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Follow up for early bladder cancer

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This page tells you about follow up after early bladder cancer. There is information about

 

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Follow up for early bladder cancer

After treatment for early bladder cancer there is a chance that the cancer could grow back. So you will need to go for regular check ups. The best way to check your bladder is to have a bladder examination (cystoscopy). You will probably have a cystoscopy to check your bladder 3 months after your treatment finishes. Then you are likely to have cystoscopies at regular  intervals. How often you have them and for how long depends on your situation. 

What if the cancer comes back?

If you had early bladder cancer removed and it comes back inside the bladder, you can have the growths removed during cystoscopy as before. You will probably then have chemotherapy or BCG treatment into the bladder.

If your cancer is high grade, has spread deeper into the bladder muscle, or is a return of carcinoma in situ, then you may need more intensive treatment. You can find information about this in the treating invasive bladder cancer section.

 

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What happens at follow up appointments

After treatment for early bladder cancer, there is a chance that the cancer could grow back. So you will need to go for regular check ups.

The best way to check your bladder is by your doctor looking inside the bladder using a flexible tube (a cystoscopy). You may have this under local anaesthetic or general anaesthetic.

 

How often you have check ups

Your own specialist will decide how often you should have cystoscopies. This will depend on how likely it is that your cancer could come back or spread deeper into the bladder muscle. You can read more about the risk groups for early bladder cancer on our page about staging early bladder cancer

If you notice any new symptoms between appointments, such as blood in your urine or problems passing urine, tell your GP straight away. They can refer you back to see a specialist without delay.

If your cancer is at low risk of coming back you may only need to have a cystoscopy after 3 months, and then after 1 year. After this, your doctor may discharge you from their list.

If your cancer is at moderate risk of coming back you may have a cystoscopy after 3, 9 and 18 months. After that you may have a cystoscopy every year until up to 5 years after treatment. After this your doctor may discharge you from their list.    

If your cancer is at high risk of coming back, you may have a cystoscopy every 3 months for 2 years, and then every 6 months for the next 2 years. After that you may have a cystoscopy every year.

If you have had your bladder removed for early bladder cancer, you will still have regular check ups. You may have a CT scan 6 months after your operation and yearly after that, to check there is no sign of the cancer coming back. You may also have blood tests at least once a year. These are to check your kidneys are working, and that you are absorbing enough vitamin B. Men may have yearly tests to check their urethra.

 

What happens if the cancer comes back

If you had Ta or T1 bladder cancer and it comes back inside the bladder, you can have the growths removed again during a cystoscopy, as before. The specialist will take more biopsies to check that the cancer is still at an early stage. If it is, then you will usually have treatment into the bladder. You will 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 it was
  • Carcinoma in situ that has come back after treatment into the bladder

You can read about bladder cancer grade and carcinoma in situ, TA and T1 bladder cancer on our page about staging early bladder cancer. There is information about treatment into the bladder in the section about treating early bladder cancer.  There is information about intensive treatment in the section about treating invasive bladder cancer.

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Updated: 4 August 2015