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Treatment decisions

See which types of treatment you may have for early bladder cancer, and how your doctor decides which treatment you need.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have depends on:

  • where your cancer is
  • how far it has grown or spread (the stage)
  • the type of cancer
  • how abnormal the cells look under a microscope (the grade)
  • your general health and level of fitness

Your doctor will discuss your treatment, its benefits and the possible side effects with you.

Treatment overview

Everyone with early bladder cancer has surgery to remove the cancer from their bladder lining. This operation is called trans urethral removal of bladder tumour (TURBT). You may have this minor surgery during or after tests to diagnose your cancer

Usually you also have chemotherapy into the bladder after your surgery. This lowers the risk of the cancer coming back.

After surgery, the doctor sends samples (biopsies) of the cancer to the laboratory. They check the type and grade of the cancer cells to find out whether you have low risk, intermediate risk or high risk early bladder cancer. This tells the doctor what further treatment you may need.

Treatment for low risk early bladder cancer

You have surgery (TURBT) to remove the cancer from your bladder lining.

You may not need any further treatment if your doctor completely removes your cancer during this surgery.

Treatment for intermediate (moderate) risk early bladder cancer

You have surgery (TURBT) to remove the cancer from your bladder lining. 

Usually you then have a 6 week course of chemotherapy into your bladder.

Treatment for high risk early bladder cancer

You have surgery (TURBT) to remove the cancer from your bladder lining. 

You then have a second operation (TURBT) to remove  the cancer from your bladder lining if the tissue samples (biopsies) taken during the first surgery show that you have high risk early bladder cancer. This is to double check how far the cancer has grown. You have the second operation within 6 weeks of the first.

Your bladder cancer specialist (urologist) will tell you about 2 further treatment choices. You may have:

  • a course of treatment with the BCG vaccine into the bladder
  • surgery to remove the bladder (cystectomy)

You need to talk to your specialist about the risks and benefits of these 2 treatments for you. They tell you about the stage of your cancer and how likely it is to spread. They also tell you how well these treatments have worked for other people, and about the possible side effects.

Follow up

After any treatment for early bladder cancer, your specialist keeps a close eye on you to make sure the cancer doesn't come back.

You have regular cystoscopies for some years to come. How often you have these depends on your bladder cancer risk group.

If your bladder cancer comes back

You can have the growths removed with cystoscopy again if your stage Ta or T1 bladder cancer comes back after treatment.

Your specialist takes more biopsies to check that the cancer is still at an early stage. If it is, you usually have chemotherapy or BCG treatment into the bladder. You then go back to having regular cystoscopies to check your bladder.

Your doctor may ask you to have more intensive treatment if your cancer is:

  • grade 3
  • at a more advanced stage than before
  • CIS that has come back after treatment into the bladder

Clinical trials to improve treatment

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

Information and help

Dangoor sponsorship

About Cancer generously supported by Dangoor Education since 2010.