Treatment choices for bladder cancer
The choice of treatment and the long-term outcome (prognosis) of people with bladder cancer depends on the stage of the cancer. A person's age, overall health, and quality of life must also be considered. Research studies are ongoing to determine the best treatment choices or combination of treatments that increase survival rates without adversely impacting quality of life.1, 2
Treatment choices for bladder cancer Stage Treatment choices 0
TaN0M0
TisN0M0
Standard treatments
Transurethral resection (TUR) to remove cancer cells from the bladder
TUR with intravesical bacillus Calmette-Guerin (BCG) to prevent the spread or return of cancer
TUR with intravesical chemotherapy to also prevent the spread or return of cancer
Cystectomy to remove part or all of the bladder in specific high-risk people or those who have high-grade cancer
Possible alternative treatments under study
Photodynamic therapy, which uses laser light and a special light-activated substance (Photofrin) to kill cancer cells
Interferon, which is given through a catheter into the bladder to fight cancer cells (intravesical chemotherapy)
Chemoprevention, which uses medications, vitamins, or other substances to prevent the return of cancer
I
T1N0M0
Standard treatments
TUR
TUR with intravesical BCG
TUR with intravesical chemotherapy
Cystectomy in specific high-risk people or those who have high-grade cancer
Radiation therapy to prevent the spread of cancer
Possible alternative treatments under study
Chemoprevention
Other intravesical treatments
II
T2aN0M0
T2bN0M0
Radical cystectomy (removes the whole bladder) with or without removal of the pelvic lymph nodes (lymphadenectomy)
Chemotherapy followed by radical cystectomy
Radiation therapy with or without chemotherapy to prevent the spread of cancer
TUR
Partial cystectomy
III
T3aN0M0
T3bN0M0
T4aN0M0
Radical cystectomy with or without removal of pelvic lymph nodes
Chemotherapy followed by radical cystectomy
Radiation with or without chemotherapy
Partial cystectomy may be possible for some people
IV
T4bN0M0
Any T, N1, M0
Any T, N2, M0
Any T, N3, M0
Radical cystectomy with removal of pelvic lymph nodes
Radiation therapy
Urinary diversion or cystectomy as palliative care, to help relieve symptoms and improve quality of life
Chemotherapy
IV
Any T, any N, M1
Chemotherapy
Radiation as palliative care
Cystectomy as palliative care
Recurrent
Dependent on stage and grade of initial cancer and recurrent cancer, and on the treatment already done for the initial cancer
| Author: | Shannon Erstad, MBA/MPH | Last Updated: May 25, 2007 |
| Medical Review: | E. Gregory Thompson, MD - Internal Medicine Philip Belitsky, MD, FRCSC - Urology | |
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