Roswell Park’s comprehensive approach for patients undergoing cystectomy — removal of the bladder — involves a robust program of education, preparation, and evidence-based practices to improve your experience before, during and after surgery.
Radical cystectomy is a complex operation that carries a high degree of risk. In addition to our high-volume surgical experience, we have developed a comprehensive approach to get our patients through the operation safely with optimal cancer control, survival and quality of life.
Once you have decided to have surgery to remove your bladder, you will begin a journey that we call The Cystectomy Pathway, to guide you through the next few months. In addition, our experts have developed a system, called the Quality Cystectomy Score (QCS), that identifies key factors that contribute to a successful bladder cancer surgery and improved survival. We adhere to the Cystectomy Pathway and QCS for every radical cystectomy we perform, and we aim for a four-star operation for every patient.
What is the Cystectomy Pathway?
The Cystectomy Pathway is a carefully designed program, created by Roswell Park’s experts, that is like a personal training regimen that you would follow to run a marathon. Following the pathway helps prepare you for the surgery and its life-changing impact. This means your care will involve several specialists before your surgery, during your inpatient stay, and over the weeks and months after your surgery. These include:
- Oncology nurse coordinator who will coach you through the pathway and arrange for your care with the rest of the team.
- Dietitian who will help you improve your nutritional status to boost your strength and energy, promote treatment tolerance and healing, prevent loss of muscle mass, and reduce infection risk.
- Social worker to provide support and resources for anxiety, depression, substance use, financial struggles, caregiver issues, and to arrange your home care.
- Physical and occupational therapists who will assess your current status and teach you exercises to improve your physical strength, functional ability, fine motor skills and respiratory function both before and after your surgery.
- Ostomy nurse to prepare you for life with an ostomy, an opening in your abdomen through which you will empty your urine from now on, if an ileal conduit is planned.
- Dedicated physician assistants and nurse practitioners, specializing in bladder cancer care.
- Support group specifically for bladder cancer patients
This team will be with you every step of the way. You can rely on us to answer your questions, quell anxiousness and fears, offer solutions and resources, and help you prepare for life after your cancer treatment.
What makes a quality operation?
Our bladder cancer experts developed a four-star rating system, called the Quality Cystectomy Score, that identifies eight specific quality measures that contribute to a successful bladder cancer surgery and improved survival. These include:
- Neoadjuvant (before surgery) chemotherapy, to kill cancer cells that may have spread but cannot be seen on scans. You will be evaluated to determine if you are eligible for this treatment
- Shorter operation, less than 6.5 hours
- Limited blood loss, less than 500 ml
- Negative surgical margins, leaving no cancer cells behind
- Adequate lymph node removal, ideally 20 or more
- No mortality within 30 days
- No readmission to the hospital
- No high-grade complications
Our team makes every effort to strive for a four-star operation for every patient.