Follow up for invasive bladder cancer

After your treatment has finished, your doctor will want you to have regular check ups. The aim of these appointments is to see how you are recovering from your treatment. And to make sure that any sign of the cancer coming back is picked up as soon as possible.

Your follow up will vary, depending on the treatment you have had. For example, if you have had the bladder removed (cystectomy) or bladder reconstruction, you will be asked to go back to see your surgeon regularly. If you have had radiotherapy, you will need to go back to see your radiotherapy doctor (clinical oncologist) as well as seeing a surgeon (urologist) for regular cystoscopies.

If all goes well, the time between appointments will gradually get longer. At first it is usual to see your doctor at least every 2 to 3 months. This will become 4 monthly, 6 monthly and then yearly. But this depends on your own circumstances.

Whichever doctor you see, you will have some tests from time to time. These may include

• Being examined by your doctor
• Cystoscopy if you still have your bladder
• X-rays
• CT scans
• Urine tests 
• Blood tests
• GFR test (Glomerular filtration rate test) or renogram to check how well your kidneys are working

You won't have all these tests at every visit to your specialist but your doctor will almost certainly examine you. Your doctor will also ask

• How you are feeling
• Whether you have had any new symptoms
• Whether anything is worrying you.

If you still have your bladder, you will have cystoscopies regularly to make sure there is no sign of the cancer growing back. This could be every 3 to 6 months at first. Gradually the time between the cystoscopies will get longer if all is well.

If you are worried, or notice any new symptoms between appointments you must let your doctor know straight away. You do not have to wait for your next appointment.

Do make sure you tell your doctor or specialist nurse about any continuing side effects of your treatment. Your check ups are not just to make sure your cancer is under control. They are to make sure your treatment has been as successful as possible in allowing you to live as normal and healthy a life as you can. Some side effects may be permanent, such as the bladder being able to hold less urine after radiotherapy. But it may be possible to improve the situation for you, even if the side effect cannot be got rid of altogether.

You may find your check ups quite worrying, especially at first. If you are feeling well and getting on with life, a hospital appointment can bring all the worry about your cancer back to you. You may find it helpful to tell someone close to you how you are feeling. If you are able to share your worries, they may not seem quite so bad. Having someone come along with you to your check up may help on the day.

If you find that worry is seriously affecting your life, you may need more help. It is quite common these days for people to have counselling after cancer treatment. This is a way of exploring more deeply what is worrying you and helping you come to terms with it. We have more information on what counselling is, including information about how to find counselling services in your area.