Treatment options for metastatic bladder cancer

Metastatic bladder cancer means the cancer has spread to another part of the body such as the lungs, liver or bones. Doctors also call this advanced cancer.

Treatment is not likely to cure it. But it might control it for some time and help to reduce any symptoms. 

This page is about how your doctor decides which treatment you need for metastatic bladder cancer. We have a separate section about treating muscle invasive bladder cancer which hasn’t spread to other parts of the body.

Deciding which treatment you need

A team of doctors and other professionals discuss the best treatment and care for you. They are called a multidisciplinary team (MDT).

The treatment you have for advanced bladder cancer depends on:

  • how much your cancer has spread
  • your symptoms
  • where it has spread to
  • what treatment you may have had already
  • your general health and level of fitness

Your doctor will discuss your treatment, its aims and the possible side effects with you. 

Treatment aim

The aim of treatment for most people with metastatic cancer is to control it, relieve symptoms and maintain your quality of life.

It can be difficult to decide which treatment to try or whether to have treatment at all. You need to think about how the treatment could affect your quality of life. This includes the possible side effects as well as the travelling to and from the hospital. It's important to understand what the treatment can achieve.

There might be a counsellor or specialist nurse at the hospital who you can chat to. You may also want to talk things over with a close relative or friend.

After you have had time to think about the options, you and your doctor make the final decision together. It can be helpful to talk over difficult decisions with someone who is outside your circle of family and friends.

Help with understanding your options

Some bladder cancer organisations can give you information about treatment. They can also tell you about cancer support groups. This is where you can talk to other people who have been through similar experiences.

You can also use Cancer Chat. This is our free online discussion forum for people affected by cancer. It is a safe space to talk to other people in similar situations, and find information and support.

The treatments

For metastatic bladder cancer you might be able to have one or more of the following treatments: 

  • chemotherapy
  • targeted cancer drugs or immunotherapy
  • radiotherapy to the part of the body where the cancer has spread
  • surgery to remove cancer in the bladder
  • surgery to unblock the ureters or urethra
  • drugs to strengthen the bones
  • joining a clinical trial

Talk to your doctor or specialist nurse about your treatment choices. They can explain why some treatments are an option for you, and others aren't. 

For support and information, you can call the Cancer Research UK information nurses. They can give advice about who can help you and what kind of support is available. Freephone: 0808 800 4040 - Monday to Friday, 9am to 5pm.

Clinical trials

Your doctor might ask if you’d like to take part in a clinical trial. Doctors and researchers do trials to make existing treatments better and develop new treatments.

If you decide not to have treatment

You may decide not to have cancer treatments, such as chemotherapy. But you can still have medicines to help control symptoms, such as sickness or pain.

Your doctor or nurse will explain what could help you. You can also ask them to refer you to a local symptom control team to give you support at home.

  • Bladder cancer: diagnosis and management
    National Institute for Health and Care Excellence (NICE), February 2015

  • BMJ Best Practice. Bladder Cancer
    D Lamm and others
    BMJ Publishing Group Ltd, 2018

  • EAU Guidelines on Muscle-invasive and Metastatic Bladder Cancer
    J A Witjes and others
    European Association of Urology, 2022

  • Bladder cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up.
    T Powles and others
    Annals of oncology, 2022 Volume 33, Issue 3, Page 244 - 258

  • Bladder Cancer: overview and management. Part2: muscle-invasive and metastatic bladder cancer
    B Anderson
    British Journal of Nursing, 2018. Volume 27, Number 18, Pages 8 – 20

  • Management of Muscle-Invasive Urothelial Cancer and the Emerging Role of Immunotherapy in Advanced Urothelial Cancer
    K V Giridhar and others
    Mayo Clinic Proceedings, 2017. Volume 92, Issue 10, Pages 1564 - 1582

Last reviewed: 
09 Dec 2022
Next review due: 
09 Dec 2025

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