The choice of treatment and the long-term outcome (prognosis) for people who have bladder cancer depends on the stage and grade of cancer. Your health professional also considers your age, overall health, and quality of life when developing your treatment plan.

Bladder cancer is usually curable if it is diagnosed while the cancer is still contained in the bladder, and up to 80% of bladder cancers are diagnosed at this early stage.³

Treatment choices for bladder cancer may include:

• Surgery to remove the cancer. Surgery, either alone or in combination with radiation therapy, chemotherapy, or biological therapy, is used more than 90% of the time to treat bladder cancer.¹
• Chemotherapy to destroy cancer cells using medications. 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.
• Biological therapy to boost your body's immune system to fight cancer cells. This therapy is commonly used to prevent the return (recurrence) of bladder cancer.

Initial treatment

Surgery is used to treat most stages of bladder cancer.

• Small bladder tumors that remain near the surface (superficial) may be burned with a low-voltage electrified probe (electrocautery) during a cytoscopy.
• Transurethral resection (TUR) is used to remove large superficial bladder tumors or tumors that penetrate more deeply into the tissue but have not spread outside the bladder.
• Surgical removal of the bladder (cystectomy) is usually done for the most advanced stages of cancer that is confined to the bladder. Cystectomy may also be done for high-grade bladder cancers or when there are multiple tumors in the bladder. Surgery may not be recommended for an older adult who has a long-term medical condition.

Chemotherapy uses medications to destroy cancer cells. For superficial bladder cancer, the medications may be delivered directly into the bladder using a catheter (intravesically). For cancer that has deeply invaded the bladder or spread to lymph nodes or other organs, chemotherapy may be given orally or intravenously (IV). Side effects may differ, depending on the medications used and your age and overall health. Recent studies show that chemotherapy given before cystectomy (neoadjuvant) may increase the effectiveness of treatment for many people.^{10, 11} More studies are being done.

Radiation therapy, which uses high-dose X-rays or other high-energy rays to destroy cancer cells, is one of the standard treatments for certain types of bladder cancer. Radiation therapy also is used as palliative care to relieve symptoms and preserve kidney function. Home treatment can help manage some of the side effects of radiation therapy.

Biological therapy uses medications to boost or restore your body's immune system. Biological therapy is most often used for superficial bladder cancer. It may be used after a transurethral resection (TUR) to prevent cancer recurrence.