Bladder Cancer (cont.)


Surgery is an option for most people with bladder cancer. You and your surgeon can talk about the types of surgery and which may be right for you:

  • Transurethral resection (TUR): The doctor uses a cystoscope to treat early bladder cancer (Stage 0 or Stage I). No incision (cut) into your body is needed, but general anesthesia or spinal anesthesia is usually given.

    The doctor inserts the cystoscope into the bladder through your urethra. The cutting tool is slipped through the cystoscope. A small wire loop at the end of the tool removes the cancer and burns away remaining cancer cells with an electric current.

    TUR may need to be repeated. Also, chemotherapy or biological therapy may be given after this type of surgery.

    For a few days after TUR, you may have some blood in your urine and difficulty or pain when passing urine. Otherwise, TUR generally causes few problems.

  • Open surgery: The surgeon makes an incision into your body to remove the cancer from your bladder.

    • Part of the bladder (called a partial cystectomy): For some people with a single, small tumor in the bladder, the surgeon does not remove the entire bladder. The surgeon removes the tumor, the part of the bladder containing the tumor, and nearby lymph nodes.

      After part of the bladder is removed, you may not be able to hold as much urine in your bladder as before surgery. You may need to empty your bladder more often. This problem usually gets better with time.

    • All of the bladder (called a radical cystectomy): For bladder cancer that has invaded the muscle layer (Stage II or some Stage III), the most common type of surgery is radical cystectomy. The surgeon removes the entire bladder, nearby lymph nodes, and part of the urethra. In addition, the surgeon usually removes the prostate from a man and may remove the uterus from a woman. Other nearby tissues may also be removed.

      When the entire bladder is removed, the surgeon makes another way for urine to be collected from the kidneys and stored. You may wear a flat bag outside the body under your clothes, or the surgeon may use part of your intestine to create a pouch inside the body. The Rehabilitation section on page 23 has more information.

      When the prostate or uterus is removed, a man can no longer father a child and a woman can no longer get pregnant. Also, a man may be unable to have sex after surgery. If the surgeon removes part of a woman's vagina, sex may be difficult.

      Because bladder cancer surgery may affect your sex life, it may help you and your partner to talk about your feelings and help one another find ways to share intimacy during and after treatment. See Sources of Support on page 26 for more information.

It takes time to heal after surgery, and the time needed to recover is different for each person. It's common to feel weak or tired for a while.

Also, you may have pain or discomfort for the first few days. Medicine can help control your pain. Before surgery, you should discuss the plan for pain relief with your doctor or nurse. After surgery, your doctor can adjust the plan if you need more pain control.

After TUR or partial cystectomy, the urethra needs time to heal. You'll have a catheter. A catheter is a tube put through the urethra into the bladder to drain urine. You'll have the catheter for 5 days to 3 weeks. Your nurse or doctor will show you how to care for it.

You may want to ask your doctor these questions before having surgery:

  • What type of surgery do you recommend for me? Why?
  • Will lymph nodes and other tissues be removed? Why?
  • How will I feel after surgery?
  • If I have pain, how will you control it?
  • How long will I be in the hospital?
  • Will I have any long-term effects because of the surgery?
  • If my bladder is removed, who will teach me how to store urine in a pouch or bag?
  • If my bladder is removed, will I need to wear a medical alert bracelet for the rest of my life?

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