Several different procedures and drugs can be used to treat bladder cancer. In some cases, more than one type of treatment will be necessary. The course of treatment your doctor recommends will depend on the specific type of bladder cancer cells present, and how much the cancer has spread. Common treatments for bladder cancer include surgery, immunotherapy, chemotherapy, and radiation therapy.
Surgery
Surgery is usually the first step in treating bladder cancer. Types of surgery for cancer removal include: Transurethral resection: Surgical instruments are passed through the urinary opening (urethra) into the bladder. Cancer cells can be cut away, burned away with an electrical device, or removed with a laser. Segmental cystectomy: If the tumor is limited to one area of the bladder, then surgery may remove only that part of the bladder. Leaving the rest of the bladder allows for more normal urinary functioning. Complete cystectomy: If the tumor is more widely spread throughout the bladder, the entire bladder is removed. If the entire bladder is removed, a new way to hold urine and excrete it from the body must be created. This is called bladder reconstruction. Several options exist: Incontinent diversion: In some cases, urine may be diverted to a bag that you wear outside your body. Urine continually collects in this bag, and you will be taught how to empty it regularly. Continent diversion: A piece of your intestine may be used to create a new bladder-like sac to hold urine inside your body. To drain the urine, a tube is passed through a valve into the sack several times a day. Neobladder: This newer technique uses a segment of intestine to create a bladder that is placed in the pelvis where the original bladder was located. This neobladder is attached to the urethra (the tube through which urine exits the body). Many people can learn how to control urination from the neobladder during the day. Immunotherapy drugs are usually administered directly into your bladder (a process called intravesical administration). They may be given as the only treatment, or they may be given after surgery or another treatment to fight any cancer cells left behind.
Chemotherapy
Chemotherapy uses strong drugs to kill cancer cells or prevent them from dividing. These medicines may be administered directly into your bladder, through an intravenous (IV) line into your bloodstream, or by mouth. Chemotherapy can be given before surgery to shrink the tumor, or after surgery to kill any remaining cancer cells. Sometimes more than one chemotherapy drug is used at the same time. Chemotherapy may be used in combination with radiation therapy.
Radiation
Radiation therapy uses high-energy beams to kill cancer cells. Radiation is often used to kill any cancer cells that remain after surgery, but it can also be used to shrink a tumor before surgery.
