Treatment depends on the size of your cancer, whether it has spread (the stage), the type you have, what the cancer cells look like (the grade), and your general health
In superficial bladder cancer, or non-muscle invasive bladder cancer, the cancer cells are only in the bladder’s inner lining.
These patients are offered surgery to remove the cancer from their bladder lining. The first step in this direction is the transurethral resection of the bladder tumour. This operation is performed through the urethra without cutting the skin. The tumour is resected and sent for histological examination.
The outcome of the histological examination will determine whether the patient needs further treatment or not. The type and grade of the cancer cells is checked to see if you have low risk, intermediate risk or high risk early bladder cancer. These risk groups describe how likely it is that your cancer will spread or come back after treatment
The treatment you have depends on:
- The size of your tumour (T stage)
- What the cells look like under a microscope (grade)
- How many tumours there are
- The type of bladder tumour you have
- Whether you have had treatment in the last year for superficial bladder cancer
The main treatments for superficial bladder cancer are:
- Surgery -Transurethral resection of Bladder Tumour
- Chemotherapy into the bladder
- BCG into the bladder
Low Risk Superficial Bladder Cancer:
If after the Transurethral resection of Bladder Tumour the histology is Low Grade the patient might not need any further treatment or have chemotherapy into the bladder (intravesical chemotherapy)
Intermediate (Moderate) Risk Superficial Bladder Cancer:
If after the Transurethral resection of bladder tumour the histology is Intermediate (Moderate) Risk Superficial Bladder Cancer, usually the patient then has a 6 week course of chemotherapy into your bladder.
High Risk Superficial Bladder Cancer:
If after the transurethral resection of bladder tumour the histology is High Risk Superficial Bladder Cancer the patient will have a second TURBT operation within 2-6 weeks of the first. This is to double check if the bladder cancer has grown.
Further treatment choices. You may have:
- A course of treatment with the BCG vaccine into the bladder
- Surgery to remove the bladder (radical cystectomy)
Patients with Muscle Invasive Bladder Cancer (MIBC) are usually offered either a radical cystectomy or radiotherapy. There are other treatments which are less effective.
You need to talk to your specialist doctor and nurse about the risks and benefits of these treatments. They will discuss with you with regards to the stage of your cancer and how likely it is to spread. They will also inform you of how well these treatments have worked for other people, and about the possible side effects.