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Types of treatment for early bladder cancer

Men and women discussing bladder cancer

This page tells you about treatment for early bladder cancer. You can find information about

 

A quick guide to what's on this page

What early bladder cancer is

Early bladder cancer is also called superficial bladder cancer or non muscle invasive bladder cancer. This means the cancer cells are only in the inner lining of the bladder. The doctor divides early bladder cancer into 3 risk groups. These are low risk, intermediate risk or high risk early bladder cancer. These risk groups describe how likely it is that your cancer will spread further or come back. The doctor uses this risk group to decide which treatment is best for you. 

Treatment choices for early bladder cancer

If you have early stage bladder cancer, your specialist will remove the areas of cancer in the bladder lining. This operation is called a trans urethral removal of bladder tumour (TURBT). If the doctor thinks you have bladder cancer, they usually give you an injection of mitomycin C chemotherapy into the bladder after the TURBT. This lowers the risk of the cancer coming back.

The doctor sends the cancer to the lab.This is to check the type and grade of the cancer cells and to find out if you have low risk, intermediate risk or high risk early bladder cancer. 

For low risk early bladder cancer, the main treatment is surgery to remove the cancer. You may not need any further treatment.

For intermediate (moderate) risk bladder cancer, you usually have a 6 week course of chemotherapy into your bladder. 

For high risk early bladder cancer, you will have a second TURBT operation within 6 weeks of the first. You will then have a choice of treatment. You may have a course of BCG vaccine into the bladder, or an operation to remove the bladder (a cystectomy). You will need to talk this through with your bladder specialist.

Keeping an eye on you

After treatment you will need regular checkups for some years, to make sure the cancer doesn’t come back.

CR PDF Icon You can view and print the quick guides for all the pages in the Treating bladder cancer section.

 

What early bladder cancer is

Early bladder cancer is also called superficial bladder cancer or non muscle invasive bladder cancer. This means that the cancer cells are only in the inner lining of the bladder. There are 3 stages of early bladder cancer

The links above take you to an explanation of bladder cancer staging.

In Tis (CIS or carcinoma in situ) the cancer cells are still only in the bladder lining of the bladder. They are in flat sheets that look a bit like moss. Carcinoma in situ can occur in patches throughout the bladder lining and the cells are very abnormal. It has quite a high risk of spreading into the deeper layers of the bladder.

Ta and T1 tumours are also called papillary bladder cancer. To your specialist examining the bladder lining with a cystoscope, they look a bit like little mushrooms growing out of the lining of the bladder.

Doctors divide early bladder cancer into 3 risk groups. These risk groups describe how likely it is that your cancer will spread further or come back after treatment. The 3 risk groups are

  • Low risk early bladder cancer
  • Intermediate (moderate) risk early bladder cancer
  • High risk early bladder cancer

Your doctor should tell you whether your cancer is low risk, intermediate risk or high risk. This is important as they use this risk group to help them decide which tests and treatment are best for you.  

 

Treatment choices for early bladder cancer

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

If your doctor thinks you have bladder cancer, they usually give you an injection of mitomycin C chemotherapy into the bladder after the TURBT. This is called intravesical chemotherapy. It lowers the risk of the cancer coming back.

After surgery, the doctor sends the cancer to the lab. 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 need.

Treatment for low risk early bladder cancer
If you have low risk early bladder cancer, the main treatment is surgery to remove the cancer from the bladder lining. If the doctor completely removes your cancer during the TURBT operation, you may not need any further treatment. 

Treatment for intermediate (moderate) risk early bladder cancer
If you have intermediate (moderate) risk early bladder cancer you usually have a 6 week course of chemotherapy into your bladder after the TURBT operation. 

Treatment for high risk early bladder cancer
If the first TURBT operation shows that you have high risk early bladder cancer, you will have a second TURBT operation within 6 weeks of the first. This is to double check how far the cancer has grown. The specialist will tell you about 2 treatment choices. You may have

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

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

You can read about BCG treatments and chemotherapy into the bladder in the section about treatment into the bladder.  We have information about the TURBT operation in the section about removing early bladder cancer. There is information about an operation to remove the bladder (cystectomy) in the section about surgery for invasive bladder cancer

 

After early bladder cancer treatment

After any treatment for early bladder cancer, your specialist will want to keep a close eye on you to make sure that the cancer doesn't come back. You will have regular cystoscopies for some years to come. How often you have these will depend on your bladder cancer risk group. There is information about this on our page about follow up for early bladder cancer. 

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Updated: 29 July 2015