Treatments for early stage bladder cancer

The following are treatment options for early stage bladder cancer. Early stage bladder cancer is only in the inner lining (non-invasive) or thin connective tissue layer of the bladder (non-muscle invasive). This includes stage 0a, stage 0is and stage 1 bladder cancers. Your healthcare team will suggest treatments based on the risk group. They will work with you to develop a treatment plan.

Sometimes bladder cancer comes back (recurs) after it has been treated or initial treatments don’t work. If the cancer is still non-invasive or non-muscle invasive, the following treatments can be used.

Surgery is the first treatment for early stage bladder cancer.

A transurethral resection of bladder tumour (TURBT) removes tumours from the bladder through the urethra. It is a standard surgery for early stage bladder cancer in any risk group. A TURBT is usually done during diagnosis. It may be the only treatment needed. Sometimes another TURBT is done to make sure all the cancer is removed.

A cystectomy removes all or part of the bladder. It is not usually used for early stage bladder cancer, but it may be offered for bladder cancer that is classified as high risk. It may also be used if other treatments haven’t worked. A radical cystectomy to remove the whole bladder is most commonly done. Once the bladder is removed, urinary diversion surgery is needed to make a new way to hold urine (pee) and pass it out of the body.

You may be offered intravesical immunotherapy or chemotherapy for early stage bladder cancer after a TURBT. Intravesical means the drug is placed directly in the bladder.

The drug usually used for intravesical immunotherapy is bacillus Calmette-Guérin (BCG). The most common drug used for intravesical chemotherapy is mitomycin (Mutamycin).

If bladder cancer is classified as low or intermediate risk, a single treatment of intravesical chemotherapy may be given within 24 hours of a TURBT.

If bladder cancer is intermediate risk, intravesical BCG or intravesical chemotherapy is often given for 6 weeks. If bladder cancer is high risk, intravesical BCG is given once a week for 6 weeks. This 6 weeks of treatment is called induction therapy.

If there is no cancer remaining after induction therapy, more treatment may be offered. This is called maintenance therapy. Intravesical chemotherapy can be given for up to 1 year. And intravesical BCG can be given for up to 3 years.

Induction therapy with intravesical BCG may be given again if the cancer comes back or continues to grow after the first course of intravesical BCG.

Talk to your doctor about clinical trials open to people with bladder cancer in Canada. Clinical trials look at new ways to prevent, find and treat cancer. Find out more about clinical trials.