Transurethral Resection
Transurethral resection of the bladder (TURBT) is the usual treatment method for patients whose cancers are superficial (stage Ta to stage T1).
Often, additional therapies are administered to prevent tumor recurrence. Such therapies might include intravesical chemotherapy or intravesical immunotherapy. The term, “Intravesical” means “within the bladder”. These therapies involve the placement of therapeutic agents directly into the bladder. The agents are retained in the bladder for one to two hours and are then eliminated through urination.
Intravesical Chemotherapy
Often a single dose of a chemotherapeutic agent (mitomycin C) is placed in the bladder immediately after resection and kept in the bladder for approximately 1 hour. There are times however when more of the medication will be used with weekly instillations for 6 weeks.
Intravesical Immunotherapy
BCG is a weakened version of a live vaccine strain of bovine tuberculosis. It is currently viewed as the most effective agents for treating superficial bladder cancer, and is particularly effective in treating carcinoma in situ (CIS). BCG is administered as a weekly instillation for 6 weeks beginning approximately 1 month after initial tumor resection. Successful BCG therapy may be followed by a therapeutic maintenance schedule whereby patients receive scheduled BCG dosages over a 2-year period to further decrease the risk of cancer recurrence.
IFN is typically added to BCG in patients whose cancer either recurs or is not successfully treated with BCG.
Because superficial bladder cancer has a high rate of local recurrence with the possibility of progression, close monitoring after a TURBT is important. This follow-up includes routine cystoscopies and urine tests. As time passes without signs of recurrence, the length of time between office visits will widen.
There have been some studies showing the benefit of certain vitamins in reducing the risk of cancer recurrence. Although (as is common with such studies) some of the data is disputed, researchers have found no negative effect to taking these supplements; specifically Vitamin A, B6, C, E and Zinc.
My Take
Smoking cessation is absolutely the best thing you can do to decrease the risk of bladder cancer (as well as numerous other cancer and other health related issues). There are new drugs that can help you stop smoking. We will discuss this at the time of your visit.