How to treat cauliflower-shaped bladder tumors?

Bladder tumors are cauliflower-shaped and have a relatively large impact on patients, so the treatment of tumors in these areas must also be careful. Current treatment methods include radiotherapy, chemotherapy, and surgery.

1. Surgery is the main treatment. Surgical treatment is divided into transurethral surgery, cystotomy tumor resection, partial cystectomy and radical cystectomy. Different treatment methods should be selected according to the location, infiltration depth, number, malignancy of the tumor and the patient's general condition. Radiation therapy and chemotherapy are adjuvant treatments.

2. Superficial bladder tumors (Tis, Ta, T1) carcinoma in situ: may appear alone or adjacent to the cancer. Some cells are well differentiated and long-term stable and may not require temporary treatment or drug infusion therapy, but they should be closely observed. When the other part of the cells are poorly differentiated, adjacent carcinoma in situ or develops into invasive cancer, radical cystectomy should be performed as soon as possible.

3. Invasive bladder tumors (T2, T3, T4) T2 and T3 tumors can be treated with partial cystectomy or total cystectomy depending on the extent of the tumor. Partial cystectomy should include the full-thickness bladder wall more than 2 cm away from the tumor edge. The ureteral orifice should be removed within this range, and ureterocystostomy should be performed separately. Radical cystectomy, including the prostate and seminal vesicles, is suitable for multiple, recurrent tumors and tumors involving the trigone and neck. Urinary diversion or reconstruction is required after radical cystectomy. Commonly used methods include ureterostomy, ileal cystotomy, and the controlled bladder surgery and perineal neobladder surgery used in recent years, which have achieved good results in improving the quality of life of patients.

4. Bladder tumors are prone to recurrence after resection, but recurrences may still be cured. In all kinds of surgical treatments to preserve the bladder, more than half of the cases will relapse within 2 years. The relapse is usually not in the original location, but is actually a new tumor. Moreover, 10% to 15% have a tendency to increase in malignancy. Therefore, any patient who undergoes bladder preservation surgery should be closely followed up and undergo cystoscopic examination every 3 months. If there is no recurrence within 1 year, the follow-up time may be extended as appropriate. Such follow-up should be part of treatment.