Treatment choices for bladder cancer

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Treatment choices for bladder cancer

The choice of treatment and the long-term outcome (prognosis) of people with bladder cancer depends on the stage of the cancer. A person's age, overall health, and quality of life must also be considered. Research studies are ongoing to determine the best treatment choices or combination of treatments that increase survival rates without adversely impacting quality of life.^1,²

**Treatment choices for bladder cancer**
Stage	Treatment choices
0 TaN0M0 TisN0M0	Standard treatments Transurethral resection (TUR) to remove cancer cells from the bladder TUR with intravesical bacillus Calmette-Guerin (BCG) to prevent the spread or return of cancer TUR with intravesical chemotherapy to also prevent the spread or return of cancer Cystectomy to remove part or all of the bladder in specific high-risk people or those who have high-grade cancer Possible alternative treatments under study Photodynamic therapy, which uses laser light and a special light-activated substance (Photofrin) to kill cancer cells Interferon, which is given through a catheter into the bladder to fight cancer cells (intravesical chemotherapy) Chemoprevention, which uses medications, vitamins, or other substances to prevent the return of cancer
I T1N0M0	Standard treatments TUR TUR with intravesical BCG TUR with intravesical chemotherapy Cystectomy in specific high-risk people or those who have high-grade cancer Radiation therapy to prevent the spread of cancer Possible alternative treatments under study Chemoprevention Other intravesical treatments
II T2aN0M0 T2bN0M0	Radical cystectomy (removes the whole bladder) with or without removal of the pelvic lymph nodes (lymphadenectomy) Chemotherapy followed by radical cystectomy Radiation therapy with or without chemotherapy to prevent the spread of cancer TUR Partial cystectomy
III T3aN0M0 T3bN0M0 T4aN0M0	Radical cystectomy with or without removal of pelvic lymph nodes Chemotherapy followed by radical cystectomy Radiation with or without chemotherapy Partial cystectomy may be possible for some people
IV T4bN0M0 Any T, N1, M0 Any T, N2, M0 Any T, N3, M0	Radical cystectomy with removal of pelvic lymph nodes Radiation therapy Urinary diversion or cystectomy as palliative care, to help relieve symptoms and improve quality of life Chemotherapy
IV Any T, any N, M1	Chemotherapy Radiation as palliative care Cystectomy as palliative care
Recurrent	Dependent on stage and grade of initial cancer and recurrent cancer, and on the treatment already done for the initial cancer

References

Citations
National Cancer Institute (2006). Bladder Cancer PDQ: Treatment—Health Professional Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/healthprofessional.
National Cancer Institute (2006). Bladder Cancer PDQ: Treatment—Patient Version. Available online: http://www.cancer.gov/cancertopics/pdq/treatment/bladder/patient.

Credits

Author	Shannon Erstad, MBA/MPH
Editor	Kathleen M. Ariss, MS
Associate Editor	Denele Ivins
Associate Editor	Pat Truman
Primary Medical Reviewer	E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer	Philip Belitsky, MD, FRCSC - Urology
Last Updated	May 25, 2007

Last updated:	May 25, 2007
Author:	Shannon Erstad, MBA/MPH
Reviewed By:	E. Gregory Thompson, MD - Internal Medicine, Philip Belitsky, MD, FRCSC - Urology
Editors:	Kathleen M. Ariss, MS, Pat Truman

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