The treatments for bladder cancer depend on the stage of bladder cancer. Briefly, I break it down into two different stages. The first is what we call “”superficial bladder cancer””–a small growth in the lining of the bladder that hasn’t grown into the muscle layer of the bladder. Usually this is treated–first we have to diagnose the problem, so we usually look into the bladder with a cystoscope, and we find out if there are bladder tumors .If there are bladder tumors, we either biopsy them or scrape them using a transurethral recession, done with a telescope through the urethra. We scrape the tumor to get staging–how deep it’s gone into the muscle. It’s also curative for those people who have superficial cancer. That one procedure, if it is confined, will be the treatment. Many patients, when they present, will have more than one tumor or a poorly differentiated tumor. Some of those will require some treatments like therapies in the bladder, similar to chemotherapy, but not really chemotherapy–it’s called immunotherapy. We place a small catheter in the bladder and still fluid into the bladder that causes inflammatory changes. The body’s response to that is to attack the lining of the bladder and wipe out all residual cancer cells. We usually do that once a week for about six weeks, and it is dependent on what type of cancer patients have. It doesn’t make people sick, like traditional chemotherapy. It may make them have worsening urinary frequency, or some burning with urination.
The other type of bladder tumors that grow into the muscle wall behave much more like what people consider a real cancer. These are aggressive tumors, they can spread to other areas of the body, and they cause rapid progression into the muscle or blocking the ureter tubes or spreading. Most times, we recommend as the gold therapy for treatment of bladder cancer is to take the bladder out. Sometimes patients can receive a combination of chemotherapy and radiation therapy in an attempt to preserve the bladder. This has a slightly higher incidence of recurrence, and it if does fail, we recommend taking the bladder out in addition. When you take the bladder out, you have to find a new way for urine to get to the outside of the body. We can either do that by making a small conduit that comes to the skin as a stoma, or we can create what’s called a neobladder out of portions of the bowel, and hook it up to the urethra, so you can void almost normally.