BEAT Bladder Cancer Australia
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Overview
There are different treatment options for bladder cancer, depending on whether you have superficial bladder cancer, muscle-invasive bladder cancer, or advanced cancer.
Treatments for bladder cancer include surgery, chemotherapy, radiation therapy, immunotherapy, and antibody-drug conjugates. You may receive more than one treatment.
There are simple ways to prepare for your treatment, such as stopping smoking, avoiding alcohol and doing exercise to strengthen your pelvic floor muscles.
Types of treatment
There are different treatments for bladder cancer, depending on the type of cancer.
Superficial bladder cancer – The main treatment is surgery to remove the cancer (transurethral resection of bladder tumour or TURBT). Surgery is often combined with chemotherapy or immunotherapy, which is delivered directly into the bladder (intravesical).
Muscle-invasive bladder cancer – This may be treated with surgery to remove the whole bladder (cystectomy), sometimes with chemotherapy before or afterwards. Another treatment is bladder-conserving surgery (TURBT) followed by radiation therapy and/or chemotherapy. This is called trimodal therapy.
Advanced bladder cancer – Treatment will focus on controlling the cancer and relieving symptoms (palliative treatment). It may include systemic chemotherapy, other drug therapies, surgery (cystectomy or TURBT) and radiation therapy.
Superficial bladder cancer treatment
Surgery (TURBT)
Surgery to remove the bladder tumour is called transurethral resection of bladder tumour or TURBT. It's usually done during diagnosis.Intravesical chemotherapy
Chemotherapy uses drugs to kill or slow the growth of cancer cells. In intravesical chemotherapy, the drugs are put directly into the bladder.Intravesical immunotherapy (BCG)
Bacillus Calmette-Guérin (BCG) is a vaccine that helps a person’s immune system to stop or delay bladder cancer coming back or becoming invasive.Muscle-invasive bladder cancer treatment
Surgery (cystectomy)
The most common surgery is a radical cystectomy, which removes the whole bladder, nearby lymph nodes, and possibly other nearby organs.Systemic chemotherapy
Chemotherapy uses drugs to kill or slow the growth of cancer cells. In systemic chemotherapy, the drugs are injected into a vein and travel throughout the body.Immunotherapy
Immunotherapy uses drugs (checkpoint inhibitors) to help the body's own immune system fight cancer.Radiation therapy
Radiation therapy uses a controlled dose of radiation (such as x-ray beams) to kill or damage cancer cells.Trimodal therapy
Trimodal therapy may be used instead of a cystectomy. It involves surgery to remove the bladder, followed by radiation combined with chemotherapy.Advanced bladder cancer treatment
Immunotherapy
Immunotherapy uses drugs (checkpoint inhibitors) to help the body's own immune system fight cancer. Some people with advanced cancer may have immunotherapy after chemotherapy.Antibody-drug conjugates
This drug treatment combines chemotherapy with targeted therapy. It may be used for advanced bladder cancer that has not responded to other drug treatments.Radiation therapy
Radiation therapy can be used to shrink the cancer, to stop bleeding in the bladder and to reduce cancer-related pain.What to do before and after treatment
Talk with your doctors about what you can do to prepare for treatment and help your recovery. Your doctors may suggest that you:
Stop smoking
If you smoke, aim to quit before starting treatment. If you keep smoking, you may not respond as well to treatment and you may have more treatment-related side effects. For support, see your doctor or call Quitline on 13 7848.
Begin or continue an exercise program
Exercise will help build up your strength for treatment and recovery. It can also help you deal with the side effects of treatment. Talk to your doctor, exercise physiologist or physiotherapist about the right type of exercise for you.
Improve your diet and avoid alcohol
Aim to eat a balanced diet with a variety of vegetables, fruit, wholegrains and protein. Eating well can improve your strength and you may respond better to treatment. Limiting how much you drink may also be advised, as alcohol can increase the risk of some types of cancer.
See a physiotherapist
They can teach you exercises to strengthen your pelvic floor muscles, which help control your bladder and bowel. It’s important to do these exercises after some types of treatment and if you have a neobladder.
Talk to someone
You may find it useful to talk to a psychologist or counsellor about how you are feeling. This can help you deal with any anxiety about having surgery and any longer term changes after treatment.
Relevant support
Bladder Cancer Australia Charity Foundation
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