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Genitourinary Oncology Program

Patient and Family Education

Bladder Cancer

Treatment Options

There are four primary treatment options for patients with bladder cancer:

• surgery
• radiation therapy
• chemotherapy
• biological therapy

A new type of treatment called photodynamic therapy is being tested in clinical trials.

Surgery

Surgery is local therapy to remove the tumor. A doctor may take out the cancer using one of the following methods:

• Transurethral Resection is an operation that uses a cytoscope inserted into the bladder through the urethra. The doctor then uses a tool with a small wire loop on the end to remove the cancer or to burn the tumor away with high-energy electricity (fulguration).
  
  
• Segmental Cystectomy is an operation to take out the part of the bladder where the cancer is found. Bladder cancer often occurs in more than one part of the bladder, so this operation is used only in selected cases where the cancer is in one area.
  
  
• Cystectomy is an operation to take out the bladder.Radical Cystectomy is an operation to take out the bladder and the tissue around it. In women, the uterus, ovaries, fallopian tubes, part of the vagina, and urethra are also removed. In men, the prostate and the glands that produce fluid that is part of the semen (seminal vesicles) are also removed, and the urethra may be removed as well. The lymph nodes in the pelvis may also be taken out (pelvic lymph node dissection).
  
  
• Urinary Diversion is an operation that makes a way for urine to pass out of the body so that it does not go through the bladder. It is used to relieve bladder symptoms when the tumor has spread.

If the bladder is removed, a doctor will need to make a new way for the body to store and pass urine. There are several ways to do this. Sometimes a doctor will use part of the small intestine to make a tube through which urine can pass out of the body through an opening (stoma) on the outside of the body. This procedure is sometimes called an ostomy or urostomy.

The doctor may also use part of the small intestine to make a new storage pouch (a continent reservoir) inside the body where urine can collect. A patient would then need to use a tube (catheter) to drain the urine through the stoma. Newer methods use a part of the small intestine to make a new storage pouch that is connected to the remaining part of the urethra if it has not been removed. Urine then passes out of the body through the urethra, and a stoma is not necessary.

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Radiation Therapy (also called radiotherapy)

Radiation therapy is the use of high-energy rays that damage cancer cells and stop them from growing and dividing. It is a local therapy that only affects cancer cells in the treated area. Radiation may come from a machine (external radiation) or from an implant placed directly into or near a tumor (internal radiation)

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Chemotherapy

Chemotherapy is treatment with drugs that kill cancer cells. Most anticancer drugs are injected into a vein or a muscle; some are given by mouth. Chemotherapy is a systemic treatment, meaning that the drugs flow through the bloodstream to nearly every part of the body to kill cancerous cells. It is generally given in cycles; a treatment period is followed by a recovery period, then another treatment period, and so on. Chemotherapy for bladder cancer may also be given in a fluid that is put into the bladder through a tube going through the urethra (intravesical chemotherapy).

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Biological Therapy

Biological therapy is the use of materials made by the body itself or made synthetically in a laboratory to boost, direct, or restore the body's natural defenses against disease. Biological therapy is sometimes called biological response modifier (BRM) therapy or immunotherapy. Biological therapy may be given in a fluid that is put into the bladder through a tube going through the urethra (intravesical biological therapy).

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Photodynamic Therapy

Photodynamic therapy is a new type of treatment that uses special drugs and light to kill cancer cells. A drug that makes cancer cells more sensitive to light is put into the bladder, and a special light is then used to shine light on the bladder. This therapy is being studied for treatment of early stages of bladder cancer.

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This page was last updated on: October 6, 2009.

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