If treated in an early stage, bladder cancer can often be cured. Treatment for bladder cancer depends on the stage. Stages are used to describe how much the cancer has worsened or spread. 

Bladder Cancer Stages

• Stage 0 – This stage of bladder cancer is called non-invasive papillary carcinoma or carcinoma in situ, which means there are abnormal cells that may become cancerous and spread. Treatment for Stage 0 bladder cancer may include:

• Watchful waiting
  • Intravesical chemotherapy
  • Intravesical Bacille Calmette-Guérin 
  • Transurethral resection of a bladder tumor
  • Partial or complete cystectomy 

• Stage I – In this stage of bladder cancer, the cancer has spread to the connective tissue beyond the inner lining of the bladder. Treatment for Stage I bladder cancer may include: 

• Transurethral resection of a bladder tumor with fulguration
  • Intravesical chemotherapy
  • Partial or complete cystectomy
  • Radical cystectomy
  • Radiation therapy

• Stage II – In this stage of bladder cancer, the cancer has spread to the muscle layers of the bladder. Treatment for Stage II bladder cancer may include: 

• Transurethral resection of a bladder tumor 
  • Intravesical chemotherapy
  • Partial or complete cystectomy
  • Radical cystectomy

• Stage III – In this stage of bladder cancer, the cancer has spread to the fat outside the bladder and possibly the reproductive organs, such as the uterus, vagina, prostate, or seminal vesicles; or the cancer has spread to one pelvic lymph node. Treatment for Stage III bladder cancer may include: 

• Transurethral resection of a bladder tumor 
  • Chemotherapy followed by radical cystectomy
  • Chemotherapy with or without radiation therapy
  • Immunotherapy

• Stage IV – In this stage of bladder cancer, the cancer has spread from the bladder to the lining of the abdomen or pelvis or to the lymph nodes above common iliac arteries. The cancer has also spread to other parts of the body, such as the liver, lung, and bones. Treatment for Stage IV bladder cancer may include: 

• Chemotherapy with or without radiation therapy
  • Immunotherapy
  • Radical cystectomy
  • Radiation therapy
  • Urinary diversion surgery
  • Palliative care

Bladder Cancer Treatments

Surgery

Surgery for bladder cancer may include:

• Transurethral resection of bladder tumor, which is where the surgeon inserts a cautery or laser device through the urethra into the bladder to burn out the cancer.
• Cystectomy, which can be either partial, full, or radical removal of the bladder and nearby organs and lymph nodes
• Bladder reconstruction, which creates a new way for urine to pass by making a new pouch for the urine

Chemotherapy

Chemotherapy for bladder cancer can be given in different ways, such as:

• Intravesical chemotherapy, which is when cancer drugs are given directly into the bladder
• Systemic (whole body) chemotherapy, which is used when the cancer cannot be surgically removed. Systemic chemotherapy can be given directly into a vein or a pill by mouth. 
• Chemoradiation, which is when chemotherapy is combined with radiation therapy 

Chemotherapy drugs used for the treatment of bladder cancer include cisplatin, cisplatin plus fluorouracil, cisplatin plus methotrexate and vinblastine, gemcitabine plus cisplatin, gemcitabine plus paclitaxel, methotrexate plus vinblastine and doxorubicin and cisplatin, and mitomycin plus fluorouracil.

Radiation Therapy – Radiation therapy uses directed, high-energy X-rays, protons, or other types of radiation to kill bladder cancer cells. 

Trimodality Therapy – Trimodality therapy uses a combination of chemotherapy, radiation therapy, and transurethral resection of bladder tumor in an effort to preserve as much of the bladder as possible. 

Immunotherapy, also called biologics – Immunotherapy is when the body’s immune system, or the body’s natural defenses, is used to fight cancer cells. Common immunotherapy drugs administered for bladder cancer are Bacillus Calmette-Guerin, interferon, and atexolizumab.

Palliative Care

In addition to standard treatments, patients with cancer may also be treated with palliative care. Palliative care is used to relieve pain and other symptoms to make a patient more comfortable. 

New and Experimental Treatments

New and experimental treatments for bladder cancer include the drugs pembrolizumab, nivolumab, and ipilimumab.

Long-Term Follow Up

Ongoing, long-term follow-up is an essential part of the treatment for patients with bladder cancer because the cancer can reoccur even after it has been treated.

Sources

This content was written by the MediFind Medical Team. Last updated: 6/9/2022