What is Muscle Invasive Bladder Cancer (MIBC)?
The urinary system consists of the kidneys, ureters, bladder, and urethra. The bladder is a balloon shaped organ that is designed to store and empty the urine made by the kidneys. MIBC is cancer of the bladder that has spread into the thick muscle layer deep to the wall of the bladder.
If MIBC goes untreated, it may spread outside of the bladder and into other tissues nearby. This type of cancer has a high risk of spreading to lymph nodes and other organs if it goes untreated.
What are some common causes of Bladder Cancer (BC)?
There are many risk factors that have been described, which may lead to BC. Some of the more common causes are:
· Smoking
· Radiation to the pelvis
· Certain chemical exposure such as working in places with direct exposure to plastics or paint
· Genetics (family history of bladder cancer)
· Certain cancer drugs
What are some common symptoms of Bladder Cancer (BC)?
Bladder cancer often is asymptomatic. One of the most common first signs is blood in the urine or hematuria. This blood can be microscopic and discovered on urinalysis (Microscopic Hematuria) or urine checks by your doctor or blood that is visible to the naked eye (Gross Hematuria). Bladder cancer can sometimes also be discovered on imaging tests done for other unrelated reasons, which prompt a referral to the urologist.
How is MIBC treated?
Treatment depends on several factors including your overall health and life expectancy as well as the type and extent of the cancer. The two most common treatments for MIBC are:
· Cystectomy or surgical removal of the bladder with/without chemotherapy
· Chemotherapy and radiation
What does a Cystectomy entail?
There are two types of cystectomy: radical and partial. In partial cystectomies, your surgeon may discuss removing only a portion of your bladder to preserve your normal urinary function. Radical cystectomy is thought of as the best cure for MIBC and involves removal of:
· The entire bladder
· Nearby lymph nodes
· Portion or all of the urethra
· The prostate (in men)
· The uterus, ovaries, fallopian tubes, and part of the vagina (in women)
· Other nearby tissues as indicated
Where is my urine stored after a Radical Cystectomy?
Your surgeon may discuss different types of urinary diversions with you. Some of the common diversions may include creating a new bladder out of a portion of your bowels or creating a pouch that is connected to the skin and surrounded by a bag where the urine collects throughout the day (Ileal Conduit). Each type of diversion has pros and cons which you should discuss with your surgeon.
How is the surgery performed and what are the expectations?
Surgery can be performed with traditional open technique, laparoscopically, or using advanced robotic surgery. Your surgeon should be comfortable with the chosen technique as outcomes depend on the level of comfort and experience of the surgeon. Typically, the robotic technique tends to be favored due to the minimally invasive nature of the procedure and typically faster recovery times.
You should expect to be in the hospital between 3-10 days depending on the surgical technique and your body’s healing capabilities. A cystectomy is major surgery and healing from it is a marathon and not a sprint, so be patient!
How do I find out more?
Your local urologist should be able to discuss your treatment options with you. You can also contact Dr. Shakuri-Rad and schedule a consultation to review all options and treatment modalities that may be best suited for your specific diagnosis.
As always, the information above is meant to be informative and does not replace your physician's recommendations or judgement. Each individual case has to be evaluated carefully to determine the best course of action. Call or use our contact page to request an appointment to further discuss your unique case with Dr. Shakuri-Rad.