Different types of treatment are available for people with bladder cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. There are four types of standard treatment for bladder cancer:
- Radiation therapy
- Biologic therapy
If you’ve been diagnosed with bladder cancer, your doctor may recommend one of the following types of surgery:
- Transurethral resection (TUR) with fulguration: Surgery in which a cystoscope (a thin lighted tube) is inserted into the bladder through the urethra. A tool with a small wire loop on the end is then used to remove the cancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
- Radical cystectomy: Surgery to remove the bladder and any lymph nodes and nearby organs that contain cancer. This surgery may be done when the bladder cancer invades the muscle wall, or when superficial cancer involves a large part of the bladder. In men, the nearby organs that are removed are the prostate and the seminal vesicles. In women, the uterus, the ovaries, and part of the vagina are removed. Sometimes, when the cancer has spread outside the bladder and cannot be completely removed, surgery to remove only the bladder may be done to reduce urinary symptoms caused by the cancer. When the bladder must be removed, the surgeon creates another way for urine to leave the body.
- Partial cystectomy: Surgery to remove part of the bladder. This surgery may be done for people who have a low-grade tumor that has invaded the wall of the bladder but is limited to one area of the bladder. Because only a part of the bladder is removed, people who have this type of surgery are able to urinate normally after recovery. This type of surgery is also called segmental cystectomy.
- Urinary diversion: Surgery to make a new way for the body to store and pass urine.
Biologic therapy is a treatment that uses a person’s immune system to fight cancer.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External radiation therapy is the type used to treat bladder cancer.
The way chemotherapy is given depends on the type and stage of the cancer being treated.
Even if your doctor removes all the cancer that can be seen at the time of surgery, some people may be given chemotherapy after surgery to kill any cancer cells that are left. Treatment given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy.
For some bladder cancer survivors, regional chemotherapy may be put into the bladder through a tube inserted into the urethra. This is called intravesical therapy.
Biologic therapy is a treatment that uses a person’s immune system to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or immunotherapy.
Bladder cancer may be treated with an intravesical biologic therapy called BCG (bacillus Calmette-Guérin). The BCG is given in a solution that is placed directly into the bladder using a catheter.
After starting treatment for bladder cancer, follow-up tests may be needed. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred.
Recurrent Bladder Cancer
Bladder cancer often recurs, or comes back, even when the cancer is superficial. Treatment of recurrent bladder cancer depends on previous treatment and where the cancer has recurred.
Surveillance of the urinary tract to check for recurrence is standard after a diagnosis of bladder cancer. Surveillance involves closely watching your condition but not giving any treatment unless there are changes in test results that show the condition is getting worse. During active surveillance, certain exams and tests are done on a regular schedule. Surveillance may include ureteroscopy and imaging tests.
New types of treatment for bladder cancer are being tested in clinical trials. To learn more about clinical trials, visit cancer.gov/clinicaltrials.
Source: National Cancer Institute, cancer.gov
This article was published in Coping® with Cancer magazine, September/October 2016.