Bladder cancer

The Urology Department has extensive experience in the treatment of both early and advanced-stage bladder cancer, (superficial bladder carcinoma or 'bladder polyps'), locally invasive stage cancer (invasive bladder carcinoma) and highly advanced or metastatic stage cancer.

For each stage of bladder cancer, we try to offer a personalised and scientifically based treatment. We base our work on years of experience within our own department and on knowledge gained in various university centres at home and abroad.

New development that we can offer:

• After thorough diagnostics, both during the first TURB operation (see below), and during further tissue diagnostics and radiological scans, the most appropriate treatment for your specific situation will be determined. This always depends on the degree of aggressiveness and the exact stage of the disease.
• Minimally invasive bladder operations (keyhole surgery, robot-assisted).
• Clinical trials (scientific research) into new surgical, radiotherapeutic or medicinal treatments with a strong focus on all new forms of immunotherapy.

After referral, new patients are normally seen for consultation within three weeks. During this first appointment, you will be able to have an initial orientation meeting with the urologist, uro-oncologist, radiotherapist or medical oncologist (internist).

• The urologist specialises in the diagnosis and surgical treatment of bladder tumours.
• The radiotherapist specialises in the treatment of bladder tumours with external radiation.
• The medical oncologist specialises in the medicinal treatment of bladder tumours, especially for advanced or metastatic stages of the disease.

You may see other colleagues in a supporting role:

• a pathologist specialising in urological tumours
• a radiologist specialising in the imaging of genito-urinary tumours
• an internist (geriatrician, nephrologist) to assess your general health status
• urology nurses specialising in all aspects of pre- and post-operative urological care or ostomy care
• oncology nurses specialising in cancer treatment
• psychologically oriented care providers (psychologist, psychological nurse), for psychological and emotional support during the cancer treatment
• a nutritionist (dietitian) to advise on diet and nutrition before and during treatment
• physiotherapists for teaching pelvic floor exercises in certain types of bladder replacement

It is very important to know that we will always try to weigh the benefits of any treatment against the potential side effects together with you.

Both an exact diagnosis as well as staging are essential to determine the best treatment plan for you. Among other things, these help to figure out which stage your bladder cancer is at, as well as the appropriate approach. The stage of cancer will be taken into account, but also your personal wishes or expectations regarding the treatment.

Our Bladder Cancer Team includes a specialised pathologist who focuses on the analysis of genito-urinary tumours, such as bladder cancer. Not only the pathologist is specialised, but also the uro-radiologist and nuclearist who specialises in the latest staging exams (scans). To look for potential metastases, we use the latest radiological and isotope (nuclear) tests in our hospital according to the latest scientific insights. For some very specialised PET examinations, we work closely with certain recognised hospitals in East and West Flanders. After all, a precise diagnosis also means better treatment.

Minimally invasive procedures reduce (the risk of) complications, shorten hospital stays and speed up recovery after surgery. Our department has all of the modern diagnostic techniques available for the initial diagnostic procedure involving the removal of the bladder tumour (TransUrethral Resection of the bladder tumour - this operation is called TURB), whether or not supported by 'blue-light cystoscopy' (PDD or photodynamic diagnostics).

The department has great expertise in classic 'open' surgical bladder cancer treatment with bladder removal and various types of bladder replacement, but it also focuses on minimally invasive procedures. Since early 2020, robot-assisted radical cystectomy has been performed by an expert robot surgeon that has garnered international fame. Our hospital annually treats more than twenty-five such patients, with a strong focus on continuous quality evaluations, as well as patient-oriented evaluation within the Bladder Cancer care pathway.

Depending on the stage of your bladder cancer, feasibility of surgery and personal preference, external radiotherapy - whether or not in combination with chemotherapy - is sometimes offered as an alternative treatment.

External radiotherapy uses the most recent radiotherapeutic techniques. During this external radiation, imaging is used every day to focus the radiation as precisely as possible to minimise the chance of side-effects of the radiotherapy.

These treatments are carried out on a preferential basis by the Groeninge General Hospital radiotherapy service within the E17 network, but there is also good cooperation with the other radiotherapy services at a regional level, while always respecting the free choice of each patient.

Patients for whom a bladder removal has been planned or who present at a locally advanced stage of cancer, very often qualify for chemotherapy or immunotherapy (medication). In these stages of bladder cancer, we can offer both gold-standard and innovative medication. This includes targeted therapy that has revolutionised the treatment of bladder tumours. Our services can offer surplus new medication within clinical trials: urologists and oncologists participate intensively in these clinical trials, and this results in one of the widest selections of new medications that can be offered in our region.

As a Urology Department, we regularly take part in clinical trials. As a patient, you will never be obliged to participate in clinical studies. If you do not wish to participate, you will still receive our full attention as well as the gold-standard treatment.

Clinical studies are a form of scientific research into new surgical or radiotherapeutic treatments, medications, new combinations of medication or drugs with a proven effect that are tested in new or other situations. Sometimes, such as with a new radiotherapy schedule or surgical technique, a new dosage of the same medication or a new chronological schedule for the administration of the medication are applied. Clinical studies are carried out according to very strict scientific guidelines. Their aim is to check whether new treatments are safe and effective and/or better than the current standard treatment.

This research is performed on our own initiative, in collaboration with several university departments (KULeuven, Ghent University or the University of Antwerp) or on the initiative of a medical firm that wishes to evaluate innovative medication.

For more and more types of cancer, a better understanding of a patient's genetic background also means better (more targeted) treatment of their cancer. Within the framework of clinical trials, our departments have access to genetic research.

Our department is strongly committed to the development of the BladderQare Programme, which is developed progressively according to the strict standards of Value-Based Health Care (VBHC). Within this programme, care is developed centrally by a dedicated team of doctors and other health-care professionals based on what the patient and his or her family find important. The results of oncological (cancer) treatment are maintained prospectively in a database, which makes it possible to compare them with other national and international hospitals. The follow-up of patient satisfaction with their treatment, as well as side-effects and the broader framework are also monitored by means of internationally validated questionnaires and reported about according to a systematic methodology (ICOHM).

• Urologists
• Radiotherapists
• Medical oncologists
• Nuclear Medicine
• Radiology
• Physiotherapists/physical therapists
• Onco-nurse
• Psychologist
• Dietitian
• ...