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Making the Decision to Have Surgery for Bladder Cancer

You have to be healthy for surgery to be a good choice. Before surgery, you'll meet with your surgeon, who is a urologist (a doctor who specializes in problems with the urinary tract, including the bladder). In this meeting, you will talk about the procedure. You'll also be able to ask questions and address concerns you may have. You may want to ask about the possible side effects of the surgery and talk about its risks. You may also want to ask your doctor when you can expect to return to your normal activities. You may want to ask where the scars will be and what they will look like.

The surgeon will ask if you are taking medications. This is to make sure you're not taking medications that could affect the surgery. After you have discussed all the details with the surgeon, you will sign a consent form that says the doctor can perform the surgery.

Your doctor will use the stage of your cancer to help decide the type of surgery you should have. There are several types of surgery for bladder cancer:

  • If your cancer is superficial and a grade I or II, the surgeon will probably remove it all in a process called transurethral resection (TUR). This may be followed by some type of intravesical therapy (treatment, such as chemotherapy or immunotherapy, is inserted inside the bladder). In follow-up visits, your doctor will look at your bladder. This procedure is called a cystoscopy. For it, the doctor sees inside your bladder using a tool called a cystoscope, which is a thin, lighted tube inserted through your urethra into your bladder. You will also give urine samples to have tests done, such as a urine cytology.

  • If your cancer has a grade higher than II or has spread to tissue beneath lining of the bladder, you'll probably need surgery to remove part or all of the bladder. If part of the bladder is removed, the operation is called a partial cystectomy. When all the bladder is removed, the type of surgery is called a radical cystectomy. You may also need chemotherapy or radiation, or both. Your doctor may not know for sure until the surgery how much of the bladder needs to be removed.

  • If your whole bladder is removed during surgery, you will need reconstructive surgery to create a new path for urine to leave your body.

Your medical team will review the surgical options appropriate to your condition. To help deal with the medical information and remember all of your questions, it is helpful to bring a family member or close friend with you to doctors' appointments. In addition, bringing a written list of concerns will make it easier for you to remember your questions.

You may also want to consider getting a second opinion before starting any treatment. Certain health insurance companies require a second opinion for such diagnoses.  According to the American Cancer Society, it is very rare that the time it will take to get a second opinion will have a negative impact on your treatment. The peace of mind a second opinion provides may be well worth the effort. 


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