Common Treatment Combinations Based on Your Stage of Bladder Cancer

The type of treatment your doctor recommends for you depends on the type of cancer you have and its stage — that is, how invasive it is.

Here are some common treatment combinations based on the stage of your bladder cancer:

For stage 0 or stage I bladder cancer, meaning the cancer has not spread much beyond the bladder lining, your doctor may recommend these treatments:

• Transurethral resection surgery only

• Transurethral resection surgery followed by intravesical immunotherapy or chemotherapy

• Partial or radical cystectomy if there are many superficial cancers or if the cancer looks "high grade," meaning the cells look very unusual under a microscope

• Internal radiation therapy, with or without external radiation therapy

For stage II bladder cancer, meaning the cancer has spread into the bladder's muscle layer, your doctor may recommend any of these treatments:

• Radical cystectomy, which is surgery to remove the bladder and some surrounding tissues

• Chemotherapy followed by radical cystectomy

• External radiation therapy with or without chemotherapy

• Internal radiation therapy with or without external radiation therapy

• Transurethral resection surgery (in selected patients)

• Partial cystectomy, which is surgery to remove part of the bladder

For stage III bladder cancer, meaning the cancer has spread into the bladder's fatty layer or to the prostate (in men) or to the vagina or uterus (in women), your doctor may recommend any of these treatments:

• Radical cystectomy

• Chemotherapy followed by radical cystectomy

• External radiation therapy with or without chemotherapy

• External and internal radiation therapy

• Partial cystectomy (in selected patients)

For stage IV bladder cancer, meaning the cancer has spread far from your bladder, your doctor may recommend any of these treatments:

• Radical cystectomy

• External radiation therapy to ease symptoms

• Urinary diversion to ease symptoms

• Cystectomy to ease symptoms

• Chemotherapy alone or after surgery or radiation

• A clinical trial of chemotherapy

You'll want to learn all you can about your disease and treatment choices. This makes it possible to take an active part in decisions about your medical care. One of the best ways to get the information you need is to ask your doctor and other health care professionals. Ask how the treatment will change your daily life, how it will affect your diet, and how you will look and feel after treatment. Ask how successful the treatment is expected to be. You should also ask about possible risks and side effects.

To help deal with the medical information and remember all your questions, it is helpful to bring a family member or close friend with you to doctors' appointments. In addition, bringing a written list of concerns will make it easier for you to remember your questions.