Common Treatment Combinations Based on Your Stage of Bladder Cancer

The type of treatment your doctor recommends for you depends on the type of cancer you have and its stage--that is, how invasive it is.

Here are some common treatment combinations based on the stage of your bladder cancer.

For stage 0 or stage I bladder cancer, meaning the cancer has not spread beyond the bladder lining, your doctor may recommend these treatments. They are listed from the most to least commonly done.

• Transurethral resection surgery only

• Transurethral resection surgery followed by intravesical immunotherapy

• Partial or radical cystectomy if there are many superficial cancers or if the cancer looks “high grade,” meaning the cells look very unusual under a microscope

• A clinical trial for immunotherapy or for chemoprevention to help keep the cancer from coming back.

For stage II bladder cancer, meaning the cancer has spread into the bladder’s muscle layer, your doctor may recommend any of these treatments. They are listed from the most to least commonly done.

• Radical cystectomy, which is surgery to remove the bladder and some surrounding tissues

• Chemotherapy followed by radical cystectomy

• External radiation therapy with or without chemotherapy 

• Transurethral resection surgery

• Partial cystectomy, which is surgery to take out part of the bladder

For stage IIIbladder cancer, meaning the cancer has spread into the bladder’s fatty layer or to the prostate (in men) or to the vagina or uterus (in women), your doctor may recommend any of these treatments. They are listed from the most to least commonly done.

• Radical cystectomy

• Chemotherapy followed by radical cystectomy

• External radiation therapy with chemotherapy

• Partial cystectomy

For stage IV bladder cancer, meaning the cancer has spread far from your bladder, your doctor may recommend any of these treatments. They are listed from the most to least commonly done.

• Radical cystectomy

• External radiation therapy to ease symptoms

• Urinary diversion to ease symptoms

• Cystectomy to ease symptoms

• Chemotherapy alone or after surgery or radiation

• A clinical trial of chemotherapy 

You’ll want to learn all you can about your disease and treatment choices. This makes it possible to take an active part in decisions about your medical care. One of the best ways to get the information you need is to ask your doctor and other healthcare professionals. Ask how the treatment will change your daily life, how it will affect your diet, and how you will look and feel after treatment. Ask how successful the treatment is expected to be. You should also ask about possible risks and side effects.