Treatment options for urinary cancer will depend on your age, overall health and the extent of the cancer. Treatments for kidney and bladder cancer are given below.
- Surgery: Nephrectomy, or surgery to remove the kidney, is the most common cancer treatment. In a radical nephrectomy, the entire kidney is removed along with the adrenal gland, nearby tissue and sometimes lymph nodes. In a simple nephrectomy, only the kidney is removed. In a partial nephrectomy, only the part of the kidney containing the tumor is removed. The upside is that, because you have two kidneys, if one is removed, the other can usually pick up its work.
- Radiation therapy: Radiation therapy uses high-energy x-rays to kill cancer cells or, when the cancer has already spread to the bone, to relieve pain.
- Targeted therapy: This involves drugs that are used to attack specific parts of cancer cells, but have fewer side effects than chemotherapy drugs. This can be the first line of treatment for kidney cancer.
- Biological therapy: Also called immunotherapy, this uses the body’s immune system to fight the cancer.
- Chemotherapy: This involves the use of drugs to kill cancer cells; however, kidney cancer is often resistant to chemotherapy drugs.
- Arterial embolization: This is a procedure in which small pieces of a gelatin sponge or other material are injected through a catheter to clog the main renal blood vessel, thus shrinking the tumor by depriving it of blood and other substances it needs to grow. This technique is most often used before surgery to make the operation easier or, in cases where removing the tumor isn’t possible, to relieve pain.
- Chemotherapy: This involves the use of drugs to kill cancer cells. For bladder cancer, these drugs may be administered by mouth or intravenously, and in early-stage bladder cancer, it can be infused into the blood through the urethra. Chemotherapy may be given before or after surgery, and medications may be prescribed to counteract chemotherapy’s side effects.
- Radiation: Radiation uses high-energy x-rays to kill cancer cells. There are two types of radiation therapy—external beam, which is emitted from a machine outside the body, and internal, in which radioactive seeds are implanted directly into the tumor. Radiation is sometimes used after surgery to destroy any remaining cancer cells.
- Surgery: There are several types of surgery that may be used, depending on the stage of the disease. For superficial cancer, surgeons may perform a transurethral resection, in which a doctor inserts a cytoscope into the bladder through the urethra, removes the cancer with a small wire loop and burns away any remaining cells with an electric current or high-energy laser. For cancer that has spread to surrounding tissue, doctors may perform a cystectomy, which involves the removal of nearby lymph nodes and, in cases of a radical cystectomy, includes the creation of an opening in the abdomen for the discharge of urine, called a urostomy. (A new procedure called a urinary tract diversion involves the creation of an internal pouch to store urine using a piece of the colon; this pouch can the be drained several times a day.) For women, a radical cystectomy also includes the removal of the uterus, ovaries, fallopian tubes, anterior vaginal wall and urethra. For men with advanced bladder cancer, a cystoprostatectomy, or the removal of the bladder and prostate, may be used.
- Biologic therapy: In immunotherapy for bladder cancer, a liquid containing a live, weakened form of the bacteria that causes tuberculosis is installed in the bladder. The bacteria can stimulate the immune system, increasing the body’s ability to fight the cancer.
- Photodynamic therapy: This is a new treatment in which light-sensitive molecules are injected into the bloodstream; these molecules remain in cancer cells longer than normal cells. The doctor will insert a cytoscope through the urethra into the bladder and shine a red laser at the tumor. When the tumor is exposed to the light, the photosensitizers can cause cell damage and death.