Most urothelial cancer can be cured if treated early. Treatment for urothelial cancer depends on the stage. Stages are used to describe how much the cancer has worsened or spread.

Stages and Treatments

There are multiple stages and treatment options for urothelial cancer. More specific treatment descriptions are available below.

Stage 0 – This stage of urothelial cancer is also called noninvasive papillary carcinoma or carcinoma in situ, which means that abnormal cells appear in the lining of the kidney pelvis, ureter, or bladder. These abnormal cells may become cancerous and spread to nearby tissue.

Treatment for Stage 0 urothelial cancer may include:

  • Transurethral resection with fulguration
  • Partial or complete cystectomy
  • Intravesical Bacille Calmette-Guerin
  • Intravesical chemotherapy

Stage I – In this stage of urothelial cancer, the cancer has spread from the lining of the kidney pelvis, ureter, or bladder to the connective tissue.

Treatment for Stage I urothelial cancer may include:

  • Transurethral resection of a bladder tumor
  • Intravesical chemotherapy
  • Partial or complete cystectomy
  • Radical cystectomy

Stage II – In this stage of urothelial cancer, the cancer has spread to the muscle of the kidney pelvis, ureter, or bladder.

Treatment for Stage II urothelial cancer may include:

  • Transurethral resection of a bladder tumor
  • Intravesical chemotherapy
  • Partial or complete cystectomy
  • Radical cystectomy

Stage III – In this stage of urothelial cancer, the cancer has spread from the muscle of the kidney pelvis to the fat surrounding it, to other kidney tissue, or from the muscle of the ureter to the fat surrounding it.

Treatment for Stage III urothelial cancer may include:

  • Transurethral resection of a bladder tumor
  • Chemotherapy followed by radical cystectomy
  • Chemotherapy with or without radiation therapy
  • Immunotherapy

Stage IV – In this stage of urothelial cancer, the cancer has spread to the fat surrounding the kidney, the lymph nodes, a nearby organ, or to other parts of the body, such as the lung, liver, or bone.

Treatment for Stage IV urothelial cancer may include:

  • Chemotherapy with or without radiation therapy
  • Immunotherapy
  • Radical cystectomy
  • Radiation therapy
  • Urinary diversion surgery
  • Palliative care

Types of Treatments

Treatments for urothelial cancer depend on the type and stage and may include:

  • Intravesical Bacille Calmette-Guérin
  • Transurethral resection of bladder tumor
  • Cystectomy, or bladder removal, which can be partial, complete, or radical, which includes nearby organs and lymph nodes
  • Bladder Reconstruction
  • Intravesical chemotherapy
  • Systemic chemotherapy
  • Radiation therapy
  • Chemoradiation
  • Trimodality therapy
  • Immunotherapy, also called biologics

Surgery

Surgery for urothelial cancer may include:

Transurethral resection of bladder tumor, which is where the surgeon inserts a cautery or laser device through the urethra into the bladder to burn out the cancer.

Cystectomy, which can be either partial, full, or radical removal of the bladder and nearby organs and lymph nodes

Bladder reconstruction, which creates a new way for urine to pass by making a new pouch for the urine

Chemotherapy

Chemotherapy for urothelial cancer can be given in different ways, such as

Systemic (whole body) chemotherapy, which is used when the cancer cannot be surgically removed. Systemic chemotherapy can be given directly into a vein or a pill by mouth.

Chemoradiation, which is when chemotherapy is combined with radiation therapy

Chemotherapy drugs used for the treatment of urothelial cancer include:

  • Cisplatin
  • Cisplatin plus fluorouracil
  • Cisplatin, methotrexate, and vinblastine
  • Gemcitabine and cisplatin
  • Gemcitabine and paclitaxel
  • Methotrexate, vinblastine, doxorubicin, and cisplatin
  • Mitomycin with fluorouracil

Radiation Therapy – Radiation therapy uses directed, high-energy X-rays, protons, or other types of radiation to kill cancer cells.

Trimodality Therapy – Trimodality therapy uses a combination of chemotherapy, radiation therapy, and transurethral resection of bladder tumor in an effort to preserve as much of the bladder as possible.

Immunotherapy, also called biologics – Immunotherapy is when the body’s immune system, or the body’s natural defenses, is used to fight cancer cells.

Common immunotherapy drugs administered for urothelial cancer are:

  • Bacillus Calmette-Guerin
  • Interferon
  • Atexolizumab

Palliative Care

In addition to standard treatments, patients with urothelial cancer may also be treated with palliative care. Palliative care is used to relieve pain and other symptoms to make a patient more comfortable.

New, Experimental Treatments

New and experimental treatments for urothelial cancer include the immunotherapy drugs pembrolizumab (Keytruda), nivolumab (Opdivo), and ipilimumab (Yervoy).

Long-Term Follow Up

Ongoing, long-term follow-up is an essential part of the treatment for patients with cancer because the cancer can reoccur even after it has been treated.

Sources

This content was written by the MediFind Medical Team. Last updated: 6/9/2022

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    Urothelial Cancer Approved Drugs

    These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Urothelial Cancer.

    Found 1 Approved Drug for Urothelial Cancer

    DOXOrubicin

    Brand Names
    Doxil, Adriamycin
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