Surgery, chemotherapy, and radiation are some of the treatments for bladder cancer. Treatments used depend on your cancer’s stage and grade, and your age, overall health, and personal preferences.
Bladder cancer occurs when one or more tumors affect the bladder, an organ in the lower abdominal area that stores urine.
There are several different treatment options for bladder cancer.
Keep reading to learn more about the potential treatment options for bladder cancer, how they work, and when they’re used. We’ll also discuss new treatments on the horizon, the cost of bladder cancer treatment, and the outlook for people with bladder cancer.
Treatment of bladder cancer typically involves some form of surgery. This approach aims to remove as much of the cancer as possible.
According to the
- Transurethral resection: A transurethral resection of bladder tumor (TURBT) involves inserting a small, thin tool into the bladder to remove the cancer. It’s typically used for earlier-stage bladder cancers.
- Partial cystectomy: A partial cystectomy removes only the area of the bladder where the cancer is. It may be used for tumors that are only found in one part of the bladder and cannot be removed by transurethral resection.
- Radical cystectomy: A radical cystectomy is the removal of the entire bladder. This is typically done when bladder cancer affects multiple areas of the bladder or has invaded the muscle tissue of the bladder.
If the cancer has spread beyond the bladder, it’s also possible that lymph nodes or other pelvic organs may be removed during bladder cancer surgery. This is typically done during a radical cystectomy.
Radiation therapy uses high energy radiation to kill cancer cells or slow their growth. In bladder cancer, this type of treatment is given as
A healthcare professional may recommend radiation therapy:
- after surgery to remove any remaining cancer cells
- for people who can’t have surgery or chemotherapy
- to help treat advanced bladder cancer in palliative situations (i.e., to stop bleeding or pain in incurable bladder cancer)
Chemotherapy uses drugs that affect the growth and division of cells. Because cancer cells grow and divide more quickly than many other types of cells, chemotherapy can kill them or reduce their growth.
There are
- Intravesical: Intravesical chemotherapy is given directly into the bladder via a catheter. It’s used for very early stage bladder cancers, typically after TURBT.
- Systemic: Systemic chemotherapy for bladder cancer is given intravenously (IV). It may be used before surgery to help shrink a tumor or after surgery to get rid of any remaining cancer cells. Systemic chemotherapy is also used for advanced bladder cancers.
Immunotherapy is a type of cancer treatment that aims to boost your immune system’s response to cancer. There are
Immune checkpoint inhibitors
Medications like nivolumab (Opdivo) and pembrolizumab (Keytruda) work by switching off one of the mechanisms that keeps the immune system from attacking cells in the body.
They can be used to:
- treat advanced bladder cancer
- prevent cancer from returning after surgical treatment
- when other treatments haven’t been effective
Intravesical immunotherapy
These treatments are introduced to the bladder as a liquid via a catheter.
For instance, in Bacillus Calmette-Guerin (BCG) immunotherapy, a type of bacteria called BCG is introduced directly to the bladder to help stimulate an immune response to the cancer. It’s typically used for early stage bladder cancers that haven’t invaded the bladder muscle tissue.
Other types of intravesical immunotherapies include nadofaragene firadenovec (Adstiladrin) and nogapendekin alfa inbakicept (Anktiva).
Drug antibody conjugates
Drug antibody conjugates bind to certain parts of cancer cells. Those used for bladder cancer deliver chemotherapy drugs directly to cancer cells. They may be used when other treatments haven’t been effective or aren’t recommended.
Targeted therapy is a type of treatment directed specifically at different markers associated with cancer cells. While some treatments, such as chemotherapy, have broad effects, this treatment hones in on cancer cells.
Monoclonal antibodies are a type of targeted therapy.
Another targeted therapy drug for bladder cancer is erdafitinib (Balversa). According to the
Targeted therapy is used for more advanced bladder cancers. It may also be recommended when bladder cancer has recurred.
Doctors and scientists continue to develop newer, more effective treatments for bladder cancer. These can include things like newer combinations of existing therapies or completely new treatments.
For instance, researchers are working on ways to improve BCG treatment, since
A 2022 trial looked at combining BCG with an immune-stimulating drug called N-803 in people who didn’t respond to BCG. After 2 years, this treatment led to a 99% bladder cancer-specific overall survival. Additionally, over 90% of participants avoided having a cystectomy in this time period.
Another 2022 trial looked at using chemotherapy instead of BCG after transurethral resection. After 24 months, recurrence-free survival was 82% and overall survival was 84%. None of the study participants died from bladder cancer during the study period.
In a
Bladder cancer treatment can be expensive.
A
Most health insurances cover at least some of the costs of treatments that are considered medically necessary for a health condition like bladder cancer.
However, if you have insurance, it’s important to check in with your provider before starting your treatment. That way, you’ll have a better idea of what’s covered and what you’ll be responsible for paying for yourself.
It’s also possible that bladder cancer treatment may be less expensive abroad. Traveling in order to receive medical treatment is sometimes called medical tourism.
If you’re interested in this route, the Centers for Disease Control and Prevention (CDC) provides some tips for how to engage in medical tourism safely:
- Be very thorough about checking the qualifications of the healthcare professionals you’ll be seeing and the credentials of the facilities where you plan to receive treatment.
- Consider the language of the country where you’ll be traveling to and have a plan for communicating with healthcare professionals and staff.
- Consult with your doctor 4 to 6 weeks before your trip to discuss general health information and any possible risks.
- Bring copies of all of your medical records related to your condition.
- Obtain a travel health insurance policy before leaving for your treatment.
The overall outlook for bladder cancer depends on many factors, such as:
- the specific type of bladder cancer
- the stage of the cancer at diagnosis
- how the cancer responds to treatment
- whether the cancer spreads (metastasizes) to other areas of the body
- if the cancer comes back after treatment
- your age and overall health
The outlook for people with cancer is estimated as a 5-year survival rate. This is the percentage of people with a certain type and stage of cancer who are alive 5 years after their diagnosis compared to people without the cancer.
According to the
| Stage | Description | 5-year survival rate |
|---|---|---|
| In situ | Bladder cancer only affects the inner lining of the bladder and hasn’t spread further into bladder tissue. | 97% |
| Localized | The cancer has begun to invade deeper into bladder tissue but still remains localized to the bladder. | 71% |
| Regional | The cancer has spread into nearby lymph nodes. | 39% |
| Distant | The cancer has spread to more distant tissues. | 8.8% |
| Overall | Overall 5-year survival rate. | 78% |
These estimates are based on data from many people with bladder cancer over a long span of years. The 5-year survival rates are improving, but it’s important to note these figures don’t always reflect recent advances in treatment or individual factors.
As such, always discuss your individual outlook with your care team.
The most effective treatment for bladder cancer depends on the stage and grade of the cancer. TURBT is the first-line treatment for early stage bladder cancer. After that, treatment depends on how advanced the cancer is:
- Non-muscle invasive (localized): BCG and intravesical chemotherapy.
- Muscle invasive: Preoperative chemotherapy, followed by cystectomy. However, if you cannot get surgery, chemoradiation may be considered.
- Metastatic: Systemic treatment with drug antibody conjugates or chemotherapy.
A doctor can help develop the best treatment plan for you.
The earliest stages of bladder cancer (stage 0, or in situ) are curable with treatment, according to the ACS. Any non-metastatic bladder cancer can potentially be cured if cystectomy is part of the treatment plan. But as the cancer becomes more advanced, the chances of a cure decline.
Many bladder cancers are diagnosed in this early stage. The SEER database notes that 1 in 2 bladder cancers are diagnosed at the in situ stage.
In 2024, the Food and Drug Administration (FDA) approved a type of immunotherapy called nogapendekin alfa inbakicept-pmln (Anktiva, Altor BioScience, LLC) to be used alongside BCG for people whose cancer did not respond to BCG alone.
There are many different treatment options for bladder cancer. The specific type of treatment that’s recommended for you will depend on things like your cancer’s stage and grade as well as your age and overall health.
Most bladder cancer treatment plans involve some type of surgery. Other treatments, such as chemotherapy, radiation therapy, and immunotherapy may be used in addition to this.
The outlook for bladder cancer is best when it’s diagnosed early. If you’ve recently received a diagnosis of bladder cancer, have an open discussion with your care team about your individual outlook and what to expect from treatment.