Hospital da Luz Lisboa performs innovative bladder cancer treatment

Hospital da Luz Lisboa performed recently and for the first time in Portugal an innovative procedure – robotic partial cystectomy with high-dose-rate brachytherapy – to treat bladder cancer in an 81-year-old patient.

Using this new multidisciplinary therapeutic approach, that combines surgery and radiotherapy, the patient was submitted, in the same day, to surgery and to a first brachytherapy session (internal radiotherapy), the remaining nine sessions taking place in the three following days. 

After those treatments, the patient was discharged from hospital, now being followed-up in consultation at Hospital da Luz Lisboa.

The robotic surgery was performed by urologist Kris Maes, head of Urology Service and coordinator of the Uro-Oncology Center and the Robotic and Minimally Invasive Surgery Center from Hospital da Luz Lisboa, with the assistance of urologist Rui Formoso.

The surgery was designed to remove a bladder tumor, with preservation of the organ and the muscular and nervous structures responsible for urinary continence. Pelvic lymphadenectomy (removal of lymphatic ganglia) was also performed and inserted catheters designed for brachytherapy. The brachytherapy sessions were planned and performed by radio-oncologist Francisco Mascarenhas, coordinator of the Radiotherapy Service from Hospital da Luz Lisboa, and Fernando Marques, medical physicist of the same service. With this multidisciplinary procedure, it is possible to perform, in four days, a minimally invasive surgery (robotic) and several sessions of high-dose-rate localized brachytherapy, after which the treatment is concluded and the patient discharged.

The surgical intervention and the initial brachytherapy procedures were followed in videoconference by clinical head professionals (radio-oncologists, urologists and medical physicists) of the Arnhem Radiotherapy Institute (Netherlands) and the Urology Service of Rijnstate Hospital, also in Arnhem, the center that has developed this new therapeutic approach for bladder cancer treatment, at world level, and where a team from Hospital da Luz Lisboa, composed of urologists, radio-oncologists and medical physicists, received technical and practical training. Therefore, Hospital da Luz Lisboa became the first hospital at international level to apply this new procedure, besides the original center (Rijnstate Hospital).

According to data from the National Oncologic Registry reported in 2015, the incidence rate for bladder cancer is of 17.1 per 100 thousand inhabitants, representing the eighth more frequent malignant tumor in both genders, and the sixth more frequent in men, with an incidence rate of 28 per 100 thousand inhabitants.

It is worth mentioning that a great percentage of patients with bladder cancer are over 70 years old, some of which with general health conditions that may not favour the option of open surgery and long periods of treatment.