What is Muscle Invasive Bladder Cancer?

When tumors grow into or through the muscle wall of the bladder, it is known as “muscle invasive bladder cancer,” or MIBC. Bladder cancer is most often found in the tissue (called urothelial or transitional cells) that line the inside of the bladder and approximately 25-30% of bladder tumors grow into or through the muscle wall of the bladder which makes it muscle invasive bladder cancer. When bladder tumors spread into the bladder muscle, they are more likely to spread further and be more life threatening.

Webinar: Understanding Muscle Invasive Bladder Cancer

Watch urologist Dr. Tracey Krupski of the University of Virginia Health System explain MIBC.

Part 1: Understanding Muscle Invasive Bladder Cancer and Indications for Cystectomy

Transcript (PDF)

Part 2: Preparing for Surgery

Transcript (PDF)

Part 3: Quality of Life and Q&A

Transcript (PDF)

How is muscle invasive bladder cancer treated?

Once the tumor has invaded the muscle layer of the bladder, it has a greater chance of spreading further beyond the bladder. The objective is to remove the cancer as completely as possible. There are different treatments including chemotherapy, surgery and radiotherapy.


For patients who are healthy enough, chemotherapy may be provided in advance of surgery to help remove any cancer cells that may have gone beyond the bladder itself. This is known as neoadjuvant chemotherapy.

Radical cystectomy surgery

Chemotherapy is often followed by bladder removal surgery, called a radical cystectomy. The urologist will create a urinary diversion to have a new way for the urine made in the kidneys to leave the body.

Bladder preservation therapy

For some, surgery to remove the bladder is not an option and they may benefit from tri-modality or bladder preservation therapy using chemotherapy, surgery to remove as much of the tumor as possible and radiation to the area where the tumor was located.

Ask your doctor about which option to treat muscle invasive bladder cancer is recommended. You can also learn more about the treatment options for all stages of bladder cancer by clicking on the button below.

Preparing for surgery

Before undergoing surgery for MIBC, there are decisions and considerations to keep in mind. Firstly, you’ll need to decide between surgery or opting for chemo-radiation. If you choose chemo-radiation, your urologist will remain involved, overseeing a maximal endoscopic resection and monitoring your bladder every three months. However, if you decide on surgery, a second decision arises regarding whether to undergo chemotherapy before the procedure.

While it is recommended to undergo chemotherapy before surgery for most people, the choice ultimately lies with you. You may decide based on your personal preferences or if the data doesn’t support chemotherapy in your specific case. Factors such as kidney function also play a role; if proceeding with chemotherapy may harm your kidneys too much, it might not be advisable.

The third decision revolves around what happens after your bladder is removed. With the bladder gone, choices regarding the type of urinary diversion for your urine become crucial. This aspect involves a significant surgery, and considerations must be made for the removal of additional organs, such as the bladder, prostate, seminal vesicles (for men), or parts of the uterus, Fallopian tubes, and vaginal wall (for women).

These decisions are pivotal, and discussing them thoroughly with your medical team ensures that the chosen course aligns with your preferences and health needs

Treatment comparison tool:

Click on the button below to compare the different types of treatments for muscle invasive bladder cancer.

Podcasts about MIBC:

These “Bladder Cancer Matters” podcasts offer additional information about muscle invasive bladder cancer:

Webinars about MIBC:

BCAN webinars are online, recorded conversations with medical experts. We offer several Patient Insight Webinars with about information about muscle invasive bladder cancer, including:

Stories from MIBC patients:

Get Help: Survivor to Survivor

The Bladder Cancer Advocacy Network’s (BCAN’s) Survivor to Survivor (S2S) program connects newly diagnosed bladder cancer patients and caregivers with survivors and co-survivors who have gone through similar experiences.

S2S matches bladder cancer patients with trained volunteers who offer a sympathetic ear and share their own experiences as well as insight about their own bladder cancer diagnosis, treatment and survivorship.

Call center for bladder cancer patients and loved ones

A muscle invasive bladder cancer diagnosis can be scary, stressful and even expensive. To speak with an oncology social worker who can talk to your about your feelings about your muscle invasive bladder cancer diagnosis, call during regular business hours (ET) 833-ASK-4BCA (833-275-4222).