Surgery, chemotherapy, radiation therapy and immunotherapy therapy — alone or in combination — can all be effective bladder cancer treatments. Your oncology team will make a recommendation based on the type, stage and location of your cancer.
Surgery
For early stage bladder cancer, transurethral resection (TUR) surgery may be performed through a resectoscope — a tube inserted into the bladder via the urethra. This avoids the need for an incision. When the cancer has spread beyond its original site into adjacent wall tissue, a cystectomy may be performed through an open incision. If only a portion of the bladder is removed, it is called a partial cystectomy. Removing the entire bladder is a radical cystectomy.
Chemotherapy
Chemotherapy may be an effective bladder cancer treatment against bladder cancer and may be recommended in combination with surgery and/or radiation therapy, especially for more advanced bladder cancers.
There are three different forms of chemotherapy. Neo-adjuvant or primary systemic chemotherapy is used before radiation or surgery to help shrink the tumor. Adjuvant chemotherapy is used after radiation therapy or surgery to destroy any remaining cancer cells. Systemic chemotherapy circulates the chemotherapy throughout the body via the bloodstream when the cancer is metastatic.
Immunotherapy or Biologic Therapy
Immunotherapy also called biologic therapy, uses certain drugs to boost your body’s own immune system so it can better fight the cancer. Intravesical therapy is directly delivered into the bladder through a catheter rather than by mouth or through intravenous injection. Bacillus Calmette-Guerin (BCG) therapy is the most effective intravesical immunotherapy for bladder cancer. The BCG vaccine was originally developed to protect against tuberculosis. It works by boosting the entire immune system rather than targeting only the tumor. In high doses, it can slow the growth of tumor cells and help the body to destroy the cancer.
Bladder Cancer Radiation Therapy
Radiation therapy uses high-powered x-rays to shrink tumors and destroy cancerous cells. There are two basic types of radiation therapy: External Beam Radiation Therapy uses highly sophisticated, often robotically controlled systems to irradiate tumors from outside the body. Internal Radiation Therapy, also known as Brachytherapy, delivers radiation from a source implanted inside the body. Which one is best suited for your particular situation depends on the size, location and stage of the tumor or tumors.