Treatment

Treatment for bladder cancer is primarily based on muscle involvement.

Nonmuscle-invasive Bladder Cancer

• Can often be treated by removing the tumor(s) via a transurethral approach (TURB). Sometimes chemotherapy or other treatments are introduced into the bladder with a catheter to help fight the cancer.
• Includes non-invasive urothelial carcinoma, carcinoma in situ, tumor confined to the lamina propria, mucosa, submucosa and is also dependent on the following prognostic factors.
  • Cancer has not reached the muscle wall of the bladder (called non-muscle-invasive or superficial bladder cancer)
  • Cancer has spread through the inner lining of the bladder and into the muscle wall of the bladder or beyond it (called muscle-invasive bladder cancer or invasive bladder cancer)
  • Depth of invasion into the bladder wall
  • Type of bladder cancer (histology)
  • Whether the cancer is low grade or high grade (urothelial histologies)
  • Presence versus absence of carcinoma in situ

Muscle-invasive Bladder Cancer

• Much more likely to spread to other parts of the body and is generally treated by either removing the bladder or treating the bladder with radiation and chemotherapy. High-grade cancers are much more likely to be muscle-invasive than low-grade cancers. Thus, muscle-invasive cancers are generally treated more aggressively than non-muscle invasive cancers.
• Additional prognostic factors are
  • Number of tumors (single vs multiple)
  • Tumor size (e.g., >3 cm or <3 cm)
  • Invasion of the lamina propria (in situ vs invasive)
  • Invasion of the connective tissue next to the lining of the bladder
  • Whether the tumor is the primary tumor or a recurrence.

See the Bladder Cancer Treatment (PDQ®) - NCI or the NCCN guidelines Detail (nccn.org) for more complete information on treatment for bladder cancers. Both these websites are updated regularly with current clinical practices.

Updated: April 22, 2025