Treatment options for invasive bladder carcinoma

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Treatment options for invasive bladder carcinoma

  1. 1. Treatment Options for Invasive Bladder Carcinoma Ahmad Abid Bin Abas 07-5-02
  2. 2. Treatment Modalities• Surgery :1) Transurethral Resection with fulguration.2) Radical Cystectomy3) Segmental Cystectomy4) Urinary Diversion (Ileal conduit,orthotopic neobladder)
  3. 3. (TUR)• http://passingtravelers.com/13099-2/cancer-after-the-initial-diagnosis
  4. 4. Radical Cystectomy
  5. 5. Urinary Diversion• http://kidney.niddk.nih.gov/kudiseases/pubs/urostomy/
  6. 6. Treatment Modalities• Radiation Therapy :1) External Radiation (Machine outside the body)2) Internal Radiation (Radioactive substance sealed in needles, seeds, wires, or catheters)
  7. 7. Treatment Modalities• Chemotherapy1) (MVAC) - 2-3 cycles of methotrexate,vinblastine, adriamycin plus cisplatin.2) (CMV) - cisplatin, methotrexate plus vinblastine
  8. 8. Treatment Modalities• Biologic Therapy (Immunotherapy)1) An immune-stimulating bacterium.-Bacille Calmette-Guerin (BCG)2) A synthetic version of an immune system protein. (Interferon alpha)
  9. 9. New Treatment Modalities still in Clinical Trials• Chemoprevention . (drugs,vitamins etc..)• Photodynamic Therapy (PDT) (drug + laser beam)
  10. 10. Treatment Options by Stage 0 Stage 0 (Papillary Carcinoma and Carcinoma in Situ)• Transurethral resection with fulguration.• Transurethral resection with fulguration followed by intravesical biologic therapy or chemotherapy.• Segmental cystectomy or radical cystectomy.
  11. 11. Treatment Options by Stage I• * same modalities as stage 0 but more options as follow :• Radiation implants with or without external radiation therapy.
  12. 12. Treatment Options by Stage II• Radical cystectomy with or without surgery to remove pelvic lymph nodes.• Combination chemotherapy followed by radical cystectomy.• External radiation therapy combined with chemotherapy.• Radiation implants before or after external radiation therapy.• Transurethral resection with fulguration.• Segmental cystectomy.
  13. 13. Treatment Options by Stage III• Radical cystectomy with or without surgery to remove pelvic lymph nodes.• Combination chemotherapy followed by radical cystectomy.• External radiation therapy combined with chemotherapy.• External radiation therapy with radiation implants.• Segmental cystectomy.
  14. 14. Treatment Options by Stage IV• Radical cystectomy with surgery to remove pelvic lymph nodes.• External radiation therapy (may be as palliative therapy to relieve symptoms and improve quality of life).• Urinary diversion as palliative therapy to relieve symptoms and improve quality of life.• Cystectomy as palliative therapy to relieve symptoms and improve quality of life.• Chemotherapy alone or after local treatment (surgery or radiation therapy).
  15. 15. References• http://www.mayoclinic.com/health/bladder- cancer/DS00177/DSECTION=treatments-and- drugs• http://www.cancer.gov/cancertopics/pdq/trea tment/bladder/Patient/page5

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