Is surgery necessary for 87-year-old bladder cancer?

Whether an 87-year-old bladder cancer patient should undergo surgery should be comprehensively evaluated based on physical condition, tumor stage, and patient willingness. Surgery is the main treatment for bladder cancer, but elderly patients need to carefully weigh the risks and benefits. They can consider transurethral bladder tumor resection, partial cystectomy, or radical cystectomy, combined with adjuvant treatments such as chemotherapy and radiotherapy. Patients should consult a professional to choose the most suitable treatment plan based on their own situation, and pay attention to postoperative care and improvement of quality of life.

1. Physical condition assessment: 87-year-old patients usually have multiple underlying diseases, such as hypertension, diabetes, cardiovascular and cerebrovascular diseases, etc., and have low tolerance for surgery. A comprehensive physical examination is required before surgery to evaluate cardiopulmonary function, liver and kidney function, and coagulation function to ensure the safety of the surgery. For patients in poor physical condition, transurethral bladder tumor resection, which is less invasive, can be selected to reduce surgical risks.

2. Tumor staging determines treatment options: The staging of bladder cancer directly affects surgical selection. For early bladder cancer, such as Ta and T1, transurethral bladder tumor resection can be selected, and postoperative intravesical chemotherapy can be used to reduce the risk of recurrence. For mid-to-late stage bladder cancer, such as T2-T4, partial cystectomy or radical cystectomy is the main option, but it is necessary to assess whether the patient can tolerate surgical trauma and postoperative quality of life.

3. Patient willingness and quality of life: The acceptance of surgery and postoperative quality of life of elderly patients are important considerations. Some patients may prefer conservative treatment, such as chemotherapy, radiotherapy or immunotherapy, to alleviate symptoms and prolong survival. Doctors should fully communicate with patients and their families, understand the patients' wishes, and develop individualized treatment plans.

4. Specific options for surgical treatment: Transurethral resection of bladder tumors is suitable for early bladder cancer, with less trauma and quick recovery; partial cystectomy is suitable for patients with tumors limited to one place, retaining some bladder function; radical cystectomy is suitable for patients with extensive tumor infiltration, requiring removal of the entire bladder and urinary diversion, which may affect the quality of life after surgery.

5. The role of adjuvant therapy: Chemotherapy, radiotherapy and immunotherapy can be used as adjuvants to surgery to improve the treatment effect. Chemotherapy can reduce the size of the tumor and reduce the difficulty of surgery; radiotherapy can kill residual cancer cells and reduce the risk of recurrence; immunotherapy can activate the patient's own immune system to enhance anti-tumor ability.

6. Postoperative care and rehabilitation: Elderly patients recover more slowly after surgery and need intensive care. Vital signs should be monitored in the early postoperative period to prevent infection and complications; a high-protein, high-vitamin diet should be adopted to promote wound healing; appropriate rehabilitation training should be carried out, such as pelvic floor muscle exercises, to improve urination function.

7. Psychological support and improvement of quality of life: The diagnosis and treatment of bladder cancer may cause great psychological pressure on patients, and psychological support is needed. Family members should spend more time with patients to help them build confidence; after surgery, they can improve their quality of life by participating in social activities, cultivating interests and hobbies, etc.

Whether an 87-year-old bladder cancer patient should undergo surgery requires comprehensive consideration of physical condition, tumor stage and patient wishes to select the most suitable treatment plan. Regardless of whether surgery is performed or not, attention should be paid to postoperative care and improvement of quality of life, and comprehensive medical support should be provided to patients through multidisciplinary collaboration.