Journal Article

Bladder cancer

Efstathiou, Jason A, Guo, Charles C, Hahn, Noah M, Lerner, Seth P, Lotan, Yair, Kamat, Ashish M, Choi, Woonyoung, Malmström, Per-Uno, Kassouf, Wassim

2016

Overview

Bladder cancer is a complex disease associated with high morbidity and mortality rates if not treated optimally. Awareness of haematuria as the major presenting symptom is paramount, and early diagnosis with individualised treatment and follow-up is the key to a successful outcome. For non-muscle-invasive bladder cancer, the mainstay of treatment is complete resection of the tumour followed by induction and maintenance immunotherapy with intravesical BCG vaccine or intravesical chemotherapy. For muscle-invasive bladder cancer, multimodal treatment involving radical cystectomy with neoadjuvant chemotherapy offers the best chance for cure. Selected patients with muscle-invasive tumours can be offered bladder-sparing trimodality treatment consisting of transurethral resection with chemoradiation. Advanced disease is best treated with systemic cisplatin-based chemotherapy; immunotherapy is emerging as a viable salvage treatment for patients in whom first-line chemotherapy cannot control the disease. Developments in the past 2 years have shed light on genetic subtypes of bladder cancer that might differ from one another in response to various treatments.

• Publisher: Elsevier Ltd,Elsevier Limited
• Subject: Antineoplastic Agents - administration & dosage / Bladder cancer / Cancer therapies / Carcinoma - diagnosis / Carcinoma - genetics / Carcinoma - pathology / Chemotherapy / Cisplatin - administration & dosage / Combined Modality Therapy / Cystectomy - methods / Disease-Free Survival / Hematuria - etiology / Humans / Immunotherapy / Internal Medicine / Metastasis / Mutation / Neoplasm Invasiveness - pathology / Patients / Treatment Outcome / Tumors / Urinary Bladder Neoplasms - diagnosis / Urinary Bladder Neoplasms - genetics / Urinary Bladder Neoplasms - pathology