Bladder Cancer Surgeon In Delhi
Bladder cancer is a group of cancers affecting the Urinary bladder. The most common causation is a history of tobacco consumption or smoking. In about 65% of cases, the disease only affects the superficial part of the bladder lining – It is called Non-Muscle Invasive Bladder Cancer. The majority of these cancers remain superficial only and do not invade the deeper layers of the bladder. Hence, they do not spread in the body. However, they do tend to recur frequently. The other type of cancer is called Muscle Invasive Bladder Cancer which is likely to spread rapidly in the body. Usually, the patient complains of blood in the urine and burning in the urine. This situation is often wrongly assumed to be a Urinary Tract Infection (UTI) and treated for long duration with antibiotics leading to a delay in diagnosis.
In such patients it is mandatory to do a Urine test for Cytology, an Ultrasound of the bladder and very often a CT scan of the abdomen. The next step is to do a cystoscopy and biopsy of the bladder. This test involves an inspection of the entire bladder from inside. A biopsy is taken from the growth. This serves both to diagnose cancer and stage the disease into Non-Muscle Invasive or Muscle Invasive disease. Since most often since the entire tumor is removed, it also serves to stop the bleeding in the urine. A single dose of Chemotherapy Medicine is also instilled into the bladder to prevent early recurrence of the tumor. The subsequent management of cancer depends on the Biopsy report.
In Noninvasive cancer, the therapy is installation into the bladder periodically of Chemotherapy agents like Mitomycin C or BCG. The bladder is also checked periodically by Cystoscopy to pick up any recurrence of cancer
In muscle-invasive cancer of the bladder, a general assessment is made of the fitness of the patient to undergo a Bladder Removal Procedure. (Cystectomy). Thereafter the patient is given a few cycles of chemotherapy prior to cystectomy. At cystectomy, the entire bladder is removed. After this, the urine is either diverted into an intestinal conduit to the abdominal stoma to collect in a bag (Ileal Conduit) or a new bladder made from the intestine is constructed (Neobladder). A neobladder patient voids from the urethra and is spared the need to carry around a urine collection bag.
In some selected cases only a Bladder sparing approach is done with either only a part of the bladder removed or none removed at all. This is then treated predominantly with Chemotherapy and Radiotherapy.