Bladder cancers can range from early stage (superficial) to muscle invasive – those that have spread deeper into the bladder’s layers to reach muscle. Muscle-invasive bladder cancer is more serious, requires more intensive treatment and may require surgery to remove the bladder (cystectomy), or an attempt to preserve the bladder will be made using a combination of chemotherapy and radiotherapy.
Chemotherapy can be given before surgery or radiotherapy to reduce the risk of the cancer returning after the definitive treatment. If radiotherapy is preferred, then four to six weeks of treatment is given. This may be combined with chemotherapy during the first and last weeks. Patients too frail for surgery or chemotherapy may be treated with radiotherapy alone.
If the cancer is advanced or metastatic, the purpose of treatment will be to control the disease, improve symptoms and prolong life. This is usually done with chemotherapy.