What you should know about metastatic bladder cancer

Bladder cancer is a common malignancy of the urinary system. The risk of bladder cancer is increased four-fold in smokers. If metastases are present, the treatment of metastatic bladder cancer depends on the clinical stage and site of metastasis. Let's learn about this disease through the article below. 

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• Stages of bladder cancer
• What is metastatic bladder cancer?
• Treatment for metastatic bladder cancer
• Palliative care for patients with metastatic bladder cancer

Stages of bladder cancer

The treatment of bladder cancer depends a lot on the stage of the bladder cancer. Therefore, understanding the stages of the disease is essential.

Today, the most commonly used classification system is the TNM system.

• T (Tumor): Measures the extent of tumor growth.
• N (Node): Indicates whether the tumor has spread to lymph nodes near the bladder.
• M (Metastatis): Indicates whether the tumor has spread to distant organs or lymph nodes.

Based on this system, bladder cancer is divided into the following stages:

Phase 0

The tumor grows only in the center of the bladder. It has not spread into the tissues or muscles of the bladder wall. The tumor has also not spread to lymph nodes or distant organs.

Stage I non-metastatic bladder cancer

The tumor has grown into the inner lining of the bladder. But not to the muscular layer of the bladder wall. Tumor has not spread to lymph nodes or other organs.

Phase II

The tumor has grown through the connective tissue layer in the bladder and into the muscular layer of the bladder.

Phase III

The cancer is now located in the fatty tissue surrounding the bladder. This stage may have spread to nearby organs such as the prostate gland (in men), uterus or vagina (in women). But they have not spread to lymph nodes and distant organs.

Stage IV

This stage is defined as having one of the following characteristics:

• The tumor has spread from the bladder into the pelvis or abdominal wall. But has not spread to the lymph nodes or other organs.
• The cancer has spread to nearby lymph nodes. But did not spread to distant organs.
• Cancer is in lymph nodes or distant sites such as bones, liver, or lungs.

Stages of bladder cancer

What is metastatic bladder cancer?

This is called metastatic bladder cancer when cancer cells invade surrounding tissues. Usually, this term refers to tumor metastasis to distant organs. But they can also metastasize locally in the muscles and connective tissues near the bladder.

Locally metastatic bladder cancer

The bladder wall is made up of 4 distinct layers.

• Mucosa.
• Under the mucosa.
• Muscle.
• Barcode.

Cancer will invade first in these layers. Once infiltrated, it can spread to surrounding fatty tissue and lymph nodes. Once it has reached the lymph nodes, it can travel to distant organs. The tumor may also continue to grow into the peritoneum.

Distant metastatic bladder cancer

Once cancer cells have reached the lymph nodes, they can spread to most parts of the body. However, the most common sites for distant metastasis are:

• Lung
• The bones
• Liver

Bladder cancer can also spread to the prostate, uterus, and vagina.

Image of cancer cells that have metastasized to bone

Treatment for metastatic bladder cancer

Treatment of metastatic bladder cancer depends mainly on the location of the metastases relative to the primary. Treatment options can be chemotherapy, radiation therapy, and targeted cell therapy.

Valence

Chemotherapy is often used in the treatment of metastatic cancer. This is often the first line of treatment to help slow the growth and spread of cancer. Chemotherapy improves survival and quality of life.

Target cell therapy

Targeted cell therapy uses drugs to target molecules. The goal is to stop the growth and spread of cancer cells. For example, Erdafitinib (Balversa) is used to treat cancer that has a mutation in the FGFR2 or FGFR3 gene. Or for patients not responding to chemotherapy.

Radiotherapy

Radiation therapy may also be indicated to treat bladder cancer. Especially metastases to bone. Or indicated when the patient cannot have surgery.

Radiation therapy can be used in the treatment of metastatic cancer

Palliative care for patients with metastatic bladder cancer

Palliative care can be incorporated to improve a patient's quality of life. They can be done concurrently with treatments for metastatic bladder cancer .

Problems with palliative care for bladder cancer patients are:

Physical

• Relieve pain caused by complications from cancer or treatments.
• You are prescribed medicine to prevent nausea or vomiting during and after chemotherapy.
• Care about nutritional status before, during and after treatment.

Affection

Supportive care for patients with depression, anxiety, or fear for both the patient and their family.

Morale

Integrate spiritual care according to the needs, values, beliefs, and cultural background of the patient and family.

Is different

Questions about legal forms, such as advanced directives and power of attorney for health care

The prognosis of patients with metastatic bladder cancer depends on many factors. The best way to prolong life is that the patient needs to follow the doctor's treatment regimen and have regular check-ups. In addition, patients should connect with family, friends, and the community for emotional support.