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Radiation Therapy for Bladder Cancer
Facts About Bladder Cancer 
- The American Cancer Society estimates
that nearly 69,000 new cases of bladder
cancer are diagnosed in the United
States each year.
- Bladder cancer is four times more common
in men than in women. It is two
times more common in Caucasians than
African-Americans.
- The five-year survival rate for all types
of bladder cancer is 80 percent. If the
cancer is confined to the bladder
(noninvasive), the five-year survival rate
is 92 percent.
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About Bladder Cancer
The bladder is located in the pelvis. It collects and
stores urine and has a muscular wall that allows it to
contract and expand.
- About 90 percent of bladder cancers are
transitional cell carcinoma. Squamous cell carcinoma,
adenocarcinoma and small cell carcinoma
account for most of the rest. Treatment options vary
depending on the type of bladder case.
- Cancer that is only in the bladder lining is called
non-muscle invasive bladder cancer (NMIBC).
This type of cancer is sometimes called superficial
bladder cancer. More than 75 percent of bladder
cancer is diagnosed as a NMIBC and it has an
excellent survival rate.
- Muscle invasive bladder cancer penetrates the
layers of muscles in the bladder and is more likely
to spread to other parts of the body. About 90 percent of bladder cancers are transitional cell carcinoma. Squamous cell carcinoma, adenocarcinoma and small cell carcinoma account for the rest.
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Treating Bladder Cancer
Treatment options are based on your type cancer, age
and overall health. Bladder cancer, if caught early, can
often be cured. The main treatments include:
- Surgery by a surgical oncologist or urologist to
remove the cancer in the bladder is usually the first
step. If a tumor is determined to be invasive, the next
step may be removal of part or all of the bladder.
Your surgeon may able to replace the bladder to help
you maintain normal urinary function.
- Radiation therapy is where a radiation oncologist
uses high-energy X-rays to destroy the tumor.
- Chemotherapy is where a medical oncologist uses
drugs to eliminate the cancer.
- Biologic therapy (also called immunotherapy) is
where doctors use a drug to stimulate your immune
system to fight the cancer.
In the past, complete removal of the bladder was the
only way to treat bladder cancer. With advances in radiation
therapy and chemotherapy, doctors are sometimes
able to treat the cancer while preserving the bladder.
This allows many patients to preserve urinary function
and allows many men to preserve erectile function. Surgery by a surgical oncologist or urologist to remove the cancer or possibly part or all of the bladder.
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Radiation Therapy Options for Bladder Cancer
Radiation therapy, sometimes called radiotherapy, is
the careful use of radiation to safely and effectively
treat cancer. Radiation therapy works within cancer
cells by damaging their ability to multiply. When these
cells die, the body naturally eliminates them. Healthy
cells are also affected by radiation, but they are able to
repair themselves in a way cancer cells cannot.
- External beam radiation therapy is the main
type of radiation used to treat bladder cancer,
often in combination with chemotherapy. During
this treatment, radiation is directed at the tumor
from a machine similar to an X-ray machine.
- Internal radiation therapy, or brachytherapy,
is also sometimes used, often in conjunction with
external beam radiation therapy. Radioactive pellets
or seeds are delivered to the tumor through
small tubes called catheters .Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them.
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External Beam Radiation Therapy
External beam radiation therapy involves a series of
daily outpatient treatments to deliver radiation to the
bladder. These treatments take less than half an hour
each, five days a week, for five to seven weeks.
- The radiation beam is usually generated by a machine
called a linear accelerator or linac. Doctors
use this machine to generate high-energy X-rays to
treat your cancer.
- Using high-tech treatment planning software, your
treatment team controls the size and shape of the
beam, as well as how it is directed at your body.
This allows doctors to treat the cancer while sparing
nearby healthy organs.
- Three-dimensional conformal radiotherapy
(3D-CRT) combines multiple radiation treatment
fields to deliver precise doses of radiation to the
cancer. This improved technique helps keep
radiation away from nearby healthy tissue.
- Intensity modulated radiation therapy, or IMRT, is
a specialized form of 3D-CRT that allows the radiation
beams to be further shaped to focus on the
tumor. IMRT is still being studied for bladder cancer.
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Potential Side Effects
The side effects you might feel will depend on the
area being treated, the dose of radiation given and
whether you also receive other treatments, such as
chemotherapy. Before treatment begins, ask your
doctor about specific side effects and how you can
best manage them. Side effects may include:
- Bladder irritation with increased need to urinate.
- Bowel irritation with abdominal cramping, rectal
pressure and diarrhea are possible.
- Fatigue where you feel tired much of the time.
- You may experience a mild skin irritation, like a
sunburn. The radiation will not cause you to lose the
hair on your head, but you may lose your pubic hair
near where the radiation was aimed. Some people
find the hair grows back in a different color or
texture than before.
- Some patients may also see sexual side effects.
Women may experience vaginal dryness. Some
men may difficulty achieving an erection. These are
temporary, but tell your doctor or nurse. They may be
able to recommend products or medications to help.
- Sometimes symptoms don’t appear until treatments
are finished. Some people have hardly any symptoms
at all. You are unique as will be your reaction to
cancer treatments.
Talk to your doctor or nurse about any discomfort or side
effects you have, however embarrassing. He or she may
be able to provide drugs or other treatments to help.
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Caring For Yourself During Treatment
- Get plenty of rest during treatment. Follow
your doctor’s orders.
- Ask if you are unsure about anything or if
you have questions about your
treatments and side effects.
- Tell your doctor about any medications or
vitamins you are taking.
- Eat a balanced diet. If food tastes funny or
if you’re having trouble eating, tell your
doctor or dietician. They may be able to
help you change the way you eat.
- Treat the skin exposed to radiation with
special care. Avoid hot or cold packs,
and only use lotions and ointments after
checking with your doctor or nurse. Your
radiation oncology team may also recommend
special creams.
- When cleaning the area, use only water
and a mild soap.
- Coping with cancer can be trying. Be sure
to ask friends, family, support groups and
your radiation oncology team for help.
- Many people say that they feel more relaxed
and open talking with fellow patients. It may
help to seek out support groups that meet
in person or over the Internet.
To order hard copies copies of this brochure, visit the ASTRO Shop.
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