Bladder cancer: overview and management. Part 2: muscle-invasive and metastatic bladder cancer

This is Part 2 of an article on bladder cancer: an overview of disease and its management. Part 1 provided an overview of non-muscle-invasive bladder cancer, how the disease presents, is diagnosed and subsequently treated ( Anderson, 2018 ). Part 2 provides an overview of muscle-invasive and metastatic bladder cancer and outlines treatment options currently available to manage the relevant stages of the disease. The management of muscle-invasive cancers comprise surgical intervention with transurethral resections, cystectomy (removal of the bladder), and systemic chemotherapy and radiotherapy (multi-modality treatment). For locally advanced and metastatic disease, systemic chemotherapy and radiotherapy are offered, but only as a palliative measure. The intent of treatments for muscle-invasive disease is curative. For metastatic disease, the intent is disease control, extending life, managing symptoms and improving quality-of-life outcomes. This article will include the treatments for the relevant stage of muscle-invasive and metastatic bladder cancer and highlight the respective risks and benefits. The risk factors for bladder cancer, such as smoking, and risks associated with relevant treatments are discussed. The role of the multidisciplinary team is underlined in the management of bladder cancer, specifically the role of the uro-oncology cancer nurse specialist in the provision of reassurance and support to patients.

British journal of nursing (Mark Allen Publishing). 2018 Oct 04 [Epub]

Beverley Anderson

Macmillan Uro-oncology Clinical Nurse Specialist, Epsom and St Helier University Hospitals NHS Trust.