Bladder cancer treatments

Bladder cancer treatment depends on the stage, grade, and type of cancer, as well as your overall health and treatment goals. Treatment options may include TURBT, intravesical therapy, immunotherapy, chemotherapy, radiation therapy, bladder removal surgery (cystectomy), bladder-preserving approaches, and clinical trials.

How is bladder cancer treated?

There is no single treatment for bladder cancer. Your care team recommends a treatment plan based on several factors, including the stage and grade of the cancer, whether it has spread beyond the bladder, your overall health, and your personal treatment goals.

What factors determine bladder cancer treatment? 

• Cancer stage (whether the cancer is non-muscle invasive, muscle invasive, or advanced)  
• Tumor grade and risk of recurrence  
• Whether cancer has spread outside the bladder  
• Overall health and age  
• Personal treatment goals and quality-of-life considerations  

Bladder cancer treatment options:

• Transurethral Resection of a Bladder Tumor (TURBT)
• Intravesical Therapy
• Bladder Removal Surgery
• Chemotherapy
• Bladder Preservation with Combined-Modality Therapy (CMT)
• Immunotherapy (including BCG)
• Palliative Care
• Clinical Trials

Bladder Cancer Treatment by Stage

Stage	Common Treatment Options
Non-Muscle Invasive Bladder Cancer (NMIBC)	TURBT, intravesical therapy, BCG, surveillance
Muscle-Invasive Bladder Cancer (MIBC)	Chemotherapy, radical cystectomy, bladder preservation therapy
Locally Advanced Bladder Cancer	Chemotherapy, immunotherapy, surgery
Advanced (Metastatic) Bladder Cancer	Systemic therapy, immunotherapy, targeted therapy, clinical trials, palliative care

Transurethral resection of a bladder tumor (TURBT)

TURBT is usually the first treatment for bladder cancer. 

During TURBT: 

• A surgeon removes visible tumors in the bladder  

• No external incision is needed  

• Tissue is examined to find cancer stage and grade  

• The procedure may both diagnose and treat early bladder cancer  

TURBT is often followed by more treatment to reduce recurrence risk.

Intravesical therapy

Intravesical therapy delivers medication directly into the bladder through a catheter. 

It is commonly used for: 

• Non-muscle invasive bladder cancer. 

• High-risk recurrent tumors.  

• Preventing recurrence after TURBT.  

Benefits include: 

• Direct treatment of bladder lining tumors  

• Limited exposure to the rest of the body  

• Reduced risk of recurrence.  

Learn more about intravesical therapy. 

Immunotherapy 

Immunotherapy uses a patient’s own immune system to recognize and fight cancer cells.  

The most common type of immunotherapy used in bladder cancer is: 

 BCG (Bacillus Calmette-Guerin).  

BCG is a weakened bacteria placed directly into the bladder. 

BCG can: 

• Reduce recurrence.  

• Reduce progression risk.  

• Preserve the bladder in many patients with high-risk NMIBC.  

Other immunotherapy options may be available for advanced bladder cancer. 

Learn more about immunotherapy for bladder cancer. 

Chemotherapy 

Chemotherapy uses medications that destroy cancer cells. It may be used systemically (given via a port): 

Before surgery (neoadjuvant chemotherapy) 

• Shrinks tumors  

• Improves surgical outcomes  

• May improve survival  

After surgery (adjuvant chemotherapy) 

• Targets remaining cancer cells  

• Reduces recurrence risk  

Within the bladder (intravesically) 

• Some chemotherapies are given intravesically (via a catheter directly into the bladder) 

Chemotherapy may also be used for advanced (metastatic) disease. 

Learn more about chemotherapy for bladder cancer.

Bladder removal surgery (cystectomy) 

Radical cystectomy removes the bladder and nearby tissues affected by cancer. 

It is often recommended for: 

• Muscle-invasive bladder cancer.  

• High-risk recurrent disease. 

• Some advanced cancers.  

After bladder removal, a urinary diversion creates a new way for urine to leave the body. 

Learn the risks and benefits of a radical cystectomy, and understand what to expect after bladder removal.

Learn more about urinary diversion options. 

Can some patients keep their bladder? 

Bladder preservation with combined-modality therapy (CMT)

For some patients, bladder preservation may offer an alternative to bladder removal. 

Combined-Modality Therapy (CMT) typically includes: 

1. TURBT  

2. Radiation therapy  

3. Chemotherapy  

Research shows carefully selected patients may achieve outcomes comparable to radical cystectomy while preserving bladder function. 

Learn more about bladder cancer preservation therapy. 

What is palliative care?

Palliative care focuses on symptom management and quality of life. 

It can help patients: 

• Manage pain.  

• Reduce treatment side effects. 

• Address emotional concerns.  

• Improve quality of life.  

Palliative care can begin at diagnosis and continue throughout treatment. 

 Learn more about palliative care. 

Should you consider a clinical trial?

Clinical trials evaluate promising new treatments before they become widely available. 

Benefits may include: 

• Access to emerging therapies  

• More treatment options  

• Contributing to future advances in bladder cancer care  

Many patients take part in clinical trials alongside standard treatment. 

Search BCAN’s Clinical Trial Database.

Dr. John Gore from the University of Washington Medicine wants patients to know.

FAQs about bladder cancer treatment options

What is the most common treatment for bladder cancer? 

The most common treatment depends on the stage of disease. For non-muscle invasive bladder cancer, TURBT followed by intravesical therapy or BCG is often used. Muscle-invasive disease often requires chemotherapy and radical cystectomy. 

Can bladder cancer be treated without removing the bladder? 

Yes. Some patients may qualify for bladder preservation using combined-modality therapy that combines TURBT, chemotherapy, and radiation therapy. 

Is BCG considered chemotherapy? 

No. BCG is an immunotherapy that stimulates the immune system to attack bladder cancer cells. 

What treatment is used for advanced bladder cancer? 

Advanced bladder cancer may be treated with chemotherapy, immunotherapy, targeted therapies, antibody-drug conjugates, clinical trials, and supportive care. 

How do doctors choose the best bladder cancer treatment? 

Doctors consider the cancer stage, grade, risk level, overall health, treatment goals, and patient preferences when developing a treatment plan. 

Bladder cancer treatment resources

Bladder cancer treatment comparison tool

BCAN has an easy treatment comparison tool to help you navigate which treatments make the most sense for you.

Finding support during bladder cancer treatment

BCAN offers tools, support groups, a helpline and resources so you never have to face bladder cancer alone.

Diagnosing Bladder Cancer

Learn about tests and procedures that can find bladder cancer.

Types, Stages and Grades

Learn how bladder cancer is classified and how stage and grade influence treatment recommendations.

Managing Treatment Side Effects

Find information about common side effects of bladder cancer treatment and strategies to help manage them.

Clinical Trials

Explore clinical trials and learn how research studies may provide access to new bladder cancer treatments.

Support Programs

Connect with BCAN support groups, educational programs, a helpline, and other resources for patients and caregivers.

Patient Handbook

Download BCAN’s free patient handbook to learn about diagnosis, treatment, recovery, and living with bladder cancer.