Cancers de la vessie

The main symptom associated with bladder cancer is blood in the urine (hematuria). The urine may be pink or dark red, depending on the intensity of the bleeding. Hematuria is sometimes too faint to be detected by the naked eye.

Other less common symptoms may include frequent or urgent need to urinate, decreased bladder capacity, urinary retention (the inability to urinate despite the urge to do so), burning during urination, bladder spasms, or lower back pain.

Depending on the type of cancer and its stage of development, the radiation oncologist will prescribe the treatment best suited to the patient's clinical situation: radiation therapy, with or without chemotherapy.

External radiotherapy

This treatment uses X-rays directed through the skin to the area to be treated. These rays are produced by a linear accelerator and gradually destroy the cancer cells.

Your treatment will begin with a scanning session (called virtual simulation) to identify the areas to be treated (target volumes) and the healthy organs around them that must be preserved as much as possible.

Your treatment plan will be tailored to your individual needs (taking into account your specific characteristics and those of your disease) and scheduled over several weeks. Sessions take place from Monday to Friday and last approximately 15 minutes.

The radiation is invisible and painless and does not make you radioactive.

Your doctor will give you some instructions to follow carefully to ensure the treatment is effective.

Chemotherapy in combination with radiotherapy

Concomitant chemotherapy may be recommended to increase the effectiveness of radiotherapy: this is known as radiosensitizing chemotherapy.

Chemotherapy is a treatment based on drugs that act on the mechanisms of cell division.

It is a general treatment (called systemic treatment) that acts throughout the body. This allows cancer cells to be reached regardless of their location in the body, even if they are isolated and cannot be detected by diagnostic tests.

Chemotherapy drugs are administered by infusion. At Centre François Baclesse, chemotherapy is administered concurrently with radiotherapy to sensitize the cells and enhance the action of the radiation on the areas being treated.

Side effects are predictable but not systematic; each situation is unique and each patient reacts differently. We invite patients to report any adverse effects to their referring physician at the CFB during weekly follow-up consultations. Nowadays, the most common acute side effects are very well managed with symptomatic treatments. These will be prescribed by your radiation oncologist if necessary.

During radiotherapy

• Fatigue: Fatigue is a common side effect but is not necessarily caused by the treatment. It is often due to the daily repetition of treatment and chemotherapy.
• Bladder irritation or inflammation: Frequent and urgent need to urinate, burning sensation when urinating, blood in the urine.
• Inflammation of the rectum: Diarrhea and false urge to have a bowel movement.
• Vaginitis: Inflammation of the vagina may occur during treatment.
• Skin redness: The skin in the lower abdomen and areas exposed to radiation may become red (erythema), similar to sunburn. It is important to note that the skin will return to its original color a few months after the end of treatment.

During chemotherapy

Side effects will depend on the choice of drugs and the doses required to treat the tumor. However, it is important to know that a number of chemotherapy drugs do not cause hair loss and that nausea after chemotherapy is increasingly well controlled.

• Kidney problems: Some drugs can affect kidney function, requiring medical monitoring during treatment.
• Decreased white blood cell, red blood cell, and platelet counts: Chemotherapy drugs often decrease the number of cells produced by the bone marrow. A decrease in the number of white blood cells can lead to an increased risk of infection because they are involved in the body's defense system. A significant decrease in the number of red blood cells, which are responsible for transporting oxygen in the body, may require a transfusion. This manifests as paleness, shortness of breath, dizziness, and fatigue. Platelets are responsible for blood clotting, and a significant decrease in their number can lead to a risk of bleeding or bruising. This decrease may require a platelet transfusion.
• Hearing problems: Hearing loss is sometimes observed.

The effects observed during treatment generally fade a few months after the end of treatment. Some signs may appear after several months or years; these are known as "late effects." In rare cases, they may be related to the treatments received. We encourage you to report any side effects, even late ones, to your radiation oncologist.

The following side effects may occur:

• Persistent urinary problems: Frequent urge to urinate, burning during urination, and sometimes intermittent bleeding may persist for several weeks or even months after the end of treatment.
• Digestive problems: These mainly include diarrhea or alternating diarrhea and constipation associated with abdominal pain; in rare cases, rectal bleeding may occur. These symptoms will subside after a few weeks.
• Sexual problems: Loss of sexual desire and lack of self-confidence and body image may also persist for a long time before a certain balance is regained. Vaginal dryness may interfere with sexual intercourse, requiring the use of lubricant.