Bladder Cancer Treatment in Hyderabad, India
PACE Hospitals is recognized as the best hospital for urinary bladder cancer treatment in Hyderabad, Telangana, India. Our multidisciplinary team of expert urologists, oncologists, radiologists, pathologists, and specialized nursing staff is committed to delivering comprehensive, personalized care for patients diagnosed with bladder cancer.
We utilize state-of-the-art diagnostic tools and advanced treatment modalities—including minimally invasive surgery, chemotherapy, immunotherapy, and radiation therapy—to ensure the most effective and targeted treatment approach.
Understanding the complexity and emotional impact of a cancer diagnosis, we focus on timely diagnosis, compassionate care, and patient-centered support throughout every stage of treatment. At PACE Hospitals, we are dedicated to achieving the best outcomes in a safe, supportive, and healing environment.
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Why Choose PACE Hospitals for Urinary Bladder Cancer Treatment?
State-of-the-Art Diagnostic & Advanced Treatment Facilities
Best Urologists, Oncologists, and Radiologists in Hyderabad, India
Advanced Minimally Invasive Surgery - Laparoscopic / Robotic TURBT & Radical Cystectomy
Affordable & Transparent Bladder Cancer Treatment with Insurance & Cashless Options
Diagnosis of Bladder Cancer
The diagnosis of bladder cancer begins with an evaluation of the patient's medical history, symptoms, and risk factors. Healthcare experts generally start by taking a thorough history and performing physical examinations to guide further testing. The diagnostic process can include a range of tests and imaging procedures that help to confirm the presence of cancer, assess its extent, and determine the most appropriate treatment approach.
The diagnostic approach for bladder cancer may include:
- Medical history and physical examination
- Urine cytology
- Imaging tests
- Biopsy
- Urinary biomarkers
Medical history and physical examination
The first step in diagnosing bladder cancer involves obtaining a detailed medical history and performing a physical examination. During the medical history assessment, the healthcare expert may inquire about:
- Symptoms: Key symptoms of bladder cancer, such as hematuria (blood in the urine), frequent urination, painful urination, and lower back pain.
- Risk factors: Smoking (the most significant risk factor), exposure to certain chemicals, chronic urinary tract infections (UTIs), and previous history of bladder infections or bladder stones.
- Previous medical conditions: Any history of bladder infections, kidney stones, or previous cancer treatments that may increase the likelihood of developing bladder cancer.
The physical examination often includes a focused abdominal and pelvic exam, checking for abnormalities such as:
- Palpable mass: Enlargement or hardening in the abdomen or pelvic region.
- Tenderness: In the abdomen, lower back, or pelvic areas.
- Lymph node examination: To detect any signs of lymph node enlargement.
Urine cytology
One of the first diagnostic tests for bladder cancer is urine cytology, where a sample of the patient’s urine is examined under a microscope. The presence of cancerous cells in the urine can be indicative of bladder cancer. While urine cytology is not highly sensitive (particularly for low-grade tumors), it can be useful in detecting high-grade tumors and providing initial clues.
Imaging tests
Once bladder cancer is suspected, imaging tests are performed to visualize the bladder and surrounding structures. These tests help determine the size, location, and spread of the tumor.
Imaging tests that can diagnose bladder cancer include the following:
- Ultrasound: Non-invasive imaging that uses sound waves to create an image of the bladder. It can detect the presence of a mass or abnormality, but it cannot definitively confirm bladder cancer.
- CT urography (CT scan): A specialized type of CT scan that uses contrast dye to provide detailed images of the urinary tract, including the kidneys, ureters, and bladder. CT urography is particularly useful in detecting tumors that may have spread beyond the bladder.
- MRI (Magnetic Resonance Imaging): MRI provides high-resolution images and may be used to evaluate tumor invasion into the bladder wall or surrounding tissues. It is especially useful in assessing muscle-invasive bladder cancer (MIBC) and evaluating lymph node involvement.
- Cystoscopy: A definitive diagnostic procedure where a thin, flexible tube with a camera (cystoscope) is inserted through the urethra to visualize the bladder lining directly. Cystoscopy allows the physician to examine the interior of the bladder, take tissue samples (biopsies), and identify suspicious areas. It is considered the gold standard for diagnosing bladder cancer.
Biopsy
If a suspicious lesion is observed during cystoscopy, a biopsy is performed to obtain a tissue sample for microscopic examination by a pathologist. The biopsy helps determine whether the lesion is cancerous and, if so, the type of cancer (e.g., urothelial carcinoma) and its grade (how abnormal the cells appear). This information is essential for determining the prognosis and treatment plan.
Urinary biomarkers
In some cases, additional urinary biomarkers may be used to aid in diagnosis or monitor disease progression
✅Urinary Bladder Cancer Differential Diagnosis
Bladder cancer can be confused with other conditions that cause blood in the urine, or hematuria, such as urinary tract infections (UTIs), kidney stones, and other cancers.
Other conditions that can be confused with bladder cancer include:
- Urinary tract infections: UTIs, including cystitis, are a common cause of hematuria
- Kidney stones: Also known as nephrolithiasis, kidney stones are a common cause of hematuria
- Prostate cancer: Prostate cancer can cause hematuria and is a potential differential diagnosis for bladder cancer.
- Renal cell carcinoma: Renal cell carcinoma is a potential differential diagnosis for bladder cancer
- Ureteral trauma: Ureteral trauma can be a differential diagnosis for bladder cancer
✅Bladder Cancer Staging
Once bladder cancer is diagnosed, the next step is to determine its stage, which helps guide treatment decisions. The most commonly used staging system for bladder cancer is the TNM system, developed by the American Joint Committee on Cancer (AJCC). This system classifies cancer based on three factors:
- T (Tumor): Describes the size and extent of the primary tumor. It ranges from T0 (no tumor) to T4 (tumor invasion into nearby tissues).
- N (Nodes): Refers to the extent of regional lymph node involvement. It ranges from N0 (no lymph node involvement) to N3 (extensive lymph node involvement).
- M (Metastasis): Describes whether cancer has spread to distant parts of the body. M0 means no distant metastasis, while M1 means metastasis is present.
Based on these parameters, bladder cancer is staged as follows:
- Stage 0: Non-invasive cancer confined to the inner lining of the bladder.
- Stage I: Cancer has spread into the lamina propria (deeper layer of the bladder wall) but not into the muscle.
- Stage II: Cancer has invaded the bladder muscle.
- Stage III: Cancer has spread beyond the bladder to surrounding tissues such as the prostate, uterus, or vagina.
- Stage IV: Cancer has spread to distant organs such as the lungs or liver.
✅Considerations of a Urologist Before Opting for Surgery for Bladder Cancer
Uro surgeons carefully consider numerous crucial aspects when selecting whether to perfer, bladder cancer surgery to guarantee the best possible patient results. These considerations include:
- Cancer Stage and Grade: The stage (how far the cancer has spread) and grade (how aggressive the cancer cells are) of the bladder cancer are critical in deciding whether surgery is appropriate. Early-stage cancers may be treated with less invasive procedures, while advanced cancers may require more extensive surgery.
- Patient’s Overall Health: A surgeon will evaluate the patient’s overall health, including factors such as age, heart and lung function, and any comorbidities (e.g., diabetes, kidney disease). This will determine whether the patient can safely undergo surgery.
- Type of Surgery: There are different surgical options, such as a partial cystectomy (removal of part of the bladder) or a radical cystectomy (removal of the bladder). The surgeon will consider which procedure is most appropriate based on the tumor’s location, size, and involvement with surrounding tissues.
- Potential for Recurrence: The likelihood of recurring cancer after surgery will influence the decision-making process. Surgeons may recommend additional treatments (e.g., chemotherapy, immunotherapy) if there’s a high risk of recurrence.
- Quality of Life Considerations: Surgical decisions will also consider the patient’s quality of life post-surgery. For example, removal of the bladder often requires the creation of a new way for urine to be stored and expelled (urinary diversion), which may affect the patient's lifestyle.
- Patients’ Preferences and Concerns: Surgeons will take into account the patient’s preferences regarding treatment. Some patients may not want a major surgery, and others may be more concerned about long-term effects, such as the need for a stoma (A surgically opening created on the abdominal wall for waste elimination when normal digestive or urinary pathways are impaired) or changes in urinary function.
- Multidisciplinary Team Input: A surgeon will typically work with a multidisciplinary team (e.g., oncologists, radiologists) to determine the best course of treatment, especially when cancer is advanced or involves complex issues.
These considerations help ensure that the surgery is both effective in treating bladder cancer and appropriate for the patient’s unique medical needs.
Urinary Bladder Cancer Treatment
Bladder cancer treatment options depend on the cancer's stage, type, and grade, and may include
- Surgery
- Chemotherapy (both intravesical and systemic)
- Radiation therapy
- Immunotherapy
- Targeted therapy
Surgery
Transurethral Resection of Bladder Tumor (TURBT)
Transurethral Resection of Bladder Tumor (TURBT) is a procedure to treat bladder cancer. It involves using a special tool to remove the tumor from the bladder through the urethra. The removed tissue is examined to determine cancer stage and grade. Afterward, patients may experience temporary side effects like burning during urination. TURBT is a key treatment for non-invasive bladder cancer and helps prevent recurrence.
Cystectomy
Cystectomy is a surgical procedure to remove part or all of the bladder, primarily used to treat invasive bladder cancer or recurrent non-invasive cancer. It can be partial, removing a portion of the bladder, or radical, removing the entire bladder along with nearby lymph nodes and organs. The surgery can be performed through open or minimally invasive methods.
Partial Cystectomy
Partial cystectomy is a surgical procedure where only the portion of the bladder containing cancer is removed, preserving as much bladder function as possible. It is typically used for localized bladder cancer that hasn't spread extensively.
This approach is less invasive than radical cystectomy and can be performed using open, laparoscopic, or robotic techniques. However, it is suitable for only a small percentage of patients, usually those with small, solitary tumors. Additional treatments like chemotherapy or radiation may follow to reduce recurrence risks.
Lymph Node Removal
Lymph node removal, or lymphadenectomy, is a crucial component of bladder cancer treatment, particularly during radical cystectomy for muscle-invasive cases. It involves removing lymph nodes around the bladder to reduce the risk of cancer recurrence within the pelvis. However, extended lymph node removal beyond the standard procedure does not appear to improve survival outcomes, but may increase surgical risks and complications. The procedure helps with accurate staging and may improve oncologic outcomes by eliminating micro-metastatic disease.
Chemotherapy
Intravesical Chemotherapy
Intravesical chemotherapy for bladder cancer involves delivering chemotherapy drugs directly into the bladder through a catheter. This treatment is primarily used for non-muscle invasive bladder cancer (NMIBC) to reduce the risk of recurrence. It targets cancer cells within the bladder lining without affecting the rest of the body. Treatment typically follows a transurethral resection of the bladder tumor (TURBT) and may involve a series of weekly sessions, depending on cancer risk level.
Systemic Chemotherapy
Systemic chemotherapy for bladder cancer involves administering drugs through the bloodstream to target cancer cells throughout the body. It is used before surgery (neoadjuvant) to shrink tumors, after surgery (adjuvant) to eliminate remaining cells, or for advanced cancers. Systemic chemotherapy can improve survival rates but may have significant side effects, requiring careful patient selection and monitoring.
Radiation Therapy
External Beam Radiation
External beam radiation therapy (EBRT) for bladder cancer involves using a machine outside the body to deliver high-energy beams to destroy cancer cells. It is often combined with chemotherapy to preserve the bladder and avoid surgery, particularly for muscle-invasive cancers. EBRT can also be used to relieve symptoms like pain and bleeding.
Brachytherapy
Brachytherapy, a bladder-sparing treatment for muscle-invasive bladder cancer (MIBC), involves implanting radioactive substances directly into the bladder wall, offering a potential alternative to radical cystectomy with comparable local control rates.
Immunotherapy
BCG (Bacillus Calmette-Guérin)
Bacillus Calmette-Guérin (BCG) is a form of intravesical immunotherapy used to treat non-muscle invasive bladder cancer (NMIBC), particularly high-risk cases. It is administered directly into the bladder through a catheter, typically once a week for six weeks, starting a few weeks after tumor removal surgery (TURBT). BCG stimulates the immune system to attack cancer cells, reducing the risk of recurrence and progression. Common side effects include bladder irritation, frequent urination, and flu-like symptoms. BCG is not chemotherapy, but an immunotherapy that helps prevent cancer recurrence in the bladder lining.
Systemic Immunotherapy
Systemic immunotherapy for bladder cancer involves using drugs that enhance the body's immune response to fight cancer cells. These treatments, such as checkpoint inhibitors, target specific pathways to boost the immune system's ability to recognize and attack cancer cells. They are often used for advanced or recurrent bladder cancer, offering a promising alternative to traditional chemotherapy by potentially providing durable responses with fewer side effects.
Targeted Therapy
Targeted therapy for bladder cancer involves drugs that specifically target molecules involved in cancer cell growth and survival, offering a more precise treatment approach than traditional chemotherapy. These therapies are often used for advanced or metastatic bladder cancer, particularly when other treatments have failed.
They typically target genetic alterations or pathways crucial for tumor growth, such as those affecting blood vessel formation. Targeted therapies generally have fewer side effects than chemotherapy but can still cause issues like fatigue, diarrhea, and skin reactions. They are part of precision medicine, tailored to the genetic traits of the tumor, and can be combined with other treatments for enhanced effectiveness.
Other Treatments
- Palliative care: Palliative care for bladder cancer focuses on improving the quality of life by alleviating symptoms and stress associated with the disease. It is not limited to end-of-life care but can be beneficial at any stage of serious illness. Palliative care includes treatments like chemotherapy, immunotherapy, and radiation therapy to manage symptoms such as pain, bleeding, and discomfort.
- Ureteral Stents: Ureteral stents are used in bladder cancer management to relieve or prevent blockages in the ureters, which can occur when bladder tumors press against these tubes, obstructing urine flow. Stents are small tubes inserted into the ureters to ensure urine can flow from the kidneys to the bladder, preventing kidney damage.
While they provide relief, there is evidence suggesting that ureteral stenting may increase the risk of developing upper tract urothelial carcinoma in patients with bladder cancer. Therefore, their use is carefully considered based on individual patient needs and potential risks.
Follow-up care: Follow-up for bladder cancer is crucial to monitor recurrence and progression, especially after treatment. For non-muscle invasive bladder cancer (NMIBC), regular cystoscopies are performed every 3–6 months initially, depending on risk level, and may decrease in frequency over time if no recurrence is detected.
For muscle-invasive bladder cancer, follow-up involves imaging studies like CT scans to check for distant recurrence, typically every 6 months for the first few years. The frequency and type of follow-up can vary based on the patient's risk factors and treatment history, with a focus on early detection of recurrence and management of potential complications.
Bladder Cancer Treatment Cost in Hyderabad, India
The cost of bladder cancer treatment in Hyderabad typically ranges between ₹80,000 to ₹3,75,000 (~US$960 to US$4,800), depending on multiple factors such as the stage of cancer, type of treatment, duration of therapy, diagnostic tests, medications, and the need for chemotherapy, radiation therapy, immunotherapy, or post-treatment care.
Cost Breakdown by Bladder Cancer Treatment Type
- TURBT (Transurethral Resection of Bladder Tumor) - for non-muscle invasive bladder cancer: ₹80,000 to ₹1,20,000 (~US$960 to US$1,440)
- Radical Cystectomy - for muscle-invasive bladder cancer: ₹2,50,000 to ₹3,75,000 (~US$3,000 to US$4,500)
- Chemotherapy - for muscle-invasive or metastatic bladder cancer (neoadjuvant or adjuvant setting), regimens: Gemcitabine + Cisplatin (Gem-Cis) or Dose-Dense MVAC: ₹20,000 per cycle (~US$240), 4 to 6 cycles based on staging and response
- Radiation Therapy - advanced imaging and planning to maximize cancer control while minimizing side effects.: ₹40,000 to ₹1,75,000 (~US$480 to US$2,100)
- Immunotherapy - used in advanced or recurrent bladder cancer cases: ₹85,000 to ₹2,80,000 per month (~US$1,020 to US$3,360)
At PACE Hospitals, our expert urology and oncology teams offer comprehensive, evidence-based bladder cancer care using the latest in diagnostic tools, surgical techniques, and systemic therapies. We ensure every patient receives a personalized, cost-effective treatment plan with a focus on clinical excellence and long-term outcomes.
Frequently Asked Questions (FAQs) On Bladder Cancer Treatment
What is the best treatment for bladder cancer?
Stage-dependent: BCG post-TURBT for non-invasive, cystectomy + chemo for invasive, and immunotherapy/chemo for advanced disease. The best approach often involves a multidisciplinary team to tailor treatment to individual needs. Factors such as tumor biology, patient preferences, and overall health are considered to optimize outcomes. Early-stage cancers may be managed conservatively, while more aggressive tumors require comprehensive surgical and medical interventions.
Can bladder cancer be cured by chemotherapy?
Chemo alone rarely cures but improves survival when combined with surgery (neoadjuvant/adjuvant) or palliates advanced cases. Chemotherapy can shrink tumors, making them more manageable, and is often used in conjunction with other treatments like surgery or radiation. In advanced stages, chemotherapy focuses on controlling symptoms and improving quality of life rather than achieving a cure.
What is the survival rate of bladder cancer?
Localized: ~77% 5-year survival. Metastatic: ~15%. Rates vary with stage and treatment. Early detection significantly improves survival outcomes, as localized tumors are more treatable. The prognosis worsens with disease progression, highlighting the importance of timely diagnosis and intervention.
Can ultrasound detect bladder cancer?
Ultrasound detects bladder tumors with 83–93% sensitivity for lesions >5 mm, but may miss smaller/flat tumors. It differentiates cysts from masses but can't confirm malignancy. Sensitivity drops for <3 mm tumors. Ultrasound is non-invasive and cost-effective, making it useful for initial screening. However, it lacks specificity for cancer diagnosis, often requiring further tests like cystoscopy or biopsy for confirmation. Ultrasound's role is primarily in identifying potential abnormalities that warrant more detailed evaluation.
Can a CT scan detect bladder cancer?
CT urography identifies tumors but has limited sensitivity (59–79%) for small/flat lesions. It aids staging and upper tract evaluation but requires cystoscopy for confirmation. CT scans provide detailed images of the bladder and surrounding structures, helping assess tumor spread and plan treatment. They are particularly useful for evaluating lymph node involvement and distant metastases, which are crucial for determining the extent of disease and guiding treatment decisions.
How long does bladder cancer surgery take?
TURBT takes <1 hour; radical cystectomy requires 2–6 hours, depending on complexity and urinary diversion. The duration can vary based on the surgeon's experience and the need for additional procedures like lymph node dissection. Factors such as the patient's overall health and the presence of complications can also influence surgical time. Recovery times differ significantly between these procedures, with TURBT typically allowing quicker recovery compared to cystectomy.
What is bladder cancer surgery?
Surgery includes TURBT (transurethral tumor removal) for non-invasive cancer and radical cystectomy (bladder removal) for invasive cases, often with urinary reconstruction. TURBT is minimally invasive, using a scope to remove tumors from the bladder lining. Radical cystectomy is more extensive, involving the removal of the bladder and possibly surrounding tissues, followed by the creation of a new way for urine to exit the body, such as an ileal conduit or neobladder.
How is bladder cancer treated?
Early-stage: TURBT + BCG/chemotherapy. Muscle-invasive: Cystectomy ± chemo. Metastatic: Systemic therapy (chemo/immunotherapy). Treatment choices depend on tumor stage, patient health, and tumor characteristics. For non-invasive tumors, intravesical therapies like BCG are effective in reducing recurrence. Invasive tumors require more aggressive approaches, including surgery and chemotherapy. Advanced disease often involves systemic treatments to manage symptoms and extend survival.
What is BCG treatment for bladder cancer?
BCG immunotherapy, instilled into the bladder post-TURBT, triggers immune responses to reduce recurrence in non-invasive cancers. BCG is effective in preventing tumor recurrence and progression by stimulating an immune response against cancer cells. It is commonly used for high-risk non-muscle-invasive bladder cancer and has been shown to reduce the risk of recurrence and progression to more invasive disease.
How does BCG work for bladder cancer?
BCG induces local inflammation, activating T-cells and cytokines to target cancer cells. This immune response helps eliminate residual cancer cells within the bladder. The exact mechanisms involve the activation of various immune pathways that recognize and destroy tumor cells, providing a targeted approach to managing bladder cancer.
How is chemotherapy given for bladder cancer?
Intravesical (direct bladder instillation) for localized disease; systemic (IV) for advanced/metastatic cases. Intravesical chemo targets bladder tumors directly, while systemic chemo addresses distant spread. Intravesical treatments are less invasive and have fewer side effects compared to systemic chemotherapy, which can affect the whole body.
What is Stage 1 bladder cancer treatment?
TURBT + intravesical BCG/chemo, followed by regular cystoscopy surveillance. This approach aims to prevent recurrence and progression. Stage 1 tumors are non-invasive, and treatment focuses on removing the tumor and preventing future occurrences. Regular follow-up is crucial to monitor any signs of recurrence or progression.
What is Stage 2 & 3 bladder cancer treatment?
Radical cystectomy with lymph node dissection, often preceded by neoadjuvant chemotherapy. This aggressive approach aims to remove all cancerous tissue and affected lymph nodes. Neoadjuvant chemotherapy can shrink tumors before surgery, potentially improving surgical outcomes. Radical cystectomy is a major surgery requiring significant recovery time and often involves urinary diversion.
What is stage 4 bladder cancer treatment?
Cisplatin-based chemo, immunotherapy (e.g., pembrolizumab), or palliative care to manage symptoms. Treatment focuses on improving quality of life and extending survival. Stage 4 cancer is advanced, and treatments are generally aimed at controlling symptoms rather than achieving a cure. Immunotherapies and targeted therapies offer new options for managing advanced disease, providing hope for improved outcomes.
