They are more likely to spread. Almost all muscle-invasive cancers are high grade. Treatment for bladder cancer Treatment for bladder cancer depends on how quickly the cancer is growing. Treatment for non-muscle-invasive bladder cancer Treatments for non-muscle-invasive bladder cancer include surgery, immunotherapy and chemotherapy. Surgery Most people with non-muscle-invasive bladder cancer have an operation to remove the cancer.
Immunotherapy Immunotherapy uses your own immune system to treat cancer. Chemotherapy This treatment uses medication to destroy or slow the growth of cancer cells, while causing the least possible damage to healthy cells. Treatment for muscle-invasive bladder cancer Treatments for non-muscle-invasive bladder cancer include surgery, chemotherapy, radiation therapy and immunotherapy. Surgery The most common treatment for muscle-invasive bladder cancer is surgery to remove the bladder.
Chemotherapy For muscle-invasive bladder cancer, chemotherapy is injected into a vein. You may have chemotherapy: before surgery, to shrink the cancer and make it easier to remove neoadjuvant chemotherapy after surgery, if there is a high risk of the cancer coming back adjuvant chemotherapy with radiation therapy before deciding to have surgery chemoradiation to treat bladder cancer that has spread to other parts of the body. Chemotherapy is given as a course, at regular intervals for several months.
Radiation therapy You might have radiation therapy instead of surgery. Side effects of treatment for bladder cancer All cancer treatments can have side effects. Bladder reconstructions and stomas If you have had your bladder removed, the way you pass urine will change.
There are several options that your treatment team will talk to you about: Urostomy sometimes called an ileal conduit is where doctors create a new hole in your abdomen called a stoma. Urine drains from the stoma to the outside of your abdomen into a special bag. Neobladder is where a new bladder made from your small bowel forms a pouch inside your body to store urine.
You will pass urine by squeezing your abdominal muscles. You will also pass a small tube catheter into the neobladder pouch each day to help drain the urine. Continent urinary diversion is a pouch made from your small bowel inside your body to store urine.
The urine empties through a hole called a stoma to the outside of your abdomen into a special bag. Sexuality and bladder cancer Having bladder cancer and treatment can change the way you feel about yourself, other people, relationships and sex.
Living with advanced cancer Advanced cancer usually means cancer that is unlikely to be cured. It can help in these ways: slow down how fast the cancer is growing shrink the cancer help you to live more comfortably by managing symptoms, like pain.
Treatment depends on: where the cancer started how far it has spread your general health your preferences and what you want to do. Ask your doctor about treatment and palliative care services that may help you. Support for carers, family and friends Caring for someone with cancer can be difficult sometimes. If you are caring for someone with bladder cancer, these organisations can help: Cancer Council Tel.
Continence Foundation of Australia Tel. Bladder cancer , The American Cancer Society. Give feedback about this page. Was this page helpful?
Yes No. View all cancer. Related information. Support groups Cancer Council - support groups. From other websites Cancer Council Victoria.
CancerHelp UK — Research into bladder cancer. Sexuality and intimacy, Cancer Council. Content disclaimer Content on this website is provided for information purposes only. Read the latest issue of Urology Health extra, the Urology Care Foundations patient-focused magazine.
This web site has been optimized for user experience and security, therefore Internet Explorer IE is not a recommended browser. Thank you. See More See Less The bladder wall has many layers, made up of different types of cells.
Talk to your doctor if you have the following symptoms: Hematuria blood in the urine - the most common symptom, often without pain Frequent and urgent urination Pain when you pass urine Pain in your lower abdomen Back pain Symptoms You Should Not Ignore.
See More See Less Blood in the urine is the most common symptom of bladder cancer. Smoking is a Big Risk Factor You are more likely to get bladder cancer if you smoke or breathe in tobacco smoke. Workplace Exposure is another Known Cause Some things in the workplace may put you at a greater risk for bladder cancer. The color and content of your urine will be checked. This test will also look at body cells under a microscope. Blood tests: A comprehensive metabolic panel CMP , which includes kidney and liver function tests will be among the blood tests your doctor will order.
A Computerized tomography scan also known as CT or CAT scans with a bladder scope "cystoscopy" are often good enough to diagnose bladder cancer. Cystoscopy : A doctor will use a thin tube that has a light and camera at the end of it cystoscope to pass through the urethra into the bladder. It allows your doctor to see inside the bladder cavity. Usually your doctor will use a flexible cystoscope and a local anesthetic for your exam in the office.
The doctor will take a tissue sample with a cystoscope in the operating room. Taking the tissue at this time will allow your doctor to look at the cells.
The tissue sample will be sent to a laboratory where they will find out the stage of your cancer. Rigid cystoscopy: The scope that the doctor uses when you are put to sleep is not flexible like the one used in the office, but rigid. This means that it is straight and does not bend. This cystoscope is bigger, has a light at the end, and surgical instruments can pass through it. This allows for more extensive work like the transurethral resection of bladder tumor TURBT described below.
See More See Less If any of these tests suggest that you have bladder cancer, the next step to confirm the diagnosis is a transurethral resection of a bladder tumor TURBT described below. This is a very important procedure for accurate tumor typing, staging and grading. For this test, your doctor uses a catheter to place an imaging solution into your bladder through your urethra.
The solution is left in the bladder for about an hour. The doctor then uses the cystoscope to inspect the bladder with regular white light and then with blue light. The bladder cancer cells show up better with blue light. Retrograde pyelogram: This test uses x-rays to look at your bladder, ureters and kidneys.
The test is done during a cystoscopy. Magnetic resonance imaging MRI These tests use a powerful magnetic field, radio waves and a computer to produce detailed pictures of the inside of your body. Grading and Staging. Tumor Grade Grading is one of the ways to know if the disease will come back. Tumor Stage The tumor stage tells how much of the tissue has the cancer. The stages of bladder cancer are: Ta: Tumor on the bladder lining that does not enter any layers of the bladder Tis: Carcinoma in situ CIS -A high-grade cancer but "flat" cancer.
It looks like a reddish, velvety patch on the bladder lining T1: Tumor goes through the bladder lining, into the second layer, but does not reach the muscle layer T2 : Tumor grows into the muscle layer of the bladder T3: Tumor goes past the muscle layer into tissue surrounding the bladder, usually fat surrounding the bladder T4: Tumor has spread to nearby structures of the bladder such as the prostate in men or the vagina in females What Does NMIBC Look Like?
See More See Less Bladder cancer is described by how far into the wall of the bladder the cancer has grown which is the clinical stage. Intravesical Therapy. Intravesical Therapy Intravesical "within the bladder" therapy, is when a treatment drug is put directly into your bladder. Clinical Trials. After Treatment. See More See Less If your health care provider stages you as low-risk for cancer progression, then you will be asked to return, usually in three months, just for a surveillance scope of your bladder.
Here are some possible problems you may have after treatment: Gastrointestinal GI problems : Your bowel function may return more slowly after your surgery.
This often happens after abdominal surgery. Your surgeon and other health care providers will take steps to monitor bowel function and avoid GI problems. Urinary diversion : Urinary diversion following bladder surgery may present challenges for which you should prepare yourself. You may need to learn how to remove urine from your body with a catheter. There also is potential for leakage from the stoma opening that is made to take away urine.
Infections related to urinary diversion may occur, as may infections related to the kidneys. It is important for you to learn as much as you can about the urinary diversion method that you will use, and how to manage changes to your body.
Before you leave the hospital, your health care providers will ensure that you get the education you need so you can manage your new way of life. Hormonal changes : For females who are not yet menopausal, you may have hot flashes after your ovaries are removed.
Reproductive health : When the prostate is removed, a man can no longer father a child. Also, a man may be unable to have sex after surgery. When the uterus is removed, a woman can no longer get pregnant. If the surgeon removes part of a woman's vagina, then sex may be difficult. Sexual dysfunction: In reality, bladder cancer surgery is likely to affect your sex life.
If you have a partner, you may be worried about maintaining sexual intimacy and your relationship. It may help you and your partner to talk about your feelings. You can find other ways to be intimate after you had treatment. If you do not have a partner, you may want to explore how to manage your dating life after bladder cancer surgery.
Either way, you and your partner may benefit from the advice of a counselor who specializes in discussing sexual issues. Your health care provider may be able to refer you to medical professionals and counselors who specialize in sexual issues after cancer treatment.
You can also find a certified sex therapist near you on the website of the American Association of Sexuality Educators, Counselors and Therapists. The radiation comes from a large machine that aims beams of radiation at the bladder area in the abdomen. You may go to a hospital or clinic five days a week for many weeks to get radiation therapy. Each treatment session takes about 30 minutes. Radiation therapy is painless, but it may cause other side effects.
Problems with radiation include upset belly, vomiting or loose stools. Also, you may feel very tired during radiation therapy.
Your health care team can suggest ways to treat or control these side effects. You may hear about clinical trials for your bladder cancer. Clinical trials are research studies that test if a new treatment or procedure is safe and effective.
Through clinical trials, doctors find new ways to improve treatments and the quality of life for people with disease. Trials are available for all stages of cancer. The results of a clinical trial can make a major difference to patients and their families. Please visit our clinical trials research webpage to learn more. Make sure that you stay in touch with your health care provider. You should expect to return to your doctor for quite some time after treatment and surgery.
Follow-up is not the same for all people. However, continuous observation may include some or all of the following:. If you had bladder removal surgery, it takes time to heal.
The time needed to recover is different for each person. It is common to feel weak or tired for a while. Like any other major surgery, bladder surgery may have complications. Older patients and women are more likely to get complications after cystectomy. There are some things you can do before surgery to help your recovery. If you smoke, try to get help so you can quit before surgery. You also need to make sure you eat right so that your body can heal and can cope with the changes.
Each person is different and each body may respond differently to therapy. It is vital that you take care of yourself and stay in touch with your health care provider. Try to adopt healthy lifestyle habits including exercise, a well-balanced diet and no smoking.
Your health care provider may suggest a cancer support group or individual counseling. Peer support to help men deal with Erectile Dysfunction. This web site has been optimized for user experience and security, therefore Internet Explorer IE is not a recommended browser.
Thank you. Diagram of the Layers of the Bladder Enlarge. Talk to your doctor if you have these symptoms: Hematuria blood in the urine - the most common symptom, often without pain Frequent and urgent need to pass urine Pain when you pass urine Pain in your lower abdomen Back pain Symptoms You Should Not Ignore Blood in the urine is the most common symptom of bladder cancer. Smoking is a Big Risk Factor You are more likely to get bladder cancer if you smoke or breathe in tobacco smoke.
Workplace Exposure is Another Known Cause Some things in the workplace may put you at a greater risk for bladder cancer. Tests for MIBC These tests may be done to see if you have bladder cancer: Urine cytology: The color and content of your urine will be checked. This test will also look at body cells under a microscope. Blood tests: A comprehensive metabolic panel CMP , which includes kidney and liver function tests, will be among the blood tests your doctor will order.
Cystoscopy : A doctor will use a thin tube that has a light and camera at the end of it cystoscope to pass through the urethra into the bladder. It allows your doctor to see inside the bladder. Your doctor will likely use a flexible cystoscope and a local anesthetic for your exam in the office to see if there is a growth in the bladder. Transurethral resection of bladder tumor TURBT : This is a very important procedure for accurate tumor typing, staging and grading.
Blue light cystoscopy with TURBT: For this test, your doctor uses a catheter to place an imaging solution into your bladder through your urethra. The solution is left in the bladder for about an hour. The doctor then uses the cystoscope to check the bladder with a white light and then with blue light. Bladder cancer cells show up better with blue light. Other Imaging Tests These tests may help your doctor diagnose and stage bladder cancer.
Retrograde pyelogram : This test uses x-rays to look at your bladder, ureters and kidneys. The test is done during a cystoscopy. Magnetic resonance imaging MRI : These tests use a strong magnetic field, radio waves and a computer to make detailed pictures of the inside of your body.
Positron emission tomography PET scan : If your chest, abdomen or pelvic image results are not normal or if your doctor cannot get a lymph node biopsy, your doctor may order a PET scan. For this, you will be given a special drug a tracer through your vein or you may swallow the drug.
Your cells will pick up the tracer as it passes through your body. When the scanner passes over the bladder, the tracer allows your doctor to better see where and how much the cancer is growing. Grading and Staging. Tumor Grade Grading is one of the ways to know if the cancer will return. Tumor Stage The tumor stage tells how much of the bladder tissue has cancer.
The stages of bladder cancer are: Ta: Tumor on the bladder lining that does not enter the muscle Tis: Carcinoma in situ - a high-grade cancer - looks like a reddish, velvety patch on the bladder lining T1: Tumor goes through the bladder lining but does not reach the muscle layer T2: Tumor grows into the muscle layer of the bladder T3: Tumor goes past the muscle layer into tissues around the bladder T4: Tumor has spread to nearby structures such as lymph nodes and the prostate in men or the vagina in females.
Choices for Treatment Treatments for muscle invasive bladder cancer include: Bladder removal cystectomy with chemotherapy or without chemotherapy Chemotherapy with radiation, in addition to TURBT Chemotherapy Chemotherapy uses drugs to kill cancer cells. Chemotherapy kills fast-growing cancer cells, but the drugs can also harm normal cells, such as: Blood cells: If chemotherapy drugs lower the levels of healthy blood cells, you are more likely to get infections, bruise or bleed easily, and feel very weak and tired.
Your health care team will check for low levels of blood cells. If your levels are low, you may need to stop the chemotherapy or reduce the dose of the drug. There are also medicines that can help your body make new blood cells. Cells in hair roots: Chemotherapy may cause hair loss. If you lose your hair, it will grow back after treatment. But your hair color and texture may be different. Cells that line the digestive system: Chemotherapy can cause a poor appetite, upset belly and vomiting, loose stools, or mouth and lip sores.
Your health care team can give you medicines and suggest other ways to help with these problems. Symptoms most often go away when treatment ends. Stage IIIA: The tumor has grown into the perivesical tissue or has spread to the prostate, uterus, or vagina, but has not spread to the lymph nodes or other organs T3a, T3b, or T4a; N0; M0 , or the cancer has spread to a single regional lymph node T1 to T4a, N1, M0.
Stage IV: The tumor has spread into the pelvic wall or abdominal wall, or the cancer has spread to lymph nodes outside of the pelvis or to other parts of the body. Stage IVA: The tumor has spread to the pelvic wall or the abdominal wall but not to other parts of the body T4b, any N, M0 , or the cancer has spread to lymph nodes located outside of the pelvis any T, any N, M1a. Stage 0a: This is an early cancer that is only found on the surface of the inner lining of the renal pelvis or ureter.
This type of cancer is also called noninvasive papillary carcinoma Ta, N0, M0. Stage 0is: This stage of cancer, also known as a flat tumor or carcinoma in situ CIS , is found only on the inner lining of the renal pelvis or ureter Tis, N0, M0.
Stage I: The cancer has grown into the inner lining of the renal pelvis or ureter. The cancer has not spread to the lymph nodes or other parts of the body T1, N0, M0. Stage II: The cancer has grown into the muscle behind the inner lining of the renal pelvis or ureter. The cancer has not spread to the lymph nodes or other parts of the body T2, N0, M0. Stage III: The cancer has grown past the muscle and into the fat surrounding the kidney or ureter or into the renal parenchyma.
The cancer has not spread to the lymph nodes or other parts of the body T3, N0, M0. Recurrent cancer is cancer that has come back after treatment. If the cancer does return, there will be another round of tests to learn about the extent of the recurrence. These tests and scans are often similar to those done at the time of the original diagnosis.
Doctors also describe this type of cancer by its grade G. The grade describes how much cancer cells look like healthy cells when viewed under a microscope. The doctor compares the cancerous tissue with healthy tissue. Healthy tissue usually contains many different types of cells grouped together. If the cancer looks similar to healthy tissue and has different cell groupings, it is called "differentiated" or a "low-grade tumor.
They often plan treatment based on the grade, using the following categories:. Doctors have different ways to treat bladder cancer. The next section in this guide is Types of Treatment. Use the menu to choose a different section to read in this guide. Doctors use the results from diagnostic tests and scans to answer these questions: Tumor T : How large is the primary tumor? Where is it located? Node N : Has the tumor spread to the lymph nodes? If so, where and how many?
Here are more details on each part of the TNM system for bladder cancer. Bladder cancer TX: The primary tumor cannot be evaluated. T0 T plus zero : There is no evidence of a primary tumor in the bladder. T2: The tumor has spread to the muscle of the bladder wall. Renal pelvis and ureter TX: The primary tumor cannot be evaluated.
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