Chapter 14 - Treatment for TaT1 Tumors

Abstract

"Bladder cancer includes noninvasive papillary carcinoma (Ta) that has not invaded the bladder wall beyond the inner layer. This early stage of bladder cancer is most often treated with transurethral resection of bladder tumor. This may be followed either by observation (close follow-up without further treatment) or by intravesical therapy to try to keep the cancer from coming back. Of the intravesical treatments, immunotherapy with Bacille Calmette-Guerin (BCG) seems to be better than chemotherapy at both keeping cancers from coming back and from getting worse. But it also tends to have more side effects. Ta stage bladder cancers rarely need to be treated with more extensive surgery. Cystectomy (removal of the bladder) is considered only when there are many superficial cancers or when a superficial cancer continues to grow (or seems to be spreading) despite treatment. Stage I bladder cancers have grown into the connective tissue layer of the bladder wall but have not reached the muscle layer. If no other treatment is given, many patients will later get a new bladder cancer, which will often be more advanced. This is more likely to happen if the first cancer is high grade. If not all of the cancer was removed, options include either intravesical BCG or cystectomy (removal of part or all of the bladder). ? 2018 Elsevier Inc. All rights reserved.