Treatment Types

Treatment options are based on your type of cancer, age and overall health. Bladder cancer, if caught early, can often be cured. The main treatments are:

• Radiation therapy, where a radiation oncologist uses high-energy X-rays to destroy the tumor.
• Surgery to remove the cancer in the bladder is usually the first step. If a tumor is determined to be invasive, the next step may be removal of part or all of the bladder by a surgical oncologist or urologist.
• Chemotherapy, where a medical oncologist uses drugs to eliminate the cancer.
• Biologic therapy (also called immunotherapy), where doctors use a drug to stimulate your immune system to fight the cancer.

In the past, complete removal of the bladder was the only way to treat bladder cancer. With advances in radiation therapy and chemotherapy, doctors are sometimes able to treat the cancer while preserving the bladder. This organ preserving approach allows many patients to urinate normally rather than requiring surgical reconstruction for urinary function.

External Beam Therapy

External beam radiation therapy (also called radiotherapy) involves a series of daily treatments to accurately deliver radiation to the bladder and pelvis. Research trials have shown that radiation and chemotherapy can permit some bladder cancer patients to have organ-preserving treatment that doesn't require complete removal of the bladder.

Before treatment begins, your treatment plan will be designed. A CT scan is done in the position you will be treated, often with a supportive device to keep you comfortably in the same position for treatment. Using information from your pathology, imaging and exam, your doctor will design a treatment plan to treat the bladder and pelvis.

With external beam therapy, treatment is delivered in a series of daily sessions, Monday through Friday, for several weeks. Each treatment is painless, noninvasive and similar to a long X-ray: you hear noise but will feel nothing. Each day, you will feel the same when you leave as you did when you came.

The radiation beam is usually generated by a machine called a linear accelerator, or linac. Doctors use this machine to generate high-energy X-rays to treat your cancer.

Three-dimensional conformal radiotherapy (3-D CRT) combines multiple radiation treatment fields to deliver precise doses of radiation to the cancer. This improved technique helps keep radiation away from nearby healthy tissue.

Intensity modulated radiation therapy, or IMRT, is a specialized form of 3-D CRT that allows the radiation beams to be further shaped to focus on the tumor. IMRT is still being studied for bladder cancer.

Radiation Therapy Options

Radiation therapy, sometimes called radiotherapy, is the careful use of radiation to safely and effectively treat cancer. Radiation therapy works within cancer cells by damaging their ability to multiply. When these cells die, the body naturally eliminates them. Healthy cells are also affected by radiation, but they are able to repair themselves in a way cancer cells cannot.

• External beam radiation therapy is the main type of radiation used to treat bladder cancer, often in combination with chemotherapy. During this treatment, radiation is directed at the tumor from a machine similar to an X-ray machine.
• Internal radiation therapy, or brachytherapy, is occasionally used with external beam radiation therapy. Radioactive material is placed very close to the tumor through small tubes called catheters or with radioactive pellets.