Urinary Bladder Cancer Treatment In India

Dr Vijayant Govinda Gupta is an Urologist and Oncosurgeon in India with extensive experience in the treatment of bladder cancer. He is a full member of the European Association of Urology and Urological Society of India. He is an ex member of the American Urological Association. Trained and India and abroad, he provides consultation and surgeries at his practice in New Delhi India.

On this page read about various surgical treatment for bladder cancer including Radical Cystectomy and TURBT.

Bladder Cancer Treatment In New Delhi India

Bladder cancer is a common cancer, presenting with blood in urine, and with variable survival depending on different data and surgeon experience.

Bladder cancer is cancer of old age and is very common in old people.

Bladder cancer occurs in old men and smokers. Other risk factors for bladder cancer are exposure to paints, fumes and pollutant. Delhi and NCR region is one of the most polluted regions in the world, and hence, predisposes men and women living in Delhi to the development of bladder cancer.

Bladder Cancer Treatment In New Delhi India

Bladder cancer is a common cancer, presenting with blood in urine, and with variable survival depending on different data and surgeon experience. Bladder cancer is cancer of old age and is very common in old people.

Bladder cancer occurs in old men and smokers. Other risk factors for bladder cancer are exposure to paints, fumes and pollutant. Delhi and NCR region is one of the most polluted regions in the world, and hence, predisposes men and women living in Delhi to the development of bladder cancer.

Urinary Bladder Treatment Cost

The cost for treatment depends on many factors. Age, Comorbidities, Number of days stay expected in the hospital and size and extent of tumor. Average costs are given below.

Costs are in USD for International PatientsINR rates are comparatively less for indian patients.

TURBT – 2000 USD

Radical Cystectomy – 3000 USD

Ileal Conduit – 1000 USD

Orthotopic Neobladder / CCD – 2000 USD

Room rent – 100 USD per day

Medicines – 100 USD per day

What Is A Urinary Bladder ?

Urinary bladder or bladder is the large bag like structure present in the human pelvis that stores urine. Through out life, this bag which usually has a capacity to store upto 500 ml of urine fills up and stores urine until, you have the urge to go pass urine. The urine is usually colorless to light yellow with no smell. Urine is usually made up of excreted waste products. So if you are exposed to smoking or polllution, then these fumes will go into your blood stream via your lungs and then will come in your urine, where these pollutants will harm the bladder and over many years will lead to urinary bladder cancer.

Bladder cancer is also called urothelial cancer or urothelial carcinoma. Urothelial cancer is the most common variety of bladder cancer. There are other variants which are rarer and need more intense workup and treatment.

Urinary Bladder Cancer Symptoms

Normal urine is clear yellow. Passing red colored urine or blood in urine is the number one symptom of bladder cancer. Hematuria or blood in urine is the most common symptom of urinary bladder cancer. Read more about hematuria in my article here. Blood in urine in bladder cancer is completely painless, may occur once a while, may happen throughout the day and usually resolves on its own. The patient gets one such episode and then it stops on its own. The patient thinks that he got treated with some local medicine.

Warning – this false sense of relief allows the disease to grow. You should get prompt evaluation at once from a urologist. To know about a urologist – click here. Other rarer symptoms may be dysuria or burning in urine, bladder pain, frequent urination etc.

Nvestigations To Diagnose Urinary Bladder Cancer

Patients with bladder cancer commonly complain of passing blood in urine. The common tests required to diagnose bladder cancer are

1. Ultrasound – this is a commonly available and cheap test. in this the radiologist will ask you to hold your urine until you have a strong desire to pass urine. At this point, the radiologist will then place a probe on your stomach and see your bladder and any cancer within.

2. Contrast enhanced CT – CECT is the most important investigation. CECT will help find out about the tumor size, its characteristics, its stage and whether it has spread? Unfortunately, if your creatinine is raised, or the bladder cancer has caused your kidneys to fail (Hydronephrosis secondary to ureteric involvement), you will not be able to undergo a cect. In these cases you will require stabilization before undergoing CECT

3. MRI – Patients not fit for CECT due to kidney failure and bladder cancer, will be investigated with MRI.

4. Bone Scan – Bladder cancer normally spreads to the bones causing painful bone pains. Bone scan is a test used to detect bone metastasis.

5. FDG Pet CT – FDG Pet Ct in bladder cancer is the new modality to detect metastasis. Though expensive, it is a reliable way to detect metastatic disease.

Transurethral Resection of Bladder Tumor (Turbt)

Once a patient is diagnosed with bladder cancer, then you need a cystoscopy and TURBT. TURBT stands for transurethral resection for bladder tumor. TURBT in Delhi is performed by Dr Vijayant Govinda Gupta. In TURBT, a endoscope is put inside your bladder via your penis. There is no incision or scar on your body. With the scope the surgeon visualises the tumor and cuts it from within. This serves three purposes.

Removes the tumor – allowing biopsy

Stops the blood in urine

In some cases this procedure may be curative.

Usually a TURBT is done in 2 sittings and the next sitting is called a restage TURBT.

Restage Turbt (Second Visit)

One TURBT is not enough to either cure or stage the disease. After the first TURBT, the first biopsy report will be available. Bladder cancer biopsy report will contain two important informations.

Grade of bladder cancer – This may be high or low. Low is good news, high not so much.

Deapth of invasion – the bladded cancer may invade the wall of the urinary bladder to variable depths. If the disease is deep, it is called T2 or muscle invasive disease and qualifies you for a radical cystectomy.

If your first TURBT, reveals a disease less than T2 (T0 or T1) , then you may need another TURBT called a restage TURBT to confirm that we are not missing T2 disease.

Role of Intravesical BCG In Bladder Cancer Treatment

BCG or Bacillus Calmette Guerin is a bacteria (variant of tuberculosis). It is used as a vaccine in children to protect against TB. It was found that putting it in urinary bladder in bladder cancer patients, cures them. The strategy of putting bcg in bladder cancer patients is called intravesical BCG. In T1 or TaHG or CIS Urinary bladder cancer, Intravesical BCG can cure your bladder cancer.

Radical Cystectomy (Urinary Bladder Removal)

If you have T2 disease, then it is called muscle invasive urinary bladder cancer. People with T2 or muscle invasive bladder cancer can be cured and live healthy lives. But first you will undergo CECT and a bone scan to rule out metastasis or advanced disease.

The best cure for muscle invasive cancer urinary bladder is radical cystectomy. In this surgery the entire urinary bladder is removed surgically and your kidneys will be joined to a new bladder. This new bladder is made of intestine and has to be reconstructed. This new bladdder can be of 3 types.

  1. Orthotopic Neobladder – the most difficult surgery in urology.  I reconstruct your bladder with intestine inside your body allowing you to pass urine naturally as always. This surgery is difficult and complicated but has excellent results.
  2. Continent Cutaneous Diversion (CCD) – The bladder is built inside the body but instead of passing urine through the penis, the hole will be made in the stomach and u will have to put a pipe to remove urine every 2 hours.
  3. Ileal conduit / Urinary Diversion – Easiest to manage, the bladder is made outside and urine comes in a bag. A uro-stoma is made and a urostoma pouch needs to be worn.

All three surgeries are excellent alternatives and which suits you best is a decision made after detailed consultation and workup.

Other Alternatives To Surgery For Urinary Bladder Cancer

After your first TURBT, Bladder Cancer treatments are not always surgery. Depending on your age, choice and clinical conditions, other alternatives like intravesical BCG, radiotherapy or chemotherapy may be used.