Listed below is the step by step procedure of bladder cancer surgery:
Bladder cancer surgery is employed to remove cancerous tumor located in urinary bladder. The tumor may spread to nearby organs and as a preventive measure to avoid metastasis (spreading of cancerous cells from original location to another organ in the body) of bladder cancer, surgical procedure is implemented.
Bladder cancer affects both the genders. But, statistics have revealed that men are more likely to suffer from bladder cancer than women. Also, elderly people above the age of 55 are more susceptible to bladder cancer. So to treat all affected people, surgery is required.
Following are indications that surgery is required in treatment of bladder cancer:
Preoperative preparation phase involves few diagnostic tests which help in deciding type of surgical procedure to be implemented. Also, they help in assessing stage of cancer. Let us have a look at those diagnostic tests that help in deciding stage of bladder cancer:
Cystoscopy and biopsy along with CT scan or MRI scan scan help in diagnosing stage of bladder cancer. These diagnostic tests help oncologists in viewing internal structures of bladder and identify the stage of bladder cancer. If the cancerous tumor has advanced, entire urinary bladder can be removed. In initial stages, only the part where tumor has grown is removed. So whatever stage is found, the surgeon decides in the necessary surgery type to be used.
There are certain instructions that have to be followed a day before the surgery.
On the day of surgery, vital signs such as blood pressure, heart pulse and other tests may be conducted to ensure endurance of patient. This also helps to understand if the patient is ready to undergo surgery. Drinking of water for four hours before the surgery is prohibited.
Depending upon the stage of cancer and overall health status, bladder cancer surgical approach is decided. Age also plays an important part in deciding approach of surgery. Following are the surgical procedures implemented to treat bladder cancer:
It is a surgical procedure adopted to treat non-muscle-invasive bladder cancer. Before the surgery begins, doctor will conduct physical examination and suggest you to undergo some blood tests to know your hemoglobin level and check if you are suffering from any kind of infection. Also, blood thinning medications will be discontinued for a week or so before the surgery takes place. You need to inform doctor if you are a diabetic patient, or if you are pregnant and about substances you are allergic to. If you smoke, you will be asked to quit smoking as smoking will slow down recovery process. It's important to have light and nutritious meals for a week before the Transurethral resection of bladder tumor (TURBT) surgery.
To begin this procedure, patient is first administered anesthesia. A cystoscope, which is a long, thin and flexible instrument to which light and camera is attached, is inserted into urethra and then guided towards urinary bladder. Malignant (harmful) tumor is then removed with the help of small wire loop or by laser or by harnessing fulguration technology which makes use of high energy electricity to cut the cancerous tumor. Surrounding healthy tissues might also be removed in order to ensure complete elimination of cancerous tumor.
Post TURBT surgery, you will be required to stay in the hospital for few days. During this period, nurse will monitor your hear beat rate and your recovery. Since the surgery involves removal of tumor present in the bladder, you may notice blood in your urine. Also, patient may feel uncomfortable while urinating for few days post surgery. If you notice any major abnormalities, consult your doctor to get your doubts cleared.
Patient will be required to consume plenty of fluids in order to flush toxins and reduce chances of urine infection. Healthy and well-balanced diet will help in formation of tissues and speed up recovery process. Avoid lifting of heavy weights and in case if you need to consume pain killers, better consult with doctor before taking them.
It is a surgical procedure wherein either part or complete urinary bladder is removed. Cystectomy treatment is given when the cancer has advanced to later stages and when metastasis has occurred. The procedure may involve removal of prostrate gland and urethra in men and removal of fallopian tubes, uterus, ovaries and some part of vagina in women. This happens only when malignant tumor has invaded surrounding organs. If the tumor has not affected surrounding organs and cancerous cells have not leaked in tissues surrounding bladder, then only bladder is removed.
Sometimes, lymph nodes in pelvis region are also removed. It may happen that some cancerous cells have leaked in lymph nodes. Hence, to eliminate the risk of metastasis of cancer, lymph nodes are also removed. This is called pelvic lymph node dissection.
Laparoscopic cystectomy and robotic cystectomy are two types of cystectomy surgical procedures. Generally, laparoscopic cystectomy procedure is used often than robotic cystectomy. Both these procedures involve making of small incisions instead of one large incision on lower abdominal region. The surgery is then carried out through these small incisions and bladder is removed. Other surrounding parts are also removed with help of tools. However, it is not confirmed whether the outcome of laparoscopic cystectomy and robotic cytectomy is as good as traditional way of performing surgery and whether it can completely eradicate cancer.
Traditional way of performing surgery is still practiced in treating bladder cancer. Advantages of traditional method of surgery is that surgeon is able to get clear and larger view of the organ and hence, it becomes easy for the surgeon to remove bladder.
If bladder is completely removed, then the surgeon has to perform urinary diversion surgery as a provision to expel urine out from the body. Surgeon will create outlet to let urine pass out of the body. This will be done by diverting either a section of small intestine, or colon to stoma which is an opening on outside of the body. Patient has to wear the bag which is attached to stoma to collect and drain urine.
As an alternative to urinary bladder, surgeon can also create a temporary urinary reservoir which can perform the function of urinary bladder of storing urine. Hence, the requirement of attaching bag to stoma is eliminated. In some patients, if urethra is not removed, surgeon is able to connect the urinary reservoir to urethra. This procedure allows patient to expel urine normally. Catheter (thin tube) is sometimes inserted to enable neobladder to get empty.
There are certain side-effects of bladder cancer surgery. You need to talk to your oncologist about the side-effects before opting for the surgery.
Along with surgery, chemotherapy and radiation therapy are also implemented for complete cancer treatment.
Recovery period for every patient will differ. It depends on the prognosis (likely course) of cancer and treatment method adopted. Certain things like adhering to your rehabilitation plan prescribed by your doctor goes a long way in ensuring quick recovery.
Smoking should strictly be avoided. Consume healthy diet comprising of soups, salads,fresh fruits, lots of vegetables, whole grains etc. Avoid intake of red meat. Drink lots of water to get rid of toxins in your body. Alcohol consumption should also be restricted. Avoid lifting of heavy weights and consult with your doctor before you resume your exercise regime.
Diet is of prime importance when it comes to recovery and healing after surgical treatment. Let us consider some components of diet that should be included in your diet plan:
Proteins that are obtained from plants do not comprise complete chain of essential amino acids. Hence, right pairing of foods is essential to get complete set of proteins. For example, whenever you are consuming lentils or sprouts, make sure that you combine them with rice to reap maximum protein content. All animal sources of protein, such as eggs, meat etc. provide complete set of proteins.
Every surgery has some risks and complications associated with it. Let us have a look at risks and complications of both TURBT and cystoscopy.
TURBT is generally considered as a safe surgical procedure. But minor risks and complications may occur. These include:
If bleeding or any of the above mentioned symptoms persist for a long period of time, it is important that you consult with doctor as early as possible.
Cystoscopy complications comprise of:
If the above mentioned symptoms continue for more than few days, better show it to your oncologist as a preventive measure.
To conclude, bladder cancer surgery helps in treating cancer effectively to a certain extent. If the cancer has advanced to later stages, it is quite difficult to completely eliminate cancerous cells. Hence, early diagnosis is essential. Once, the surgery is over, take periodical appointments with your oncologist to check chances of recurrence. Positive thinking and healthy lifestyle will get you a long way from preventing recurrence of bladder cancer.
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