How many treatments are available for non-muscle invasive bladder tumors?

  Treatment options for non-muscle invasive bladder tumors include surgical treatment and postoperative bladder perfusion therapy. Surgical treatment mainly includes transurethral resection of bladder tumor (TUR-BT), transurethral laser surgery, and photodynamic therapy.  Transurethral resection of bladder tumors has two objectives: first, to remove the entire tumor visible to the naked eye, and second, to remove tissue for pathologic grading and staging.TUR-BT should completely remove the tumor until the normal bladder wall muscle is exposed. After tumor resection, basal tissue biopsy is recommended to facilitate pathologic staging and determination of next treatment options. It has been reported that re-performing TUR-BT 2 weeks to 6 weeks after T1 stage bladder tumor reduces the probability of postoperative recurrence. Laser surgery can be coagulated or vaporized, and its efficacy and recurrence rates are similar to those of transurethral surgery. However, preoperative tumor biopsy is required for pathological diagnosis. Laser surgery is difficult for tumor staging and is generally suitable for papillary low-grade uroepithelial carcinoma, as well as uroepithelial carcinoma with a history of low-grade and low staging. The Department of Urology of Shanghai First People’s Hospital currently introduces the latest international 2-micron laser, which is used to remove tumors, and can achieve basically no bleeding during surgery, and the treatment effect is quite satisfactory as far as the follow-up is concerned. Kinetic therapy is a treatment method combining laser and photosensitizer by using cystoscope. The tumor cells ingest the photosensitizer and then produce monomorphic oxygen under the action of the laser, causing tumor cell denaturation and necrosis. This treatment can be chosen for in situ bladder cancer, control of bladder tumor bleeding, multiple tumor recurrence, and inability to tolerate surgical treatment.