Types of treatment for early 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
Removing early bladder cancer tumours
After early bladder cancer treatment

Removing early bladder cancer tumours

If you have early stage bladder cancer, your specialist will remove the tumours during a cystoscopy, under general anaesthetic. They will send the tumours to the lab so the pathologist can check the grade of your cancer cells.

Treatment into the bladder

In some people, early bladder cancer comes back after surgery. So, after the cancer is removed, your specialist will give you chemotherapy treatment into the bladder. This is called intravesical therapy and lowers the chance of the cancer coming back.

If you have a medium grade tumour, you are then likely to have a further course of chemotherapy into your bladder for 6 weeks. You may also have a course of chemotherapy treatments into the bladder if the cancer comes back after initial treatment.

If you have carcinoma in situ or a high grade tumour, your doctor will probably suggest a course of BCG treatment into the bladder to reduce the chance of the cancer coming back or spreading.

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.

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

Stage Tis (also called CIS or carcinoma in situ)
Stage Ta
Stage T1

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

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

In Tis (CIS or carcinoma in situ) the cancer cells are still only in the bladder lining of the bladder, but 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. CIS is called a high risk, early bladder cancer because if it is not treated it is very likely to spread into the deeper layers of the bladder.

If you have early stage bladder cancer, you will need to have the tumours in your bladder removed. Your specialist will do this during your cystoscopy, while you are under a general anaesthetic. They will send the tumours to the lab so the pathologist can check the grade of your cancer cells. This tells your specialist which kind of further treatment you may need. We have information about removing bladder tumours in this section.

In some people, early bladder cancer comes back after surgery. So, after the cancer is removed, your specialist will give you a single dose of chemotherapy into the bladder in the first 24 hours after surgery. It is called intravesical chemotherapy and lowers the chance of the cancer coming back.

If you have a medium grade tumour you are likely to then have a further course of chemotherapy treatments into your bladder for 6 weeks. If the cancer comes back after initial treatment you may also have a course of chemotherapy treatments into the bladder.

If you have CIS bladder cancer, or a high grade Ta or T1 tumour there is a risk that after surgery and chemotherapy treatment the cancer may develop into invasive bladder cancer. Doctors call these high risk, early bladder cancers. You are likely to have treatment with BCG vaccine into the bladder to reduce the chance of the cancer coming back or spreading.

There is detailed information about chemotherapy and BCG treatments into the bladder in the section about treatment into the bladder.

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.