Bladder Cancer Treatment Options
Bladder cancer treatment depends on the type and stage of the cancer, as well as age, overall health, and daily functioning abilities. Treatment options are also influenced by the medication and medical expertise available, costs, and your preferences and goals.
Surgical Treatments
The purpose of surgery is to remove the tumor and, at times, some of the surrounding tissue. Surgical options vary from removing a single tumor on the bladder lining to taking out the entire bladder and nearby organs.​
Transurethral Resection of Bladder Tumor (TURBT)
A surgical procedure for superficial bladder cancer that removes the tumor while preserving the rest of the bladder. This technique accesses the tumor through the urethra, avoiding the need for abdominal incisions, and allows for a more precise diagnosis after testing the removed tissue.
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TURBT is performed under anesthesia in a clinic or hospital operating room. A long, thin tool with a small cutting device is inserted through the urethra into the bladder, where it is used to view and remove the tumor from the bladder lining.
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The goals of TURBT are to:
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Confirm the initial bladder cancer diagnosis.
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Take a sample of the bladder wall to see if the tumor has invaded the muscle layer.
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Remove all the visible tumors.
Cystectomy
A cystectomy treats bladder cancer by removing the entire bladder or an invasive cancer along with part of the bladder wall.
Sometimes a cystectomy may involve removing the bladder along with nearby lymph nodes. If the cancer has spread, it may also be necessary to remove some surrounding organs, such as:
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Urethra
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Prostate
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Seminal vesicles (glands that help make semen)
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Part of the vas deferens (a tube that carries sperm away from the testicles)
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Proximal urethra (part of the urethra that goes through the prostate)
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Uterus
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Ovaries
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Fallopian tubes
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Part of the vagina
Transurethral Resection of Bladder Tumor (TURBT)
A surgical procedure for superficial bladder cancer that removes the tumor while preserving the rest of the bladder. This technique accesses the tumor through the urethra, avoiding the need for abdominal incisions, and allows for a more precise diagnosis after testing the removed tissue.
​
TURBT is performed under anesthesia in a clinic or hospital operating room. A long, thin tool with a small cutting device is inserted through the urethra into the bladder, where it is used to view and remove the tumor from the bladder lining.
​
The goals of TURBT are to:
-
Confirm the initial bladder cancer diagnosis.
-
Take a sample of the bladder wall to see if the tumor has invaded the muscle layer.
-
Remove all the visible tumors.
Cystectomy
A cystectomy treats bladder cancer by removing the entire bladder or an invasive cancer along with part of the bladder wall.
Sometimes a cystectomy may involve removing the bladder along with nearby lymph nodes. If the cancer has spread, it may also be necessary to remove some surrounding organs, such as:
-
Urethra
-
Prostate
-
Seminal vesicles (glands that help make semen)
-
Part of the vas deferens (a tube that carries sperm away from the testicles)
-
Uterus
-
Ovaries
-
Fallopian tubes
-
Part of the vagina
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Radical Cystectomy vs. Partial Cystectomy
A Radical Cystectomy is removal of the entire bladder where a Partial Cystectomy removes only a part of the bladder. Fewer than 5% of people with bladder cancer are candidates a Partial cystectomy. Partial Cystectomies are used only if the cancer is in an area where it can be removed cleanly without removing the entire bladder.
Urine Diversion
If a cystectomy is performed that removes the entire bladder, an additional procedure called a urinary diversion may be performed to create a new way for urine to exit the body. The three types of urine diversion are:
Ileal Conduit
There are no routine screening tests for bladder cancer, but people at higher risk may be recommended for screening. This includes individuals with a family history of bladder cancer, smokers and those exposed to certain industrial chemicals.
Catching bladder cancer in its early stages, when it is often confined to the bladder’s inner lining, allows for less aggressive treatment and improves the likelihood of successful outcomes.
Involves removal of a section of the small intestine (ileum) to create a tube or conduit. A small opening, called a stoma, is then made in the abdominal wall. One end of the conduit connects to the ureters as the bladder did, while the other end attaches to the stoma. Urine flows from the kidneys through the conduit and exits the body via the stoma.
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Since urine may flow continuously, a disposable bag, or urostomy pouch, is attached to the abdomen over the stoma. This bag, secured with a watertight adhesive ring, collects urine as it exits. Most people find they need to empty the bag every »4 hours, depending on their fluid intake. A closable spout at the bottom of the bag allows it to be emptied directly without removal.
Neobladder
A procedure utilizing a portion of the small intestine is used to create a new bladder, or "neobladder," which functions similarly to a natural bladder. This substitute bladder connects to the ureters on one side and to the urethra on the other, allowing urine to exit the body through the normal pathway, without the need for a stoma or ostomy bag.
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While a neobladder operates like a natural bladder, it may require more frequent emptying initially and patients may experience some urine leakage, especially during sleep. Improved bladder control is often experienced over time and with traning.
Continent Cutaneous Pouch (Indiana Pouch)
A urinary diversion that utilizes a section of the large intestine to create a urine-holding pouch, commonly called an Indiana pouch, as it was developed at Indiana University. A portion of the small intestine connects this pouch to a stoma in the abdominal wall. A one-way valve, fashioned from part of the intestine, prevents urine from leaking out of the stoma.
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The stoma is typically covered with a small bandage and can sometimes be placed in the belly button, making it less visible. The Indiana Pouch is that it does not require an ostomy bag.