Doctors often find bladder cancer early because it tends to cause symptoms people notice. This is good news because the earlier the cancer stage, the more likely it is for treatment to be successful. In these early stages, the goal of treatment is to eliminate the cancer and keep it from coming back. This may not be possible as bladder cancer becomes more advanced. In later stages, treatment goals may shift to easing symptoms and prolonging life. The main bladder cancer treatments are surgery, intravesical therapy, chemotherapy, and radiation therapy. Surgery Treatment for almost all cases of bladder cancer involves surgery. The extent of the surgery will depend on the stage of the cancer. In the early stages, doctors may only need to remove the tumor and a small amount of healthy tissue. More extensive surgery is usually necessary at later stages. It may involve removing part of the bladder wall or the entire bladder and surrounding lymph nodes. Your cancer care team and surgeon will help you prepare for and recover from surgery. Intravesical Therapy In intravesical therapy, doctors administer a drug directly into the bladder. It involves inserting a urinary catheter and delivering the drug through it. The two types of drugs doctors use are chemotherapy and an immunotherapy called BCG. Intravesical BCG and chemotherapy drugs work locally on the lining of the bladder. They do not affect the entire body, which helps avoid major side effects characteristic of systemic chemotherapy and immunotherapy. BCG bladder cancer therapy and chemotherapy are most common after surgery for early stages of bladder cancer. Systemic Chemotherapy Systemic chemotherapy affects the whole body because you take the drugs by vein or by mouth. Chemotherapy kills cancer cells, or stops or slows their growth. In treating bladder cancer, doctors have two main uses for chemotherapy. The first is to shrink tumors before surgery, making them easier to remove. The other is to kill any remaining cancer cells after surgery. Sometimes, doctors combine it with radiation therapy to improve the effectiveness. In some cases, doctors may recommend chemotherapy for bladder cancer as the main treatment. This may be the case for advanced cancer and for people who can’t have surgery. Radiation Therapy Radiation therapy uses high-energy X-rays or particles to destroy cancer cells. Like chemotherapy, it can help kill cancer cells remaining after surgery. Doctors may also recommend it as a main treatment if surgery is not an option. In advanced stages of bladder cancer, radiation is useful in easing symptoms and improving comfort and quality of life. Your Treatment Options Your doctor will recommend treatment options using your cancer stage as a guide. However, your overall health and personal preference are also important. Take your time and make sure you understand the goals, benefits, and side effects of each treatment option. Together, you and your doctor can plan a course of treatment for you with the best chance of success. If possible, work with a urologic oncologist—a cancer doctor who specializes in cancer of the urinary tract. A urologic oncologist knows the most recent treatment advances and uses this knowledge to develop a personalized treatment plan for you. Search Healthgrades.com for a bladder cancer specialist in your area.