Treatment

TREATMENT OPTIONS BY STAGE

Stage 0 Bladder Cancer (Carcinoma in Situ)

• Transurethral resection with fulguration.
• Transurethral resection with fulguration followed by intravesical (within the bladder) biologic therapy or chemotherapy.
• Segmental cystectomy.
• Radical cystectomy.
• A clinical trial of photodynamic therapy.
• A clinical trial of biologic therapy.
• A clinical trial of chemoprevention therapy given after treatment to stop cancer from recurring.

Stage I Bladder Cancer

• Transurethral resection with fulguration.
• Transurethral resection with fulguration followed by intravesical biologic therapy or chemotherapy.
• Segmental or radical cystectomy.
• Radiation implants with or without external radiation therapy.
• A clinical trial of chemoprevention therapy given after treatment to stop cancer from recurring.
• A clinical trial of intravesical therapy.

Stage II Bladder Cancer

• Radical cystectomy with or without surgery to remove pelvic lymph nodes.
• Combination chemotherapy followed by radical cystectomy.
• External radiation therapy combined with chemotherapy.
• Radiation implants before or after external radiation therapy.
• Transurethral resection with fulguration.
• Segmental cystectomy.

Stage III Bladder Cancer

• Radical cystectomy with or without surgery to remove pelvic lymph nodes.
• Combination chemotherapy followed by radical cystectomy.
• External radiation therapy combined with chemotherapy.
• External radiation therapy with radiation implants.
• Segmental cystectomy.

Stage IV Bladder Cancer

• Radical cystectomy with surgery to remove pelvic lymph nodes.
• External radiation therapy (may be as palliative therapy to relieve symptoms and improve quality of life).
• Urinary diversion as palliative therapy to relieve symptoms and improve quality of life.
• Cystectomy as palliative therapy to relieve symptoms and improve quality of life.
• Chemotherapy alone or after local treatment (surgery or radiation therapy).
• A clinical trial of chemotherapy.

Glossary

• Transurethral resection (TUR) with fulguration: Surgery in which a cystoscope (a thin lighted tube) is inserted into the bladder through the urethra. A tool with a small wire loop on the end is then used to remove the cancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
• Radical cystectomy: Surgery to remove the bladder and any lymph nodes and nearby organs that contain cancer.
• Segmental cystectomy: Surgery to remove part of the bladder.
• Urinary diversion: Surgery to make a new way for the body to store and pass urine.

Reference:

National Cancer Institute, USA.