The choice of treatment and the long-term outcome (prognosis) for people who have bladder cancer depend on the stage and grade of cancer. When deciding about your treatment, your doctor also considers your age, overall health, and quality of life.
Bladder cancer has a better chance of being treated successfully if it is found early.
Treatment choices for bladder cancer may include:
- Surgery to remove the cancer. Surgery, either alone or along with other treatments, is used in most cases.
- Chemotherapy to destroy cancer cells using medicines. Chemotherapy may be given before or after surgery.
- Radiation therapy to destroy cancer cells using high-dose X-rays or other high-energy rays. Radiation therapy may also be given before or after surgery and may be given at the same time as chemotherapy. For more information, see Other Treatment.
- ImmunotherapyImmunotherapy. This treatment causes your body's natural defenses, known as your immune system, to attack bladder cancer cells. For more information, see Medications.
Stages and grades of bladder cancer
- Stage 0: Cancer cells are only on the surface of the inner layer of the bladder. This may be called carcinoma in situ.
- Stage I: Cancer has grown deeper into the inner layer but not into the muscle layer.
- Stage II: Cancer has grown into the muscle layer of the bladder.
- Stage III: Cancer has grown through the muscle layer and into nearby organs, such as the prostate, uterus, or vagina.
- Stage IV: Cancer has grown into the wall of the pelvis or the belly but not into any lymph nodes. Or the cancer has spread into at least one lymph node or to another part of the body, such as the liver, lungs, or bones.
The grade of bladder cancer is usually either low-grade (LG) or high-grade (HG). High-grade tumors tend to grow faster. They are also more likely to spread than low-grade tumors. When your doctor knows the grade of your cancer, this information will help him or her choose the best treatment plan for you.
More information about bladder cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/bladder.
Bladder cancer that comes back
After initial treatment for bladder cancer, it is important to receive follow-up care, because bladder cancer often comes back (recurs). Your doctor will set up a regular schedule of checkups and tests.
Bladder cancer may recur in the bladder, or it may spread (metastasize) to other parts of the body. Recurrent bladder cancer may be treated with surgery or chemotherapy to slow cancer growth and relieve symptoms.
Participation in a clinical trial may be recommended if you have been diagnosed with recurrent bladder cancer.
Body image and sexual problems
Sexual problems can be caused by physical or psychological factors related to the cancer or its treatment. You may experience less sexual pleasure or lose your desire to be sexually intimate.
- Women who have their bladder removed (radical cystectomy) will also have their ovaries and uterus removed. They cannot become pregnant and may experience menopause soon after having this surgery.
- Men who have their prostate glands and seminal vesicles removed may have erection problems and will no longer produce semen.
Your feelings about your body may change after treatment for cancer. Managing your feelings about your body may involve talking openly about your concerns with your partner and discussing your feelings with your doctor. Your doctor may also be able to refer you to groups that can offer support and information.
Palliative care is a kind of care for people who have a serious illness. It's different from care to cure your illness. Its goal is to improve your quality of life-not just in your body but also in your mind and spirit. You can have this care along with treatment to cure your illness.
Palliative care providers will work to help control pain or side effects. They may help you decide what treatment you want or don't want. And they can help your loved ones understand how to support you.
If you're interested in palliative care, talk to your doctor.
For more information, see the topic Palliative Care.
For some people who have advanced cancer, a time comes when treatment to cure the cancer no longer seems like a good choice. This can be because the side effects, time, and costs of treatment are greater than the promise of cure or relief. But you can still get treatment to make you as comfortable as possible during the time you have left. You and your doctor can decide when you may be ready for hospice care.
For more information, see the topics: