Treatment for bladder cancer

How treatment is planned

The treatment for bladder cancer depends on the type of cancer and the stage and grade. A team of doctors and other health care staff will plan your treatment. This is known as a multidisciplinary team. This is a team of staff who specialise in treating cancer of the urinary system and in giving information and support. It will normally include:

• urologists (surgeons who are experienced in bladder surgery)
• specialist nurses, who give information and support
• oncologists – doctors who have experience in bladder cancer treatment using chemotherapy, radiotherapy and biological therapies
• radiologists, who help to analyse x-rays
• pathologists, who advise on the type and extent of the cancer.

Other staff will also be available to help you if necessary, such as:

• physiotherapists
• counsellors and psychologists
• social workers.

Your doctor will discuss with you the best treatment in your particular situation. If you have any questions, don't be afraid to ask your doctor or the nurse looking after you. It often helps to make a list of the questions you want to ask and to take a close relative or friend with you to remind you of the things you want to know, but can easily forget. You will usually be given the contact number of a member of staff you can call if you need to clarify information.

Giving consent

Before you have any treatment, your doctor will explain the aims of the treatment to you. They will usually ask you to sign a form saying that you give your permission (consent) for the hospital staff to give you the treatment. No medical treatment can be given without your consent, and before you are asked to sign the form you should have been given full information about:

• the type and extent of the treatment you are advised to have
• the advantages and disadvantages of the treatment
• any other possible treatments that may be available
• any significant risks or side effects of the treatment.

If you do not understand what you have been told, let the staff know straight away so that they can explain again. Some cancer treatments are complex, so it is not unusual for people to need repeated explanations.

Patients often feel that the hospital staff are too busy to answer their questions, but it is important for you to be aware of how the treatment is likely to affect you. The staff should be willing to make time for you to ask questions.

You can always ask for more time to decide about the treatment if you feel that you can’t make a decision when it is first explained to you.

You are also free to choose not to have the treatment. The staff can explain what may happen if you do not have it. It is essential to tell a doctor, or the nurse in charge, so that they can record your decision in your medical notes. You do not have to give a reason for not wanting to have treatment. However, it can be helpful to let the staff know your concerns so that they can give you the best advice.

Treatment for carcinoma in situ

Carcinoma in situ, or CIS, is a very early bladder cancer. As it can be quickly growing, the treatment may be more intensive than for other types of early bladder cancer. The usual treatment is removal of the area of CIS by surgery. The surgery is followed by treatment of the inside of the bladder (intravesical therapy) with either chemotherapy or BCG. This can get rid of the CIS in up to 60% (6 in 10) of people.

If the CIS does not go away completely or comes back after treatment, further treatment with surgery, chemotherapy or BCG will be needed. Your doctor can talk to you about the most appropriate treatment in your situation.