Bladder Cancer - Treatment for Stage 0

Stage 0 bladder cancer means the cancer hasn’t invaded the bladder wall beyond the inner layer. There’re two types of stage 0, non-invasive papillary carcinoma (Ta) and flat non-invasive carcinoma (Tis).

Stage 0 is an early stage of bladder cancer, most often it is treated with transurethral resection (TURBT), then followed by observation (close follow-up without further treatment) or by intravesical therapy to try to prevent recurrence.

Immunotherapy with Bacille-Calmette Guerin (BCG) seems to be better than chemotherapy as an inravesical therapy, yet with more possible side effects.

Stage 0 bladder cancers rarely need to be treated with more extensive surgery, meaning patients will have better living condition post surgery by keeping the bladder. Removal of the bladder is considered only when there are many superficial cancers or when a superficial cancer continues to grow or possibly spread despite of treatment.

Stage 0a

Stage 0a low-grade non-invasive papillary (Ta) tumors is often treated with TURBT and follow-up observation, a single dose of intravesical chemotherapy within a day of surgery, or weekly intravesical chemotherapy, starting a few weeks after surgery. If the cancer comes back, the treatments can be repeated.

Stage 0a high-grade non-invasive papillary (Ta) tumors are more likely to recur, so intravesical Bacille-Calmette Guerin (BCG) is often recommended after surgery. Another option is intravesical chemotherapy with mitomycin. Either one usually starts a few weeks post surgery and is given on weekly basis for several weeks. Close observation without intravesical treatment is another option but is not often recommended.

Stage 0is

For flat non-invasive (Tis) tumors, patients often get 6 week treatment of intravesical BCG, starting a few weeks after TUR. Some doctors recommend repeating BCG treatment every 3 to 6 months.

Follow-up and outlook after treatment

For any stage 0 cancer, close follow-up is recommended, with cystoscopy about every 3 to 6 months for years to look for signs of recurrence or new tumors.

Prognosis of stage 0a patients is excellent. These cancers are nearly always cured with treatment. During long-term follow-up, new superficial cancers are often found in the urinary system. Although these new cancers do need to be treated, they rarely are deeply invasive or life threatening.

The long-term outlook for stage 0is (flat non-invasive) bladder cancer is not quite as good as for stage 0a cancers. These cancers have a higher risk of coming back, and may return as a more serious cancer that is growing into deeper layers of the bladder or has spread to other tissues.

 

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.