Patients with stage I bladder tumors are unlikely to die from bladder cancer, but the tendency for new tumor formation is high. In a series of patients with Ta or T1 tumors who were followed for a minimum of 20 years or until death, the risk of bladder recurrence after initial resection was 80%. Of greater concern than recurrence is the risk of progression to muscle-invasive, locally-advanced, or metastatic bladder cancer. While progression is rare for low-grade tumors, it is common among high-grade cancers.
To prevent bladder cancer, your best bet is to avoid possible carcinogens, or cancer-causing substances. For starters, don't smoke. Eat smoked or cured meats only occasionally and prepare fresh rather than processed foods.
Research also suggests that there is a reduced incidence of bladder cancer among people with adequate vitamin B-6, beta-carotene, and selenium in their diets. If you work around carcinogenic chemicals, follow safety guidelines to avoid undue exposure. And if you feel you may be...
One series of 125 patients with TaG3 cancers followed for 15 to 20 years reported that 39% progressed to more advanced stage disease, while 26% died of urothelial cancer. In comparison, among 23 patients with TaG1 tumors, none died and only 5% progressed. Risk factors for recurrence and progression include the following:[2,3,4,5,6]
Standard treatment options for stage I bladder cancer include the following:
Transurethral resection (TUR) with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy.
TUR with fulguration.
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy followed by periodic intravesical instillations of bacillus Calmette-Guérin (BCG).
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy followed by intravesical chemotherapy.
Segmental cystectomy (rarely indicated).
Radical cystectomy (in selected patients with extensive or refractory superficial tumors).
TUR with fulguration followed by an immediate postoperative instillation of intravesical chemotherapy
TUR and fulguration are the most common and conservative forms of management. Careful surveillance of subsequent bladder tumor progression is important. Because most bladder cancers recur after TUR, one immediate intravesical instillation of chemotherapy after TUR is widely used. Numerous randomized, controlled trials have evaluated this practice, and a meta-analysis of seven trials reported that a single intravesical treatment with chemotherapy reduced the odds of recurrence by 39% (odds ratio [OR], 0.61; P< .0001).[7,8]