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There are many different treatments for bladder cancer, including surgery, radiation therapy, chemotherapy, or immunological therapy.

Surgery
A common treatment for bladder cancer. The type of surgery depends largely on the stage and grade of the tumor.

Transurethral resection
The doctor may treat early stage (superficial) bladder cancer with transurethral resection (known as TUR). During TUR, a cystoscope is inserted into the bladder through the urethra. A small wire loop on the end is used to remove the cancerous area and to burn away any remaining cancer cells with an electric current.

Radical cystectomy
For invasive bladder cancer, the most common type of surgery is radical cystectomy, or when superficial cancer involves a large part of the bladder.

Radical cystectomy is the removal of the entire bladder, the nearby lymph nodes, part of the urethra, and the nearby organs that may contain cancer cells. In men, the nearby organs that are removed are the prostate, seminal vesicles, and part of the vas deferens. In women, the uterus, ovaries, fallopian tubes, and part of the vagina are removed.

If the entire bladder is removed, the patient may undergo another procedure to create a pouch to hold urine. Occasionally, small-localized, muscle-invasive bladder cancers can be removed sparing the remaining normal bladder, a procedure referred to as "partial" cystectomy.

When bladder cancer has spread beyond the bladder, often the goal of surgery is not to remove the cancer itself, but to relieve the symptoms of the disease. Additional forms of therapy are then used to treat the cancer.

Radiation therapy (also called radiotherapy)
High-energy rays are used to kill cancer cells in one specific area. Radiation therapy can also be used to shrink a tumor before surgery, to make it easier to remove, or after surgery, to kill any cancer cells that may have been left behind.

External radiation
This is usually done at least several days a week on an outpatient basis for several weeks. The high-energy rays are concentrated on the cancerous area from outside the body.

Internal Radiation
This is done by placing a small container of a radioactive substance into the bladder through the urethra or through an incision in the abdomen and requires a hospital stay. Once the implant is removed, no radioactivity is left in the body.

Chemotherapy
Drugs are used to kill cancer cells. A single drug may be used, or a combination of drugs.

For patients with superficial bladder cancer, intravesical (inside the bladder) chemotherapy may be used after TUR. A catheter (tube) is placed through the urethra and into the bladder and used to fill the bladder with liquid forms of the drug(s) used. The drugs are left in the bladder for several hours and this treatment is usually done once a week for several weeks, then can be continued once or several times a month for up to a year.

For cancer that has spread through other parts of the body, chemotherapy drugs may be given intravenously, or through a vein that carries the drugs throughout the body. The drugs are usually given in cycles so that a recovery period follows every treatment period. Occassionally chemotherapy is also given before bladder surgery - cystectomy - as a means to facilitate surgery by reducing the tumor bulk. This is known as neoadjuvant therapy and has demonstrated survival benefit for many patients needing a radical cystectomy.

Immunotherapy, also known as biological therapy,
The body's natural ability (immune system) is used to fight cancer and is most often used after TUR for superficial bladder cancer to prevent the cancer from coming back.

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