Bladder Cancer (cont.)
Medical Treatment: Radiation
Standard therapies for bladder cancer include surgery, radiation therapy, chemotherapy, and immunotherapy or biological therapy.
- Surgery and radiation therapy are local therapies. This means that they get rid of cancer cells only in the treated area.
- Chemotherapy is systemic therapy. This means that it can kill cancer cells almost anywhere in the body.
- For more information, see the Surgery section.
Radiation is a painless, invisible high-energy ray that can kill both cancer cells and normal cells in its path. New radiation treatments are able to focus radiation better and damage fewer normal cells. Radiation may be given for small muscle-invasive bladder cancers. It is commonly used as an alternative approach to or in addition to surgery. Either of two types of radiation can be used. However, for greatest therapeutic efficacy, it should be given in conjunction with chemotherapy:
- External radiation is produced by a machine outside the body. The machine targets a concentrated beam of radiation directly at the tumor. This form of therapy is usually spread out in short treatments given five days a week for 5 to 7 weeks. Spreading it out this way helps protect the surrounding healthy tissues by lowering the dose of each treatment. External radiation is given at the hospital or medical center. You come to the center each day as an outpatient to receive your radiation therapy.
- Internal radiation is given by many different techniques. One involves placing a small pellet of radioactive material inside the bladder. The pellet can be inserted through the urethra or by making a tiny incision in the lower abdominal wall. You have to stay in the hospital during the entire treatment, which lasts several days. Visits by family and friends are restricted to protect them from the effects of radiation. When the treatment is done, the pellet is removed and you are allowed to go home. This form of radiation is rarely used for bladder cancer in the United States.
Unfortunately, radiation affects not only cancer cells but also any healthy tissues it touches. With external radiation, healthy tissue overlying or adjacent to the tumor can be damaged if the radiation cannot be focused enough. The side effects of radiation depend on the dose and the area of the body where the radiation is targeted.
- The area of your skin where the radiation passes through may become reddened, sore, dry, or itchy. The effect is not unlike sunburn. Although these effects can be severe, they are usually not permanent. The skin in this area may become permanently darker, however. Internal organs, bones, and other tissues can also be damaged. Internal radiation was developed to avoid these complications.
- You may feel very tired during radiation therapy.
- Radiation to the pelvis, as is needed for bladder cancer, can affect production of blood cells in the bone marrow. Common effects include extreme tiredness, increased susceptibility to infections, and easy bruising or bleeding.
- Radiation to the pelvis may also cause nausea, diarrhea, urinary problems, and sexual problems such as vaginal dryness in women and impotence in men.
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