What is the cost of Bladder Cancer Treatment In India?

Many potential patients for surgery are concerned to know about Bladder Cancer treatment cost In India? The Average cost of Bladder Cancer treatment In India usually starts $2000 however, it may go up to as much as $15000. It depends on the hospital charges and the fee charged by the surgeon. which includes initial investigations & specialists screening, stay in a room wherein the patient’s assistant or relative can also stay with the patient, Doctor/Surgeon fee, Nursing care, Medicines & Consumables, airport pick-up & drop.

High-Quality Bladder Cancer Treatment In India

Bladder cancer growth is a typical kind of disease that starts in the cells of the bladder. The bladder is an empty solid organ in your lower abdomen that stores urine.


Bladder cancer most often begins in the cells (urothelial cells) that line the within of your bladder. Urothelial cells are also found in your kidneys and the tubes (ureters) that connect the kidneys to the bladder. Urothelial cancer can occur in the kidneys and ureters, as well, yet it’s considerably more typical in the bladder.

 

Most bladder cancers are diagnosed at an early stage when the cancer is highly treatable. However, even beginning stage bladder diseases can return after successful treatment. For this reason, individuals with bladder cancer generally need follow-up tests for quite a long time after treatment to look for bladder cancer that recurs.

Types of bladder cancer

The type of bladder cancer depends on how the tumor’s cells look under the microscope. The 3 main types of bladder cancer are:

  • Urothelial carcinoma. Urothelial carcinoma (or UCC) represents about 90% of all bladder cancer. It likewise represents 10% to 15% of kidney cancers.
  • Diagnosed in adults. It starts in the urothelial cells found in the urinary lot. Urothelial carcinoma is some of the time additionally called temporary cell carcinoma or TCC.
  • Squamous cell carcinoma. Squamous cells create in the bladder lining because of disturbance and irritation. After some time, these cells may get cancerous. Squamous cell carcinoma represents about 4% of all bladder cancers.
  • Adenocarcinoma. This sort represents about 2% of all bladder cancers and develops from glandular cells.

There are other, less common types of bladder cancer, including sarcoma of the bladder and small cell bladder cancer. Sarcomas of the bladder frequently start in the fat or muscle layers of the bladder. small cell bladder cancer is an uncommon sort of bladder cancer that is probably going to spread to different pieces of the body.

 

 

Read More About Type of Bladder Cancer

Symptoms of Bladder Cancer

The main symptom of bladder cancer is blood in your urine. This is the same for both men and women.

Blood in the urine

  • The most common symptom is blood in the Urine of Bladder Cancer. 80 out of 100 with bladder cancer (80%) have some blood in their urine. Doctors call blood in the urine haematuria (pronounced heem-at-you-ree-ah).
  • You might recognize the blood in your urine. It usually looks bright red. Rarely, it may look dark brown.
  • Sometimes the amount of blood in urine is very small that you can’t see. But after a urine test, you will get to know if you have bladder cancer or not.
  • The blood might not be in your urine all the time. It can come and go. But if you ever see blood in your urine, you should go to your doctor.
  • The bleeding is not mostly painful. But it can help your doctor to know whether you had any pain when you passed the urine with the blood in it.

It can also help if you tell them whether:

  • there is blood only when you start to Urine
  • the blood is mixed with all the urine you pass

Other symptoms of bladder cancer can include:

  • passing urine very often (frequency)
  • passing urine very suddenly (urgency)
  • pain or a burning sensation when passing urine
  • weight loss
  • pain in your back, lower tummy, or bones
  • feeling tired and unwell

These symptoms are much more likely to be caused by other conditions rather than cancer. For example, a urine infection, particularly if you do not have blood in your urine. For men, the symptoms could be caused by an enlarged prostate gland.

 

Read More About Type of bladder Cancer

Causes Of Bladder Cancer

The commonest causes are smoking of cigarettes, bidis, hookah, and exposure to chemicals in industries such as dyes, metal, paints, leather, textile, and organic chemicals. More than 90 percent of all bladder cancers originate in the urothelium and then may invade the lamina propria and detrusor muscle.

Read More About Course of Bladder Cancer

How is bladder cancer diagnosed?

Your doctor may diagnose bladder cancer using one or more of the following methods:

  • Urine Test
  • an internal examination, which involves your doctor inserting gloved fingers into your vagina or rectum to feel for lumps that may indicate a cancerous growth
  • a cystoscopy, which involves your doctor inserting a narrow tube that has a small camera on it through your urethra to see inside your bladder
  • a biopsy in which your doctor inserts a small tool through your urethra and takes a small sample of tissue from your bladder to test for cancer
  • a CT scan to view the bladder
  • an intravenous pyelogram (IVP)
  • X-rays

Your doctor can rate bladder cancer with a staging system that goes from stages 0 to 4 to identify how far cancer has spread. The stages of bladder cancer mean the following:

Stages of Bladder cancer
  • Stage 0 bladder cancer hasn’t spread past the lining of the bladder.
  • Stage 1 bladder cancer has spread past the lining of the bladder, but it hasn’t reached the layer of muscle in the bladder.
  • Stage 2 bladder cancer has spread to the layer of muscle in the bladder.
  • Stage 3 bladder cancer has spread into the tissues that surround the bladder.
  • Stage 4 bladder cancer has spread past the bladder to the neighboring areas of the body.

How is Bladder Cancer Treated?

Your doctor will work with you to decide what is the best treatment to provide based on the type and stage of your bladder cancer, your symptoms, and your overall health.

Treatment for stage 0 and stage 1

Treatment for stage 0 and stage 1 bladder cancer might include surgery to remove the tumor from the bladder, chemotherapy, or immunotherapy, which involves taking a medication that causes your immune system to attack the cancer cells.

Treatment for stage 2 and stage 3

Treatment for stage 2 and stage 3 bladder cancer may include:

  • Removal of part of the bladder in addition to chemotherapy.
  • Removal of the whole bladder, which is a radical cystectomy, followed by surgery to create a new way for urine to exit the body.
  • chemotherapy, radiation therapy, or immunotherapy that can be done to shrink the tumor before surgery, to treat cancer when surgery isn’t an option, to kill remaining cancer cells after surgery, or to prevent cancer from recurring.

Treatment for stage 4 bladder cancer

Treatment for stage 4 bladder cancer may include:

  • Chemotherapy without surgery to relieve symptoms and extend patient life
  • Radical cystectomy and removal of the surrounding lymph nodes, followed by surgery to create a new way for urine to exit the body
  • Chemotherapy, radiation therapy, and immunotherapy after surgery to kill remaining cancer cells or to relieve symptoms and extend the life
  • Clinical trial drugs

Types of Bladder Cancer Treatment In India

Basic descriptions of the most common types of treatments used for bladder cancer are listed below. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals and benefits of each treatment with your doctor and what you can expect while receiving the treatment. These types of talks are called “shared decision making.” Shared decision making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision making is particularly important for bladder cancer because there are different treatment options.

To see general treatment options based on the extent of the bladder cancer, read the next section in this guide, Treatments by Stage.

Surgery for Bladder Cancer.

Surgery is the removal of the tumor and some surrounding healthy tissue during an operation. There are different types of surgery for bladder cancer. Your health care team will recommend a specific surgery based on the stage and grade of the disease. Surgical options to treat bladder cancer include:

 

Transurethral bladder tumor resection (TURBT). 

  • This procedure is used for diagnosis and staging, as well as treatment. During TURBT, a surgeon inserts a cystoscope through the urethra into the bladder. The surgeon then removes the tumor using a tool with a small wire loop, a laser, or fulguration (high-energy electricity). The patient is given an anesthetic, medication to block the awareness of pain, before the procedure begins.
  • For people with non-muscle-invasive bladder cancer, TURBT may be able to eliminate the cancer. However, the doctor may recommend additional treatments to lower the risk of the cancer returning, such as intravesical chemotherapy or immunotherapy (see below). For people with muscle-invasive bladder cancer, additional treatments involving surgery to remove the bladder or, less commonly, radiation therapy are usually recommended.

Radical cystectomy and lymph node dissection. 

  • A radical cystectomy is a removal of the whole bladder and possibly nearby tissues and organs. For men, the prostate and urethra also may be removed. For women, the uterus, fallopian tubes, ovaries, and part of the vagina may be removed. For all patients, lymph nodes in the pelvis are removed. This is called a pelvic lymph node dissection. An extended pelvic lymph node dissection is the most accurate way to find cancer that has spread to the lymph nodes. Rarely, for some specific cancers, it may be appropriate to remove only part of the bladder, which is called partial cystectomy. However, this surgery is not the standard of care for people with the muscle-invasive disease.

During a laparoscopic or robotic cystectomy.

  • The surgeon makes several small incisions, or cuts, instead of the 1 larger incision used for traditional surgery. The surgeon then uses telescoping equipment with or without robotic assistance to remove the bladder. The surgeon must make an incision to remove the bladder and surrounding tissue. This type of operation requires a surgeon who is very experienced in minimally invasive surgery. Several studies are still in progress to determine whether laparoscopic or robotic cystectomy is as safe as the standard surgery and whether it is able to eliminate bladder cancer as successfully as standard surgery.

Urinary diversion. 

  • If the bladder is removed, the doctor will make another way to pass urine out of the body. One way to do this is to use a section of the small intestine or colon to divert urine to a stoma or ostomy (an opening) on the outside of the body. The patient at that point must wear a sack appended to the stoma to gather and deplete urine.
  • Surgeons can sometimes use part of the small or large intestine to make a urinary supply, which is a capacity pouch that sits inside the body. With these procedures, the patient does not need a urinary bag. For certain patients, the surgeon is able to connect the pouch to the urethra, making what is called a neobladder or “Indiana pouch”, so the patient can pass urine out of the body normally. However, the patient may need to insert a thin tube called a catheter if the neobladder is not fully emptied of urine. Also, patients with a neobladder will no longer have the urge to urinate and will need to learn to urinate on a consistent schedule. For other patients, an internal (inside the abdomen) pouch made of the small intestine is created and connected to the skin on the abdomen or belly button (umbilicus) through a small stoma. With this approach, patients do not need to wear a bag. Patients drain the internal pouch on various occasions a day by putting a catheter through the little stoma and immediately removing the catheter.
  • Living without a bladder can affect a patient’s quality of life satisfaction. Discovering approaches to keep all or some portion of the bladder is an important treatment objective. For certain individuals with muscle-invasive bladder Cancer, treatment plans including chemotherapy and radiation therapy (see below) may be used as an alternative to removing the bladder.

The side effects of bladder cancer surgery depend on the procedure. Research has shown that having a surgeon with bladder cancer expertise can improve the outcome of people with bladder cancer. Patients should talk with their doctor in detail to understand exactly what side effects may occur, including urinary and sexual side effects, and how they can be managed. In general, side effects may include:

  • Longer healing time
  • Infection
  • Mild bleeding and discomfort after surgery
  • Infections or urine leaks after cystectomy or a urinary diversion. If a neobladder has been created, a patient may sometimes be unable to urinate or completely empty the bladder.
  • Men may be unable to have an erection, called erectile dysfunction, after cystectomy. Sometimes, a nerve-sparing cystectomy can be performed. When this is done successfully, men may be able to have a normal erection.
  • Damage to the nerves in the pelvis and loss of sexual feeling and orgasm for both men and women. Often, these problems can be fixed with further treatment.

Before surgery, talk with your surgeon about the possible side effects of the specific surgery you will have.

The types of systemic therapies used for bladder cancer include:

  • Chemotherapy
  • Immunotherapy
  • Targeted therapy

The medications used to treat cancer are continually being evaluated. Talking with your doctor is often the best way to learn about the medications prescribed for you, their purpose, and their potential side effects or interactions with other medications. It is also important to let your doctor know if you are taking any other prescription or over-the-counter medications or supplements. Herbs, supplements, and other drugs can interact with cancer medications. Learn more about your prescriptions by using searchable drug databases.

Chemotherapy

Chemotherapy is the use of drugs to destroy cancer cells, generally by keeping the cancer cells from growing, dividing, and making more cells. A chemotherapy regimen, or schedule, typically consists of a specific number of cycles given over a set period of time. A patient may get 1 medication at a time or a mix of various medications given at the same time.

 

There are 2 types of chemotherapy that might be used to treat bladder cancer. The type the doctor recommends and when it is given depends on the stage of cancer. Patients should talk with their doctor about chemotherapy before surgery.

 

 

Intravesical chemotherapy. 

Intravesical or local, chemotherapy is normally given by a Medical Oncologist. During this kind of treatment, drugs are delivered into the bladder through a catheter that has been inserted through the urethra. Local treatment only destroys superficial tumor cells that come in contact with the chemotherapy solution.

It can’t arrive at tumor cells in the bladder divider or tumor cells that have spread to different organs. Mitomycin-C (available as a generic drug), gemcitabine (Gemzar), and thiotepa (Tepadina) are the drugs used most often for intravesical chemotherapy. Other medications that are used include cisplatin (available as a generic drug), doxorubicin (available as a generic drug), and valrubicin (Valstar). In 2020, the FDA also approved mitomycin (Jelmyto) for the therapy of patients with poor quality upper tract urothelial cancer.

Systemic chemotherapy. 

The most common regimens for systemic, or whole-body, chemotherapy to treat bladder cancer include:

  • Cisplatin and gemcitabine
  • Carboplatin (available as a generic drug) and gemcitabine
  • MVAC, which combines 4 drugs: methotrexate (Rheumatrex, Trexall), vinblastine (Velban), doxorubicin, and cisplatin
  • Dose-dense (DD)-MVAC with growth factor support: This is the same regimen as MVAC, but there is less time between treatments

Many foundational chemotherapies keep on being tried in clinical trials to help discover which medications or combinations of medications work best to treat bladder cancer. Generally a combination of medications works in a way that is better than 1 medication alone. Researchers are also studying when it is best to use chemotherapy, either before or after surgery.


If platinum chemotherapy recoils or eases back cutting edge or metastatic bladder Cancer, immunotherapy with avelumab (Tecentriq, see underneath) might be used to attempt to forestall or defer the Cancer from returning and to assist people with living longer. This is called switch maintenance treatment.

Side effects of chemotherapy depend on the individual and the dose used, but they can include fatigue, risk of infection, nausea and vomiting, hair loss, loss of appetite, and diarrhea. These side effects usually go away after treatment is finished.

Immunotherapy

Immunotherapy also called biologic treatment, is designed to support the body’s natural defenses to fight cancer. It uses materials made either by the body or in a laboratory to improve, target, or restore immune system function. It can be given locally or throughout the body.

 

Local therapy

Bacillus Calmette-Guerin (BCG). The standard immunotherapy drug for bladder cancer is a weakened bacterium called BCG, which is similar to the bacteria that cause tuberculosis. BCG is placed directly into the bladder through a catheter. This is called intravesical therapy. BCG attaches to the inside lining of the bladder and stimulates the immune system to destroy the tumor. BCG can cause flu-like symptoms, chills, mild fever, fatigue, a burning sensation in the bladder, and bleeding from the bladder.

Bacillus Calmette-Guerin (BCG). The standard immunotherapy drug for bladder disease is a debilitated bacterium called BCG, which is like the microscopic organisms that cause tuberculosis. BCG is set legitimately into the bladder through a catheter. This is called intravesical treatment. BCG joins within the covering of the bladder and animates the invulnerable framework to pulverize the tumor. BCG can cause influenza-like side effects, chills, mellow fever, weariness, a consuming sensation in the bladder, and seeping from the bladder.

Interferon (Roferon-A, Intron A, Alferon). Interferon is another kind of immunotherapy that can be given as intravesical therapy. It is now and then joined with BCG if utilizing BCG alone doesn’t help treat Bladder Cancer.

Targeted therapy

Targeted therapy is a therapy that objectives the cancer’s specific genes, proteins, or the tissue environment that contributes to cancer growth and survival. This kind of therapy blocks the development and spread of cancer cells while restricting harm to healthy cells.

Not all tumors have similar targets. To find the high-quality treatment, your doctor may run tests to identify the genes, proteins, and other factors in your tumor. This helps doctors better match each patient with the high-quality treatment whenever possible. In addition, research studies keep on discovering more about specific molecular targets and new medicines coordinated with them.

Targeted therapy for bladder cancer includes erdafitinib (Balversa). Erdafitinib is a drug given by mouth (orally) that is approved to treat people with locally advanced or metastatic urothelial carcinoma with FGFR3 or FGFR2 genetic mutations that has continued to grow or spread during or after platinum chemotherapy. There is a specific FDA-approved companion test to find out who may benefit most from treatment with erdafitinib.

Talk with your doctor about possible side effects of a specific medication and how they can be managed.

Radiation therapy

Radiation therapy is the use of high-energy x-rays or different particles to destroy cancer cells. A doctor who specializes in giving radiation therapy to treat cancer is called a radiation oncologist. The most well-known kind of radiation therapy is called external-beam radiation therapy, which is radiation therapy given from a machine outside the body. When radiation therapy is given by implants, it is called internal radiation therapy or brachytherapy. However, brachytherapy is not commonly used in 

 

bladder cancer. A radiation therapy regimen, or schedule, generally consists of a specific number of treatments given over a set period of time.
Radiation therapy is typically not used by itself as a primary treatment for bladder cancer, but however, it might be given in combination with chemotherapy. Some people who can’t get chemotherapy may get radiation treatment alone. Combined radiation therapy and chemotherapy might be used to treat cancer that is founded only in the bladder:

  • To destroy any cancer cells that may remain after TURBT, so all or part of the bladder does not have to be removed.
  • To relieve symptoms caused by a tumor, such as pain, bleeding, or blockage
  • To treat a metastasis situated in 1 region, for example, the mind or bone.

Side effects from radiation therapy may include fatigue, mild skin reactions, and loose bowel movements. For bladder cancer, side effects most commonly occur in the pelvic or abdominal area and may include bladder irritation, the need to pass urine frequently during the treatment period, and bleeding from the bladder or rectum. Most side effects go away soon after treatment is finished.

Physical, Emotional, and Social effects of Cancer.

  • Cancer and its treatment cause physical symptoms and side effects, as well as emotional, social, and financial effects. Dealing with these impacts is called palliative care or supportive care. It is a significant piece of your care that is included along with treatments expected to slow, stop, or wipe out the Cancer.
  • Palliative care focuses on improving how you feel during treatment by managing symptoms and supporting patients and their families with other, non-medical requirements. Any individual, regardless of age or type and stage of cancer, may receive this kind of care. Also, it frequently works best when it is begun just after a cancer diagnosis. Individuals who get palliative care alongside treatment for the disease regularly have less serious indications, a better quality of life, and report they are happier with treatment.
  • Palliative treatments vary widely and often include medication, nutritional changes, relaxation techniques, emotional and spiritual support, and other therapies. You may also receive palliative treatments similar to those meant to get rid of cancer, such as chemotherapy, surgery, or radiation therapy.

 

Before treatment starts, talk with your doctor about the objectives of every treatment in the treatment plan. You should also discuss the possible side effects of the particular treatment plan and palliative care options.

During treatment, your health care team may ask you to answer questions about your symptoms and side effects and to describe each problem. Be sure to tell the health care team if you are experiencing a problem. This helps the health care team treat any symptoms and side effects as quickly as possible. It can also help prevent more serious problems in the future.

Risk factors

Factors that may increase bladder cancer risk include:

Smoking. 

  • Smoking cigarettes, cigars or pipes may increase the risk of bladder cancer by causing harmful chemicals to accumulate in the urine. When you smoke, your body processes the chemicals in the smoke and excretes some of them in your urine. These harmful chemicals might harm the lining of your bladder, which can increase your risk of cancer.

Increasing age. 

  • Bladder cancer risk increases as you age. Though it can occur at any age, most people diagnosed with bladder cancer are older than 55.

 

Being male. 

  • Men are more likely to develop bladder cancer than women are.

 

Exposure to certain chemicals. 

  • Your kidneys play a key role in filtering harmful chemicals from your bloodstream and moving them into your bladder. Because of this, it’s thought that being around certain chemicals may increase the risk of bladder cancer. Chemicals linked to bladder cancer risk include arsenic and chemicals used in the manufacture of dyes, rubber, leather, textiles and paint products.

 

Previous cancer treatment. 

  • Treatment with the anti-cancer drug cyclophosphamide increases the risk of bladder cancer. Individuals who got radiation therapies focused on the pelvis for a past Cancer have a higher risk of creating bladder disease.

 

Chronic bladder inflammation. 

  • Chronic or repeated urinary infections or inflammations (cystitis), such as might happen with long-term use of a urinary catheter, may increase the risk of a squamous cell bladder cancer. In some areas of the world, squamous cell carcinoma is connected to chronic bladder irritation brought about by the parasitic disease known as schistosomiasis.

 

Personal or family history of cancer. 

  • If you’ve had bladder cancer, you’re more likely to get it again. If one of your blood relatives — a parent, sibling or child — has a history of bladder cancer, you may have an increased risk of the disease, although it’s rare for bladder cancer to run in families. A family history of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer (HNPCC), can increase the risk of cancer in the urinary system, as well as in the colon, uterus, ovaries and other organs.

 

 

Frequently Asked Questions About Bladder Cancer Treatment

 

Q: How long does someone live with bladder cancer?

A: The general 5-year survival rate for people with bladder cancer is 77%. The overall 10-year survival rate is 70% and the overall 15-year survival rate is 65%. However, survival rates depend on many factors, including the type and stage of bladder cancer that is diagnosed.

Q: Who is at high risk for Bladder Cancer?

A: Bladder cancer generally affects older persons. However, some people are at more risk such as white people, smokers, and mostly men who are older than 60 years. Also, the people who work at leather and rubber industries are at more risk. Some people who are exposed to chemicals through their profession such as painters, hairdressers and machinists will also be at risk.

 

Q: What are the common signs of Bladder Cancer?

A: Common signs are pain while urinating, blood in urine, and urgency in urination, need to urinate very often. Sometimes the signs are often confused with other related problems but if symptoms are persistent one must see a doctor for further diagnosis.

 

Q: If pain in urination and blood in urine concludes Bladder Cancer?

A: Pain during urination and blood in urine may be signs of bladder cancer. However the same symptoms are also possible for kidney cancer or may be some other less serious issue such as kidney stones. However blood in urine is an immediate condition to visit the doctor immediately.

 

Q: If Bladder Cancer spreads to other areas where it will go?

A: Bladder Cancer usually grows very slow and confined mostly to the bladder in the initial stages.When the cancer spreads it may travel to adjacent lymph nodes or invade the nearby organs sometimes it may also spread to lungs, liver and bones.

 

Q: What will be the treatment options for Bladder Cancer?

A: Bladder cancer treatment depends on the stage of the cancer. The prognosis depends on the age of the patient and other health conditions. The common procedures will be the surgery to remove the bladder, chemotherapy, radiation, immunotherapy and sometimes the combination of all these treatments. If the bladder is removed then a reconstructive surgery will be made to create a new path for urine storage.

 

Q: Are there any alternative treatments available?

A: The researchers are always looking for new and better ways to treat bladder cancer such as targeted immune therapies and testing new drugs in the clinical trials. If the patient has agreed to participate in clinical trials certain new drugs and new treatment approaches will be administered.

 

Q: What are the complications of Bladder Cancer treatments?

A: The side effects after the bladder cancer treatment will depend on the stage of cancer treated. Nausea, weight loss, hair loss and feeling of weakness are the common side effects after cancer therapy. The risks will increase with age of the patients. However, the complications will reduce with time if treatment is taken immediately.

 

Q: What are the main causes of Bladder Cancer?

A: Chronic irritation to the bladder such as urinary tract infections, smoking, medications used for diabetes, exposure to chemicals at the workplace and exposures to radiation are the main causes. It may also be hereditary to some extent.

 

Q: Is it possible to live without a bladder?

A: Yes. It is possible and most of the patients do. If the bladder is removed totally the surgeon will create another pathway to eliminate urine.

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