider adjuvant pelvic irradiation for patients w/ pT3/pT4 pN0-2 disease who recently underwent radical cystectomy w/ ileal conduit
  • Intraoperative RT may be considered in patients w/ tumors extending to the abdominal &/or pelvic wall 
  • For muscle-invasive bladder cancer, radical radiotherapy is given using a radiosensitiser (eg Mitomycin + Fluorouracil or Cisplatin plus Fluorouracil or Cisplatin plus Paclitaxel or Cisplatin alone)
    • Low-dose Gemcitabine may also be considered
  • Conventional fractional radiation therapy w/ a radiosensitizer may be used as palliative therapy
    • Recommended regimens include Cisplatin (preferred), taxanes (Docetaxel, Paclitaxel), Fluorouracil, Fluorouracil + Mitomycin, low-dose Gemcitabine, or Capecitabine
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