Treatment of multiple invasive bladder cancer

Invasive bladder cancer refers to bladder cancer that has infiltrated to the bladder muscle layer or above. This type of bladder cancer is generally treated with partial cystectomy, radical cystectomy, transurethral bladder tumor resection, chemotherapy and radiotherapy.

(1) Partial cystectomy: Partial cystectomy is suitable for single, localized invasive cancer, tumor more than 3 cm from the bladder neck, diverticular cancer, and bladder urachal cancer.

(2) Radical cystectomy: Most patients with invasive bladder cancer should undergo radical cystectomy, including pelvic lymph node dissection. If the tumor involves the prostatic urethra in men or the bladder neck in women, urethral aspiration should be considered.

(3) Transurethral bladder tumor resection: Simple transurethral tumor resection is suitable for small low-grade tumors with superficial muscle invasion or for those who are not suitable for open bladder surgery.

(4) Chemotherapy: Chemotherapy is used for bladder cancer with lymph node metastasis and distant organ metastasis, but it can cause toxic side effects such as bone marrow suppression, renal insufficiency, and mucositis.

(5) Radiotherapy: The radiotherapy area is usually the bladder and pelvic lymph nodes. It is suitable for invasive bladder cancer where surgery is impossible or inappropriate, or for invasive bladder cancer combined with radiotherapy after surgery.

When performing radical cystectomy, male patients should undergo total urethrectomy if the tumor invades the prostatic urethra, while female patients should undergo anterior pelvic organ removal, including the bladder, urethra, uterus, fallopian tubes, ovaries, and anterior vaginal wall.