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Bladder cancer - how is it treated?

Most bladder cancers are picked up an an early stage, where they are just sitting on the inner surface of the bladder. This is called "superficial" bladder cancer. If the cancer is growing into the bladder muscle itself, then more extensive treatment may be required. This is called "muscle-invasive" bladder cancer.

The first step in treating any bladder tumour is to remove the growth. This is done under an anaesthetic. A telescope is passed into the bladder along the water pipe (cystoscopy) and a special instrument is used to remove the growth. No big cuts or incisions are needed. This operation is called a "TURBT". Once the growth is removed, it can be sent to the lab where they will determine whether the growth is superficial or muscle-invasive.




Superficial bladder cancer

This type of bladder cancer usually has a good prognosis. After the tumour is removed (resected), a chemical wash is performed inside the bladder which can help to stop the growths from coming back. This is often the only type of treatment that is required.

Often the growths can come back from time to time, so you will need to have your bladder examined every few months using a cystoscopy. This is generally done under local anaesthetic and isn't usually a big bother. If the growths do come back, then they can be removed as before (TURBT).

Sometimes further treatments are given to help control the bladder tumours and prevent them getting any worse. A temporary catheter is put into the bladder along the water pipe and the bladder is filled up with a chemical wash which can kill cancer cells and stop them growing into tumours. Different chemicals may be used, but the commonest are "mitomycin-C" and "BCG".

Muscle-invasive bladder cancer

This is a more serious condition because the cancer is prone to spread around the body unless it is treated aggressively. A TURBT operation is usually not enough to reliably remove the tumour and further measures will be required.

Your specialist will organise scans of the body to make sure the cancer has not spread and to see how big it is. These scans may include CT scans or an MRI. Once all the necessary information has been gathered, the different treatments can be discussed. These include:

  • cystectomy - an operation to remove the whole bladder
  • radiotherapy - using radiation treatment to treat the tumour without the need for surgery
  • chemotherapy - injections of drugs into the bloodstream