superficial bladder cancer, relatively easy to deal with, and minimally invasive surgery is often used - transurethral bladder tumor resection, so that the bladder will not be lost.
For muscular invasive bladder cancer, radical cystectomy has always been the standard treatment method. The bladder will be completely removed.
This radical surgery has great trauma, high risk of surgery, and much money. This is the first difficulty; because the patient does not have a bladder (or only a bladder transformed from the intestine, it is difficult to compare with his own bladder), he may experience urinary incontinence, difficulty in urinary urination, dysfunction , erectile dysfunction, long-term urinary bags hanging in the abdomen, intestinal dysfunction, anastomosis stenosis, ureteral reflux, hydronephrosis , renal insufficiency, etc., which will seriously reduce the quality of life. This is the second difficulty!
The decline in quality of life caused by not having your own intact bladder may be the most painful part of patients choosing radical bladder resection!
So, there is no second choice for muscle-invasive bladder cancer. Can you protect your bladder?
The answer is yes!
At present, the more recognized preferred regimen for retention of bladder therapy is triple therapy (TMT).
TMT is a combination therapy that includes maximum transurethral bladder tumor resection (a few patients choose partial bladder resection), combined with radiotherapy and chemotherapy.
Among them, maximum transurethral bladder tumor resection is a minimally invasive surgery. The endoscopy is placed into the bladder through the urethra, and the tumor seen by the naked eye is completely removed (electrical resection or laser resection). A second minimally invasive surgery will be performed one month later, which is to cut the suspicious parts and the first surgical scars that were removed through the urethra!
It is reported that among patients with muscular invasive bladder cancer, the proportion of bladder retaining in my country is 35.9%, while in European and American countries it reaches 49%, which may be related to the fact that people in European and American countries pay more attention to quality of life.
22 Guidelines for European Urology Association 2022 recommend TMT for patients with selected muscular invasive bladder cancer, especially those who are not suitable (such as those who are elderly or have many underlying diseases and cannot tolerate major surgery) or do not undergo radical resection, TMT can be selected, and the tumor control effect is comparable to radical surgery.
Of course, TMT will also face the toxic effects of radiotherapy and chemotherapy, and the possible loss of the best surgical timing for radical surgery. Patients and their families need to make careful choices!
In addition, TMT combined with immune checkpoint inhibitor therapy is a new research direction suitable for patients participating in clinical trials. #Health Science Popularization Competition##Telebrity Creation Challenge#
