Treatment Options for Advanced Bladder Cancer

Health Writer
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If you're living with advanced bladder cancer, it can be difficult to figure out what to do next as you work to understand your diagnosis. Being aware of the treatment options to improve your quality of life can help you cope with these feelings of uncertainty.


What is advanced bladder cancer?

A person has advanced bladder cancer if the cancer cells from the inner lining of the bladder have spread to any lymph nodes or other organs outside of the bladder. When the cancer cells have spread to another organ, there is a high chance that treatment will not cure the bladder cancer. Because of this, treatment is designed to control the bladder cancer and reduce symptoms.


Stages of advanced bladder cancer

There are two stages of advanced bladder cancer. Stage III bladder cancer has spread outside of the bladder and possibly into organs or tissues close to the bladder. Stage IV bladder cancer has spread to the abdominal or pelvic wall, lymph nodes, or other parts of the body that are far from the bladder.


Treating stage III bladder cancer: Part 1

The first step in treating stage III bladder cancer is transurethral resection of the bladder (TURBT) — a non-invasive procedure that will help determine how far the bladder cancer has spread. During TURBT, the surgeon inserts an instrument with a camera on it into the urethra while the person is under anesthesia.


Treating stage III bladder cancer: Part 2

In most cases of advanced bladder cancer, chemotherapy (chemo) is given before any surgery is performed. When chemo is given before surgery, it can help to shrink the tumor and kill cancer cells that may be in other parts of the body. For people with stage III bladder cancer, chemo is taken in a pill form or it is injected into a vein or muscle so that it can enter the blood stream and reach cancer cells throughout the body.


Treating stage III bladder cancer: Part 3

After chemo is completed, a surgeon will remove the entire bladder and the lymph nodes that are close to the bladder during a procedure called radical cystectomy. Men who have radical cystectomy also have their prostate and seminal vesicles removed, while women also have their fallopian tubes, uterus, cervix, and part of their vagina removed. People who undergo radical cystectomy must also have reconstructive surgery so that their bodies have another way to store and release urine.


Treating stage IV bladder cancer: Part 1

Stage IV bladder cancers are difficult to eliminate completely because they have spread to the abdominal or pelvic wall, lymph nodes close to the bladder, or other parts of the body that are far away from the bladder. As a result, surgery is usually not an option because it cannot remove all the cancer. Instead, chemotherapy can be given to slow the rate at which the cancer spreads so that the person can live a longer and better-quality life.


Treating stage IV bladder cancer: Part 2

If stage IV bladder cancer has grown into other parts of the body that are far away from the bladder, a doctor may also recommend radiation therapy. During external radiation therapy, a machine is used to aim high-energy rays (or beams) from outside the body into the tumor. When radiation therapy is combined with chemo it is called chemoradiation.


Treating stage IV bladder cancer: Part 3

Immunotherapy is an option for people who have other health conditions that make it hard for their bodies to tolerate chemo. Immunotherapy works by helping the body’s immune system fight cancer by forcing the body to attack its own cancer cells. A live germ is injected into the blood stream. When the body reacts by attacking the germ, it also kills the cancer cells.


Clinical trials can provide more options for treatment

If advanced bladder cancer is not responding to standard treatment options, there are still opportunities to explore treatments that may control the cancer’s growth. Many people take part in clinical trials of advanced bladder cancer treatments that are still being researched. Although success is not promised, taking part in new research can be helpful to people currently battling advanced bladder cancer, and it might benefit those who develop advanced bladder cancer in the future.