Bladder cancer is one of the most common cancers found in the urinary tract. This cancer generally starts in the inner lining of the bladder and is referred to as urothelial carcinoma.
Non-Muscle Invasive Bladder Cancer (NMIBC) refers to the early stages of bladder cancer that have not yet spread into the deeper muscular layers of the bladder. In this article, we will discuss the symptoms, stages and treatment options for NMIBC.
Symptoms
The most common symptom seen in NMIBC patients is blood or blood clots in the urine, also known as hematuria. Hematuria can range from light pink or red in color to a noticeable difference from the usual urine color. Other less common symptoms include:
– Frequent urination – Patients may feel the need to urinate more often than usual, sometimes every hour or two.
– Urinary urgency – The urge to urinate is very strong and requires immediate attention.
– Pain or burning during urination – Known as dysuria. There may also be lower abdominal or pelvic pain.
– Back or flank pain – Felt on one side of the back just below the ribs.
Stages Of NMIBC
NMIBC is classified into different stages based on how far the cancer has grown into the bladder tissues:
– Ta stage – Cancer is only found in the innermost layer of cells lining the bladder.
– Tis stage – Cancer is found in the innermost lining but has not grown beyond this layer. Also called carcinoma in situ.
– T1 stage – Cancer has grown into the connective tissue layer below the inner lining of the bladder but not into the muscle layer.
It is important to determine the stage accurately as it determines the treatment protocol and long term prognosis. Diagnostic tests like cystoscopy and biopsy are used for staging.
Treatment Options
The main treatment modalities for Non-Muscle Invasive Bladder Cancer include:
Transurethral Resection Of Bladder Tumor (TURBT)
This surgery removes all visible tumors through a cystoscope inserted via the urethra. It is the standard first treatment option and also helps determine the stage and grade accurately. Additional resection may be required to remove any remaining tumors.
Intravesical Therapy
Certain medications are directly instilled into the bladder through a catheter for a specific period of time. The goal is to treat any remaining tumor cells. Commonly used drugs include:
– Bacille Calmette-Guérin (BCG) immunotherapy – Widely considered the most effective option that reduces recurrence risk by 60-70%. Has potential side effects.
– Chemotherapy drugs like Mitomycin C – Effective but less so than BCG. Used for patients who cannot tolerate or fail BCG therapy.
– Other drugs under investigation include interferons, epirubicin, gemcitabine etc.
Bladder Surgery
Options include partial or complete cystectomy if the cancer is extensive or recurrent after other therapies. It helps prevent recurrence but impacts quality of life. Often combined with chemotherapy for advanced cases.
Bladder Preservation
For carefully selected patients, bladder sparing with combinedchemoradiation is possible as an alternative to radical cystectomy. Requires close surveillance due to risk of recurrence.
Prognosis And Follow Up
With proper treatment, NMIBC has a good prognosis with over 85% 5-year survival for early stage diseases. However, frequent surveillance is needed as there is high risk of recurrence (50-70% over 5 years) that may progress to muscle-invasive disease over time if left untreated. Lifelong follow up under a urologist with periodic cystoscopy and urine tests allows for early identification of recurrence and improving survival rates. Overall, non-muscle invasive bladder cancer can usually be managed effectively if timely intervention and long term monitoring are done.
NMIBC is an early stage bladder cancer that has not spread deeply into the bladder wall tissues. Symptoms are often related to blood in urine. Staging helps determine prognosis and appropriate therapies like TURBT, intravesical therapies, or bladder surgery. Close follow up surveillance is important due to the high recurrence risks. With adherence to standard treatment guidelines, non-muscle invasive bladder cancer patients experience favorable outcomes and long term survival.
*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it
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