Bladder cancer

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Cystoscopy

Female urinary tract

Male urinary tract

Transitional cell carcinoma of the bladder; Urothelial cancer

Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.

Stage 0 and I treatments:

• Surgery to remove the tumor without removing the rest of the bladder
• Chemotherapy or immunotherapy directly into the bladder

Stage II and III treatments:

• Surgery to remove the entire bladder (radical cystectomy)
• Surgery to remove only part of the bladder, followed by radiation and chemotherapy
• Chemotherapy to shrink the tumor before surgery
• A combination of chemotherapy and radiation (in patients who choose not to have surgery or who cannot have surgery)

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Most patients with stage IV tumors cannot be cured and surgery is not appropriate. In these patients, chemotherapy is often considered.

CHEMOTHERAPY

Chemotherapy may be given to patients with stage II and III disease either before or after surgery to help prevent the tumor from returning.

For early disease (stages 0 and I), chemotherapy is usually given directly into the bladder.

A Foley catheter can be used to deliver the medication into the bladder. Common side effects include bladder wall irritation and pain when urinating. For more advanced stages (II-IV), chemotherapy is usually given by vein (intravenously).

IMMUNOTHERAPY

Bladder cancers are often treated with immunotherapy. In this treatment, a medication triggers your immune system to attack and kill the cancer cells. Immunotherapy for bladder cancer is usually performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). It is given through a Foley catheter directly into the bladder. If BCG does not work, patients may receive interferon.

As with all treatments, side effects are possible. Ask your doctor what side effects you might expect, and what to do if they occur.

SURGERY

Surgery for bladder cancer includes:

• Transurethral resection of the bladder (TURB): Cancerous bladder tissue is removed through the urethra.
• Partial or complete removal of the bladder: Many people with stage II or III bladder cancer may need to have their bladder removed (radical cystectomy). Sometimes only part of the bladder is removed. Radiation and chemotherapy is usually given after this surgery.