Bladder Cancer Surgery

Bladder cancer is one of the most common cancers that affects the urinary system. When diagnosed, surgery is an important part of the treatment process. Based on the stage and location of the cancer, several types of bladder cancer surgeries are performed. These include removing part or all of the bladder. This article shall give detailed information about bladder cancer surgery including types, procedures, benefits, costs, and the best hospitals for treatment in India.

What is Bladder Cancer Surgery?

Bladder cancer surgery involves the removal of cancerous cells or the entire bladder to prevent the spread of cancer. Doctors consider one of the primary treatment options for bladder cancer to be it, especially for patients with tumors that confine to the bladder. Depending on the stage of the cancer, there are different types of surgeries to remove the cancer. Some surgeries include the removal of just a part of the bladder and others include a complete cystectomy, which is the removal of the entire bladder.

Why Is Bladder Cancer Surgery Done?

Bladder cancer surgery is performed for several key reasons:

• To remove cancerous tumors: The most important objective of Cystectomy is to eliminate tumors or cancerous cells from the bladder to halt the progression of cancer to other areas of the body.
• To increase survival rate: Surgeons can use surgery to treat early-stage bladder cancer if it is still limited to the bladder, which significantly increases the survival rates.
• Restoration of function: If the surgeon resects the bladder entirely, they can reconstruct the urinary system to help the patient resume normal functions.

Classes of Bladder Cancer Surgery

There are different types of surgery for bladder cancer dependent on the stage and the location of the cancer. These include:

1. Transurethral Resection of Bladder Tumor (TURBT)

TURBT is typically the first surgical intervention in treating early-stage bladder cancer. The procedure involves

• Procedure: A cystoscope is introduced into the bladder through the urethra to evacuate the tumor.
• Indication: This is recommended for non-invasive cancers, which are also confined to the inner layers of the bladder.

2. Partial Cystectomy

In this surgery, the surgeon removes part of the bladder containing the malignant tissue.

• Procedure: The portion of the bladder containing the cancerous tissue is removed by the surgeon, and the remaining bladder tissue is rebuilt.
• Indication: This procedure is usually adopted when the cancer is localized to one area of the bladder.

3. Radical Cystectomy

Radical cystectomy involves the removal of the entire bladder, along with nearby lymph nodes and possibly other organs that may be affected, such as the prostate in men or the uterus in women.

• Procedure: The surgeon removes the bladder completely, and it may make a new pathway for urine leaving the body (urinary diversion), like an ileal conduit or a continent urinary reservoir.
• Indication: It is usually done for invasive bladder cancers that are deep inside the bladder wall or even extend beyond the bladder.

4. Urinary Diversion Surgery

In cases where the bladder is removed, the surgeon will create a new way for urine to be excreted. The two most common methods are:

• Ileal Conduit: A piece of the small intestine is used to create a passage for urine to flow from the kidneys to an opening in the abdomen.
• Continent Urinary Reservoir: The patient has an inside pouch-like bladder created within the body. The patient then can self-catheterize to drain off urine.

Steps of Procedure

The bladder cancer surgery procedure commonly follows these steps:

• Anesthesia: The surgeon performs the surgery while the patient is under general anesthesia.
  Incision or Insertion of Scope:
• For TURBT, the medical professional inserts the cystoscope through the urethra to remove the tumor.
• For Cystectomy, the surgeon incises the abdomen to remove the bladder along with the tissues around it.
• Tumor Excision: The surgical team excises tumors in TURBT, and in cystectomy, the whole bladder is excised.
• Urinary Diversion: After the surgical team removes the bladder, they create a new urinary passage using either an ileal conduit or a continent urinary reservoir.
• Closure: The surgical team closes the incision, and the staff shifts the patient to the recovery area.

Benefits of Bladder Cancer Surgery

Bladder cancer surgery offers several advantages:

• Cure for localized cancer: Surgery can successfully remove the cancerous tissue, which may be curative, especially in early-stage bladder cancer.
• Prevention of cancer spread: Surgery prevents the cancer from spreading to other parts of the body, thus improving survival rates.
• Restoration of function: With proper urinary diversion procedures, patients can have normal urination after surgery, even if their bladder is removed.
• Better quality of life: The removal of cancerous tissues helps to alleviate symptoms such as frequent urination, pain, and blood in the urine.

Cost of Bladder Cancer Surgery

• United States: TURBT costs range from $10,000 to $15,000, while radical cystectomy can go up to $25,000-$30,000, including urinary diversion.
• United Kingdom: The cost of TURBT can range from $6,000 to $9,000, while radical cystectomy ranges from $12,000 to $18,000.
• India: The cost of bladder cancer surgery ranges from $3,000 to $12,000, depending on the procedure.

India offers the highest quality of healthcare facilities at significantly lower costs, making it an excellent location for patients to get bladder cancer surgery.

Best Hospitals in India for Bladder Cancer Surgery

• Metro Hospital Faridabad
• Max Super Speciality Hospital, Delhi, NCR
• Medanta—Gurgaon
• Fortis Memorial Research Institute, Gurgaon, Delhi NCR

Risks and Complications

Bladder cancer surgery carries risks and potential complications.

• Infection: Risk of infection in the surgical site or urinary tract.
• Bleeding: Surgeons expect some bleeding, particularly with invasive surgeries like cystectomy.
• Urinary Problems: There may be some problems with urinary function after radical cystectomy, but urinary diversion surgeries help manage these.
• Impotence (in males): Impotence may result from nerve damage during surgery.
• Bowel Problems: Urinary diversion surgeries may sometimes affect bowel function, especially.

Recovery

Recovery from bladder cancer surgery depends on the type of treatment performed.

• TURBT: Most patients can be discharged the same day or within a short period of hospital stay. The recovery period is usually 1-2 weeks.
• Partial Cystectomy: Patients may require 1-2 weeks of recovery for normal life.
• Radical Cystectomy and Urinary Diversion: Recovery will take about 4-6 weeks because the surgical team requires more time for radical cystectomy and urinary diversion, and patients need to make some adjustments with the urinary diversion.

During the follow-up process, the patients need regular visits for follow-up assessments in terms of cancer re-emergence and urinary diversion efficiency.

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