Il tumore della vescica permette diverse possibilità di cura: chirurgia, terapia intravescicale (o endovescicale), chemioterapia e radioterapia. La scelta di un protocollo da seguire piuttosto che un altro dipende da molti fattori come il tipo di tumore, il grado di avanzamento (stadio o stadiazione) e le condizioni generali di salute del paziente. Vediamo nel dettaglio quali possono essere le possibili opzioni.
Chirurgia
La chirurgia è in genere il metodo più utilizzato per trattare il tumore della vescica. Da sola o in combinazione con le altre terapie. L’asportazione del tessuto tumorale può avvenire con varie metodiche più o meno invasive che vanno dalla resezione pura del tessuto malato fino alla cistectomia totale, che consiste nel togliere la vescica e spesso anche gli organi annessi, con le dovute complicanze ed effetti collaterali. Tutto dipende dai singoli casi. Per maggiori approfondimenti su questo aspetto vi invitiamo a leggere il seguente post:
Terapia intravescicale
Con la terapia intravescicale, il medico mette un farmaco liquido direttamente nella vescica (attraverso un catetere), un chemioterapico o un immunoterapico. In questo modo si aggrediscono solo le cellule che rivestono la vescica e non ci sono danni ad altri apparati. Ciò significa però che non sono efficaci sul cancro diffuso: tale metodica si usa infatti solo per tumori di tipo non invasivo o mininvasivo (stadiazione 0 o 1). Anche questa metodica può comportare effetti collaterali, diversi a seconda del farmaco, ma in genere passeggeri.
Chemioterapia
La chemio può in questo caso essere somministrata in modi diversi. Come abbiamo visto per via intravescicale (locale), per bocca, per via intrammuscolare o endovenosa. Tutto dipende dai singoli casi. Si può usare anche prima della chirurgia (adiuvante) o dopo e /o in combinazione con la radioterapia. I farmaci utilizzabili sono diversi ed utilizzabili su varie combinazioni o da soli: molto dipende dal grado di tollerabilità dei pesanti effetti collaterali e dunque delle condizioni di salute generali del paziente.
Gli effetti collaterali della chemioterapia dipendono dai farmaci utilizzati, dalla quantità e dalla durata. Comunemente si riscontrano:
- Nausea e vomito
- Perdita di appetito
- Perdita di capelli
- Ulcere della bocca
- Diarrea o costipazione
- Aumento del rischio di infezione (a causa di una carenza di globuli bianchi)
- Sanguinamento o lividi dopo tagli o lesioni non gravi (a causa di una carenza di piastrine nel sangue)
- Fatica (a causa del basso numero di globuli rossi)
Questi effetti collaterali di solito vanno via dopo che il trattamento è terminato.
Radioterapia per il tumore della vescica
Utilizza radiazioni ad alta energia per distruggere le cellule tumorali. In genere per la vescica si esegue la radioterapia esterna 8quella tradizionale). E’ simile ad una rx o una TAC, ma i raggi sono molto più forti e concentrati sul punto specifico del tumore da distruggere. L’irradiazione dura pochi minuti, e di solito si fa per 5 giorni a settimana consecutivi per più settimane.
Anche in questo caso gli effetti collaterali delle radiazioni dipendono dalla dose somministrata e dalla zona trattata: possono essere peggiori se combinati con la chemioterapia. Tra questi troviamo:
- Cambiamenti della pelle nella zona della irradiazione che vanno da arrossamento a gravi irritazioni con vesciche
- Nausea e vomito
- Bruciore o dolore durante la minzione
- Minzione frequente
- Ematuria
- Diarrea
- Stanchezza
- Emocromo basso, che può portare a fatica, ecchimosi o sanguinamento, o aumentato rischio di infezione
Questi effetti sono generalmente temporanei, anche se a volte si verificano problemi a lungo termine. In alcune persone i trattamenti radioterapici infatti possono portare a incontinenza .
Potrebbero interessarvi anche i seguenti post:
Fonte: Cancer.org
Foto: Thinkstock
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