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Bladder Cancer Treatment Options

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Treatment Options by Stage

Stage 0 (Papillary Carcinoma and Carcinoma in Situ)
Treatment of stage 0 may include the following:

  • Transurethral resection with fulguration.
  • Transurethral resection with fulguration followed by intravesical biologic therapy or chemotherapy.
  • Segmental cystectomy.
  • Radical cystectomy.
  • A clinical trial of photodynamic therapy.
  • A clinical trial of biologic therapy.
  • A clinical trial of chemoprevention therapy given after treatment so the condition will not recur (come back).

Stage I
Treatment of stage I bladder cancer may include the following:

  • Transurethral resection with fulguration.
  • Transurethral resection with fulguration followed by intravesical biologic therapy or chemotherapy.
  • Segmental or radical cystectomy.
  • Radiation implants with or without external radiation therapy.
  • A clinical trial of chemoprevention therapy given after treatment to stop cancer from recurring (coming back).

Stage II
Treatment of stage II bladder cancer may include the following:

  • Radical cystectomy with or without surgery to remove pelvic lymph nodes.
  • Combination chemotherapy followed by radical cystectomy.
  • External radiation therapy combined with chemotherapy.
  • Radiation implants before or after external radiation therapy.
  • Transurethral resection with fulguration.
  • Segmental cystectomy.

Stage III
Treatment of stage III bladder cancer may include the following:

  • Radical cystectomy with or without surgery to remove pelvic lymph nodes.
  • Combination chemotherapy followed by radical cystectomy.
  • External radiation therapy combined with chemotherapy.
  • External radiation therapy with radiation implants.
  • Segmental cystectomy.

Stage IV
Treatment of stage IV bladder cancer may include the following:

  • Radical cystectomy with surgery to remove pelvic lymph nodes.
  • External radiation therapy (may be as palliative therapy to relieve symptoms and improve quality of life).
  • Urinary diversion as palliative therapy to relieve symptoms and improve quality of life.
  • Cystectomy as palliative therapy to relieve symptoms and improve quality of life.
  • Chemotherapy alone or after local treatment (surgery or radiation therapy).

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