Content
- Stage 1
- Stage 2
- Stage 3
- Radiation therapy
- Chemotherapy
- Immunotherapy
- Stage 4
- Invasive bladder cancer
- How much does the treatment abroad cost?
- How much is the treatment abroad?
- Undergoing bladder cancer treatment abroad with Booking Health
Bladder cancer is the tenth most widespread oncological disease in the world. In terms of the frequency of recurrence, i.e. in 70-75% of cases, malignant neoplasms of this localization surpass almost all other types. Bladder cancer is a malignant neoplasm, but it is one of the few cancers that with timely diagnosis making and treatment has a high probability of a favorable outcome.
Stage 1
When diagnosing stage 1 bladder cancer, we talk about the formation of a malignant tumor. It is attached to the mucous membrane of the organ but does not affect its muscle layer.
Despite the small size and absence of the neoplasm spreading, bladder cancer (stage 1) can be characterized by a high degree of invasiveness. At this stage, symptoms are usually absent. If stage 1 bladder cancer is diagnosed, the prognosis is good. Recovery is achieved in 100% of patients. Cancer care mainly consists of conservative therapeutic methods.
Stage 2
Unlike stage 1, when cancer cells do not go beyond the mucous membrane, at stage 2 bladder cancer invades the muscle layer. However, there are no metastases at this stage.
The second stage of bladder cancer can develop according to different scenarios.
Cancer cells may not penetrate the transitional epithelium. In this case, further treatments are not required. Cancer cells may penetrate the transitional epithelium but do not penetrate the muscle tissue. In this case, continued cancer care is required.
In stage 2 bladder cancer treatment, the prostate gland and vesicles are often removed in male patients. In female patients, the uterus and ovaries are additionally excised. In foreign hospitals, after similar interventions for stage 2 bladder cancer treatment, patients are offered various care options for the formation of a reservoir for urine accumulation.
If a patient with stage 2 bladder cancer refuses surgery or it is not indicated for medical reasons, there are alternatives like systemic chemotherapy. Chemotherapy is also prescribed during stage 2 bladder cancer treatment when it was not possible to remove the whole tumor during the operation.
As a method of cancer care, complex treatments with external and internal radiation therapy (brachytherapy) can be chosen.
Stage 3
The third stage of bladder cancer is established when the cancer cells invade the organ wall. In this case, the next stage is the spread of the pathological process to reproductive organs. With timely, comprehensive, and sufficient cancer care, only 20-50% of patients manage to achieve recovery at this stage.
If stage 3 bladder cancer is diagnosed, the patient typically has a vivid clinical picture that includes:
- Severe pain when urinating
- Pulling pains in the lower abdomen
- Presence of blood in the urine
- Swelling of the external genital organs and lower extremities
If stage 3 bladder cancer is diagnosed, the prognosis depends on the timeliness and quality of medical care provided. An operation is performed in bladder cancer treatment to eliminate the primary tumor. It is often supplemented by other methods of cancer care.
Radiation therapy
Radiation therapy targets the cancer cells with rays or high-energy particles, which makes it possible to achieve the destruction of cancer cells or slow down their growth and multiplication. External or internal radiation therapy, or a combination of the two techniques, can be used in bladder cancer treatment.
With internal radiation therapy, a radioactive substance is placed directly inside the patient's body, as close to the tumor as possible. External radiation therapy, as the name implies, acts externally.
Radiation therapy can be used as a stand-alone treatment option, and in combination with chemotherapy or surgical treatments. The irradiation procedure is painless and does not cause discomfort. However, radiation treatment options are connected with side effects, including severe nausea and vomiting, dizziness and headache, hair loss up to complete baldness. In most cases the symptoms disappear on their own after completion of the course of treatments. In order to improve the well-being of patients during therapy, oncologists prescribe special drugs that alleviate side effects.
Chemotherapy
Chemotherapy medications stop the uncontrolled division of cancer cells and reduce the tumor size. Cancer stops progressing, and the relapse frequency is reduced significantly. Chemotherapy is used both in early-stage oncology and in advanced inoperable tumors.
In bladder cancer treatment, chemotherapy solutions are most often injected straight to the bladder. With this approach, cytostatics act locally, and chemotherapy side effects are less pronounced. Most often, chemotherapy is prescribed in combination with surgical resection of the primary tumor.
Chemotherapy treatments may have a rather serious impact on the body. Therefore, this therapy has some contraindications. To detect contraindications, doctors of specialized hospitals conduct laboratory tests and instrumental examinations. If the risk factor can be eliminated, additional treatments are prescribed. Only then the appropriate chemotherapy regimen is selected. In this case, treatment is carried out in hospitals, under the supervision of medical staff.
Immunotherapy
Today, immunotherapy is an effective method for advanced bladder cancer treatment.
Immunotherapy has been used in clinical practice for more than three decades. Due to the action of immunotherapy, the immune system is stimulated and begins to attack and destroy cancer cells. Immunotherapy is usually administered after radiotherapy.
In recent years, active research and development of new immunotherapy drugs, i.e. checkpoint inhibitors, have been carried out all over the world. These drugs are protein molecules normally produced by the body to prevent the attack of the immune system on the healthy tissues. Cancer cells express these molecules on their surface, thus suppressing the immune response and, as a shield, defending against the immune system.
In immunotherapy, drugs belonging to the group of monoclonal antibodies are used primarily.
Stage 4
At stage 4 of bladder cancer, cancer cells affect distant body organs. The prognosis for stage 4 is unfavorable.
General symptoms of stage 4 bladder cancer include impaired urinary function and pain syndrome occurring in the areas affected by cancer cells. Besides, at stage 4 of bladder cancer diagnosis, people are exhausted, suffering a significant weight loss, and weakened immunity with concomitant infectious diseases, anemia, severe intoxication with products of tumor growth and decay.
Stage 4 bladder cancer is characterized by the inoperability of the neoplasm. Therefore, at stage 4, the most appropriate methods of bladder cancer treatment are systemic drug therapies and chemoembolization.
In cancer care, chemoembolization is considered a minimally invasive method with high effectiveness. It is administered in eligible patients with stage 4 of the diagnosis.
The procedure implies introducing the anticancer drugs into the artery that feeds the tumor. Technical capabilities of super-selective catheterization of arterial vessels allow focused administration of anticancer drugs without the toxic effect observed in the systemic chemotherapy. Symptoms such as hair loss and immune system suppression that are typical for chemotherapy aren’t typical for chemoembolization.
Chemoembolization is well tolerated by patients with metastatic bladder cancer, as it carries minimal risk of complications development during treatment and after its completion. Mild side effects of the manipulation are transitory, recovery happens within a short period of time.
Invasive bladder cancer
The differentiation of non-invasive and invasive bladder cancer is vital in bladder cancer treatment decision making.
Tumors tend to recur after surgical treatments, with further transformation into invasive bladder cancer. Invasive bladder cancer, in turn, has rapid progression and is prone to metastasizing. Spreading of separate cancer cells is observed in many invasive bladder cancer cases.
Invasive bladder cancer doesn’t occur at the first stage of the pathology. Invasive bladder cancer tends to progress actively and, thus, needs radical cancer care. Invasive bladder cancer is fatal if it isn't treated.
Complete removal is a radical invasive bladder cancer treatment. The organ itself and adjacent tissues are subject to excision in invasive bladder cancer treatment.
Radiation therapy belongs to alternative treatments for invasive bladder cancer. Irradiation is mostly carried out in patients who need sparing bladder cancer treatments. Irradiation for invasive bladder cancer is indicated to patients with preserved bladder functioning. External radiotherapy is a method of choice for patients with invasive bladder cancer.
Brachytherapy is another therapeutic alternative for external irradiation for invasive bladder cancer. This method of invasive bladder cancer treatment includes insertion of radiation sources inside the body, straight to the neoplasm. This creates conditions for its maximum action on invasive bladder cancer and minimal influence on healthy tissues.
The technique shows satisfactory outcomes in patients with invasive bladder cancer, with up to 46% chances for recovery. With the subsequent chemotherapy for invasive bladder cancer a disease-free survival is up to 56%.
When invasive bladder cancer treatment is over, patients need continuous medical surveillance.
Hospitals for bladder cancer treatment abroad
Hospitals that offer bladder cancer treatment often do not undergo certification. This means that the search has to be focused on large hospitals with certified oncology centers. It’s better to get information on the ratings of the hospitals and clinicians practicing specific medical disciplines (e.g. in Germany such ratings are published in the "Focus" magazine). Clinical ratings are represented by the quantity of patients annually admitted to the hospitals and the quantity and results of medical procedures performed.
If there is an indication for a cystectomy, you need to get the information about what techniques are available in selected hospitals.
Hospitals below are recommended as the best hospital for treatment:
- University Hospital of Ludwig Maximilian University of Munich
- University Hospital Ulm
- Urology Hospital Munich-Planegg Munich
- University Hospital Frankfurt am Main
- Charite University Hospital Berlin
You can find more information at the Booking Health website.
How much does the treatment abroad cost?
Keep in mind that prices for cancer care procedures are influenced by the peculiarities of the diagnosis, presence comorbidities or concomitant pathologies detected during the initial examination at hospital, patient’s response to treatment, etc.
Generally, the price for partial or total resection starts at 27,628 EUR.
The cost of treatment with radical resection with bladder reconstruction starts at 21,628 EUR.
The cost of treatment with radical cystectomy with lymphadenectomy starts at 29,350 EUR.
The cost of treatment with the da Vinci robotic system starts at 29,502 EUR.
To get information on prices, please contact Booking Health.
Undergoing bladder cancer treatment abroad with Booking Health
The professionalism of foreign oncologists and urologists and the level of oncological care make a contribution to favorable results of bladder cancer treatment abroad, even at advanced stages.
The most convenient way to undergo treatment abroad is to contact a medical tourism operator. As one of the most transparent medical tourism companies in the world, Booking Health does everything to make your treatment abroad as comfortable as possible. Booking Health negotiates with the chosen hospital, assists in getting a medical visa, books accommodation and flights, and provides a fair cost of treatment.
To get more information about treatment abroad, leave a request on the Booking Health website.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
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