Oncology

Bladder cancer is one of the most common cancers in men and is associated, in most cases, to smoking. Superficial tumours have a significant tendency to recur, so the treatment must be oriented not only to solve the initial tumour but to prevent new future tumours. In more advanced cancers, treatment should be more aggressive but always offering the least possible damage without compromising the cure of this disease.

It is a malignant tumour in the bladder. Although there are many different types, generally they can be divided into two groups: superficial tumours and invasive tumours.

The most common symptom is the presence of blood in the urine, called haematuria. There is no correlation between the intensity of bleeding and the severity of the tumour, that is, relatively large tumours may cause minor bleeding, so you should visit a urologist for any bleeding in the urine; any bleeding is still important.

Another symptom that might appear is a discomfort when urinating that does not adequately respond to standard treatments. In more advanced cases, there may be pain in the lower abdomen or a malfunction of the kidneys.

The vast majority of bladder tumours will require endoscopic surgery (ie minimally invasive) named “TUR of the bladder“, to remove and to analyze it. Subsequent management varies depending on whether the tumour is superficial or invasive.

It is a minimally invasive endoscopic surgery where we get access to the bladder through the urethra, without incisions. It is usually done with spinal anesthesia and in most cases, the patient may go home without a catheter within a few days.

After removing the tumour by a TUR, the main objective is to avoid recurrences, that is, when new tumours appear during the follow-up. For this reason, it is sometimes necessary to start a program of bladder instillations. It is also necessary to start a close follow-up program to monitor the bladder.

Though depending on the case, it is usually necessary to perform a cystoscopy periodically. This test allows us to detect very small changes early by watching inside the bladder through a catheter that has a camera. It is a technique well tolerated when local anesthesia and flexible catheters are used. It may also be necessary to perform other tests such as urine cytology or complementary imaging tests

These tumours are more aggressive and generally require a more aggressive surgery called cystectomy, which can be performed laparoscopically.

No, in very selected cases a protocol for bladder preservation could be followed, which involves removing the aggressive tumor by a combination of treatments while maintaining a functioning bladder.

It is a tumour very similar to those of bladder but it occurs in a part of the kidney called the renal pelvis, (which is responsible for collecting urine produced by the kidney) or in the ureter, the tube through which the urine from the kidney gets to the bladder. Generally these tumors require surgery to be removed, which can be performed laparoscopically.