Treatments for bladder cancer include surgery, chemotherapy, and radiation therapy. Newer treatment options include immunotherapy and targeted therapy.

Doctors may administer medications directly into the bladder through a catheter.

Treatments for advanced bladder cancer involve radiation or administering medication through an IV that enters a person’s body through a vein.

A doctor may recommend a combination of treatments for bladder cancer.

However, most of them cause side effects, so it is important to discuss treatment with a healthcare professional.

This article details treatment options for bladder cancer, alongside their risks and benefits. It also discusses surgery, chemotherapy, radiation therapy, and more.

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According to the National Cancer Institute, doctors treat bladder cancer by targeting cancer cells.

These generally aim to destroy or remove bladder cancer cells, with the goal of curing the disease.

Alternatively, they might try to limit the disease’s development.

If bladder cancer is localized — which means it is limited to the bladder — they may be able to remove it with surgery. They may also combine this with other treatments to help shrink and destroy the tumor.

As the American Cancer Society (ACS) explains, the aim of surgery for bladder cancer is to remove the cancer cells from the body.

These procedures will also remove some noncancerous tissues. Surgeons perform them with local or general anesthesia.

There are two main surgical treatments for bladder cancer:

  • Transurethral resection of bladder tumor (TURBT): This procedure is suitable for early stage bladder cancer. Surgeons place a resectoscope through the urethra into the bladder. A resectoscope is a thin and rigid instrument. It has a wire loop at one end, which surgeons use to remove cancer cells. Sometimes, a doctor may use this method to obtain a biopsy to diagnose bladder cancer.
  • Cystectomy: This is a more complicated procedure with a higher risk of complications. It is more suitable for localized bladder cancer that occurs after a TURBT or other treatments. In a cystectomy, surgeons remove all or part of the bladder. A partial cystectomy is when surgeons remove part of the bladder, while a radical cystectomy is when surgeons remove the whole bladder.

TURBTs should not affect the outermost layers of the bladder.

However, cystectomies are more complicated. Partial cystectomies create a hole in the bladder, which surgeons must stitch close. With a radical cystectomy, surgeons may need to reconstruct the bladder afterward.

Doctors may recommend chemotherapy or radiation therapy before or after surgery to destroy any remaining cancer cells.

Benefits and risks

TURBT comes with certain risks. For example, some people might experience bleeding and pain when urinating.

The main benefit of TURBT is that side effects tend to be mild and temporary. However, repeated TURBTs can cause frequent urination and incontinence.

Cystectomies can completely remove bladder cancer cells if the cancer is only present in the bladder. However, the surgery comes with significant risks, including:

Radical cystectomies can also cause unwanted sexual effects. These include:

Finally, cystectomies can affect how someone stores and passes urine. For instance, partial cystectomies may cause frequent urination, since the bladder pouch is smaller than before.

However, radical cystectomies cause the most significant effects. This is because of the accompanying reconstructive surgeries.

Adapting to these reconstructive surgeries can be psychologically difficult. They may also cause infections, incontinence, and pouch stones.

According to the ACS, chemotherapy is when doctors use medications to kill cancer cells.

With bladder cancer, doctors have two ways of administering chemotherapy medications:

  • Intravesical chemotherapy: Doctors place the chemotherapy medications directly into the bladder. This is only appropriate for bladder cancers solely affecting the bladder’s lining, which doctors call localized bladder cancer.
  • Systemic chemotherapy: Doctors introduce chemotherapy medications into the bloodstream. The medications are mostly in IV form and sometimes in pill form. The medications spread throughout the body until they find cancer cells.

Some people might receive more than one chemotherapy medication at a time. Additionally, doctors sometimes recommend chemotherapy alongside radiation therapy.

Side effects

Doctors can use chemotherapy before surgery to shrink a tumor or after surgery to clean up any residual cancer. They can also use it in advanced cases when cancer has spread.

Despite these benefits, chemotherapy can have some unpleasant side effects. These include:

Chemotherapy can also increase the risk of infections. Additionally, some chemotherapy medications can cause nerve damage.

However, most side effects of chemotherapy disappear after treatment.

As the ACS explains, doctors can use radiation therapy to treat bladder cancer.

Across several sessions, doctors focus a strong beam of radiation on a bladder tumor. Over time, this kills the bladder cancer cells.

Radiation therapy can be useful for people who cannot receive chemotherapy or undergo surgery. It can improve the effectiveness of TURBT and may sometimes be an alternative to radical cystectomy.

Side effects

This bladder cancer treatment can cause some shorter-term side effects. These include:

  • nausea
  • vomiting
  • diarrhea
  • fatigue
  • bloody stool or urine
  • easily bleeding or bruising
  • skin damage

As with chemotherapy, radiation therapy can make infections more likely. Its long-term side effects can include incontinence, painful urination, and erectile dysfunction.

Surgery, chemotherapy, and radiation therapy are well-established treatments for bladder cancer.

However, scientists have developed newer treatments for this disease. These pharmaceutical treatments include:

  • Targeted therapy: According to the ACS, this treatment uses medications to affect specific cancer-causing genetic mutations. These can stop cancer cells from dividing or growing.
  • Immunotherapy: According to the ACS, this treatment uses medications to help the immune system destroy cancer cells. The immune system becomes more effective at detecting or destroying those cells.
  • Intravesical immunotherapy: Alongside chemotherapy medications, doctors can place immunotherapy medications directly into the bladder.

Research continues into these more recent treatments.

This section answers some frequently asked questions about bladder cancer treatments.

Is bladder cancer fully curable?

As the NIH explains, some bladder cancers are curable in the early stages. However, it is possible for the disease to reoccur.

What is the latest treatment for bladder cancer?

Doctors more commonly use immunotherapies and targeted therapies for advanced or metastasized cancers.

Surgery remains a useful treatment for bladder cancer, but it comes with risks and side effects.

However, there are other treatment options, including chemotherapy and radiation therapy. Doctors may recommend a combination of treatments depending on the case.

Scientists continue to innovate new bladder cancer treatments, such as immunotherapy and targeted therapy.