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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

Removing early bladder cancer tumours

If you have early stage bladder cancer, your specialist will remove the areas of cancer in the bladder lining during a cystoscopy. You have this under general anaesthetic. Your doctor 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 cancer with a medium risk of coming back, 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 a high grade tumour the cancer cells look very abnormal. If you have a high grade tumour or changes in the bladder lining called carcinoma in situ you have a higher risk of the cancer coming back. 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.

 

 

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.

 

Surgery

If you have early stage bladder cancer, your doctor will need to remove the areas of cancer from the bladder lining. Your specialist will do this during a cystoscopy, while you are under a general anaesthetic. The doctor will then send the cancer to the lab to check the grade of the cancer cells. This tells your specialist what further treatment you need. We have more information about removing bladder cancer in this section.

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

If you have a medium grade tumour, you will probably have a 6 week course of chemotherapy into your bladder after the first single dose. 

If you have bladder cancer that has come back after your first single treatment of chemotherapy into the bladder, you may then also have a 6 week course of chemotherapy into the bladder.

If you have high grade bladder cancer, or carcinoma in situ (CIS) there is a risk that the cancer may not only come back, but grow further into the bladder wall (invasive bladder cancer). This is known as high risk early bladder cancer. You are likely to have treatment with BCG vaccine into the bladder to lower 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 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.

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Updated: 23 October 2013