Treatment for Stage I Bladder Cancer
Stage I transitional cell carcinoma (TCC) of the urinary bladder is defined as cancer that has invaded the submucosa but not the deeper muscle layer of the bladder wall.
The recommended initial treatment for non-invasive bladder tumors, including Stage I (confined to mucosa and submucosa), is typically Trans urethral resection of bladder tumour (TURBT).
Why TURBT is Recommended
- TURBT is a minimally invasive procedure performed using a resectoscope inserted through the urethra.
- It allows for the complete removal or destruction of the tumor while obtaining tissue for accurate staging and grading.
- For tumors limited to the mucosa and submucosa (Stage I), TURBT is often curative and avoids the morbidity associated with more extensive surgeries.
Other Treatment Options Considered
- Radical cystectomy: This involves removing the entire bladder and is generally reserved for muscle-invasive bladder cancer (Stage II or higher) or high-risk non-muscle-invasive disease that has recurred after adequate TURBT.
- Radiation therapy: While sometimes used in combination with chemotherapy or for patients unsuitable for surgery, it's not the primary treatment for early-stage, non-invasive TCC.
- Systemic chemotherapy: This is typically used for advanced or metastatic bladder cancer, or sometimes intravesically after TURBT for high-risk non-muscle-invasive disease, but not as the primary treatment for Stage I TCC itself.
Therefore, TURBT is the standard and most appropriate treatment for Stage I bladder cancer.
Important Questions from Urinary System & Surgical Disorders
Which of the following statements are correct regarding renal cell carcinoma?
1. It arises from the epithelium of the proximal convoluted tubule.
2. It has a female preponderance.
3. Major subtypes are clear cell, papillary and chromophobe.
4. Surgery is the mainstay of treatment for disease. organ-confined
Select the answer using the code given below.
Which of the following are features of autosomal dominant polycystic kidney disease?
1. Cyst may also occur in liver, pancreas and arachnoid membrane.
2. Most commonly manifests between 20-30 years of age.
3. Clinical manifestations are renal and extrarenal.
4. Men tend to progress to renal failure more rapidly than women.
Select the correct answer using the code given below.
- Extracorporal Shock Wave Lithotripsy (ESWL) is most commonly used for the treatment of
Which of the following are correct regarding pathology of stress urinary incontinence?
1. Hypermobility of urethra
2. Ascend of bladder neck and proximal urethra above diaphragm
3. Lowered urethral pressure
4. Increased detrusor activity
Select the answer using the code given below.
Which of the following are correct about ectopic ureters ?
1. They are more common in males
2. They drain the upper pole of kidney
3. They are associated with duplex ureter
4. They may cause incontinence
Select the correct answer using the code given below :
