There are four types of treatment for patients with bladder cancer. Sometimes combinations of these treatments will be used.

Surgical options

Surgery is a common treatment option for bladder cancer. The type of surgery chosen will depend on the stage of cancer. Transurethral resection of the bladder is most often used for early-stage disease. In this procedure, a special telescope called a resectoscope is inserted through the urethra into the bladder. The tumor is then removed with the resectoscope, and the surface of the bladder is then destroyed by an electric current.

Partial cystectomyis the removal of a section of the bladder. It is used for a single tumor that invades the bladder wall in a single region of the bladder. This type of surgery keeps most of the bladder.

Radical cystectomyis the complete removal of the bladder. It is used for more extensive cancers for those that have spread beyond the bladder. In this surgery, an incision (cut) from the umbilical to the pubic bone is made, and the bladder and any other affected organ are removed. In men, prostate and seminal vesicles can be removed, and in women, ovaries, uterus, and part of the vagina.

Chemotherapy

Chemotherapy refers to the use of any group of drugs whose main effect is to destroy or slow down the reproduction of cells that multiply rapidly. Cancer cells absorb chemotherapeutic substances faster than normal cells (but all cells are exposed to the chemotherapy drug). Some common chemotherapy drugs used to treat bladder cancer are methotrexate, vinblastine, doxorubicin, cyclophosphamide, paclitaxel, carboplatin, cisplatin, ifosfamide, and gemcitabine. Many of these drugs are used in combinations.

There are two types of chemotherapy that can be used to treat bladder cancer. The type of doctor recommended depends on the stage of cancer. 

Intravesical chemotherapy– is usually administered by a urologist. During this type of therapy, the drugs are administered to the bladder by a catheter that has been inserted through the urethra. The local treatment destroys only superficial tumor cells that come into contact with the drug.

Systemic chemotherapy– is usually prescribed by a medical oncologist, a specialist in treating cancer with drugs. Systemic chemotherapy penetrates into the blood to reach cancer cells all over the body. It can be given intravenously or via capsules.

Immunotherapy

Immunotherapy, also called biological therapy, is designed to stimulate the natural defense of the body to fight cancer. It uses substances made either by the body or in the laboratory to improve or restore the function of the immune system. The standard immunotherapy drug for bladder cancer is a weakened bacterium called BCG or the Calmette-Guerin bacillus. It is placed directly into the bladder by a catheter; attaches itself to the inner lining of the bladder and stimulates the immune system to destroy the tumor. Interferon is another type of immunotherapy that can be administered as intravesical therapy. It is sometimes combined with BCG if the use of BCG alone does not help treat cancer.

Radiotherapy

Radiotherapy affects cancer cell DNA by the use of high energy X-rays or other types of radiation. It can be an alternative to surgery or can be used in combination with surgery or chemotherapy. Radiotherapy can be administered externally or internally.