Treatments for bladder cancer depend on the type, stage, and grade of the cancer, in addition to a patient’s overall health and may include surgery, transurethral resection of bladder tumor (TURBT), cystectomy (partial or complete bladder removal), bladder reconstruction, continental urinary reservoir (new pouch for holding urine), intravesical (in the bladder) chemotherapy, systemic (whole body) chemotherapy, radiation therapy, chemotherapy combined with radiation therapy (chemoradiation), bladder preservation trimodal therapy, and immunotherapy (biological therapy or biologics).
Surgery – Surgery for bladder cancer can include surgery to remove the bladder tumor and any surrounding cancerous tissue, transurethral resection of bladder tumor (TURBT), which is where the surgeon inserts a cautery or laser device through the urethra into the bladder to burn out the cancer, cystectomy, which involves either partial or full removal (radical cystectomy) of the bladder, and bladder reconstruction, which creates a new way for urine to be excreted, such as the creation of a continental urinary reservoir (new pouch for holding urine) through the use of a small portion of the small intestine.
Chemotherapy – Chemotherapy for bladder cancer can be administered in different ways, such as intravesical chemotherapy (used for high-grade or recurrent bladder cancers), which is when cancer drugs are administered directly into the bladder, systemic (whole body) chemotherapy, which is used when the cancer cannot be surgically removed (unresectable) and is administered via a pill or intravenously (IV), or chemotherapy combined with radiation therapy (chemoradiation). Chemotherapy may be used before surgery to reduce the tumor size, or after surgery to kill any remaining cancer cells.
Radiation Therapy – Radiation therapy uses directed, high-energy X-rays or protons or other types of radiation to kill bladder cancer cells.
Trimodality Therapy (Bladder preservation)– Trimodality therapy uses a combination of chemotherapy, radiation therapy, and transurethral resection of bladder tumor (TURBT) in an effort to preserve as much of the bladder as possible.
Immunotherapy (Biological therapy or biologics) – Immunotherapy is when the body’s immune system is used to fight cancer cells and is administered either directly into the bladder (intravesical) or systemically through pills or an IV (intravenously).
Common immunotherapy drugs administered for bladder cancer are Bacillus Calmette-Guerin (BCG), which is a tuberculosis vaccine, interferon (interferon alfa-2b ), and atexolizumab (Tecentriq), which is used for locally advanced or metastatic bladder cancer that was unresponsive to chemotherapy.
Some patients may also want to consider participating in clinical trials for bladder cancer to gain access to new, experimental treatments.