Treatment and care of people with cancer is usually provided by a team of health professionals, both medical and allied health, called a multidisciplinary team.

Treatment for bladder cancer depends on:

• the stage of the disease
• the severity of symptoms 
• your wishes and preferences
• your general health. 

Superficial bladder cancers (where the cancer is only within the lining of the bladder) are usually treated with surgery, immunotherapy or chemotherapy¹. In most cases, invasive bladder cancers (where the cancer has spread to other areas) are treated with surgery, although radiation therapy and chemotherapy may also be used¹. 

Bladder cancer can come back after it has been treated (recur)². It may come back in the bladder or in other parts of the body².

Surgery

Surgery to remove the cancer is the main treatment for bladder cancers^3,4. This is usually done using a thin hollow tube passed through the urethra and into the bladder (an operation known as a transurethral resection). The cancer is then burned or removed through the urethra.

Advanced cancers may need more than one transurethral resection operations³, or surgery to remove part of the bladder (partial cystectomy) or the whole bladder (radical cystectomy)².

Surgery may also be needed to make a new way for the body to store and pass urine (urinary diversion)².

Radiation therapy

Radiation therapy uses high-energy X-rays or other types of radiation to stop cancer cells growing.

Chemotherapy

Chemotherapy uses medicines to stop the growth of cancer cells. Treatment may involve injecting a substance into a vein or muscle, or taking pills by mouth. For bladder cancer, chemotherapy substances may be put directly into the bladder through a tube inserted into the urethra^2,3. This is used mainly for cancer that hasn’t spread beyond the lining of the bladder, and may be used during transurethral resection surgery³. 

Different chemotherapy options are used to treat different types and stages of bladder cancer². Sometimes more than one type of chemotherapy treatment may be used.

Immunotherapy

Immunotherapy increases the patient’s immune system to help it fight the cancer. Immunotherapy treatment for bladder cancer may involve taking pills by mouth or placing a solution directly into the bladder through a tube inserted into the urethra².

Some commonly used immunotherapy drugs are pembrolizumab and atezolizumab.

Research is ongoing to find new ways to diagnose and treat different types of cancer. Some people may be offered the option of participation in a clinical trial to test new ways of treating bladder cancer.