Treating different types of bladder cancer

If you’ve been diagnosed with bladder cancer (an abnormal growth of cancerous tissue in the bladder), you’ll be looked after by a team of specialists. Mark Tuthill is a leading medical oncologist and an expert in the treatment of cancers, including bladder cancer. Within this article, Dr Tuthill explains the two different types of bladder cancer and how they’re treated.

What are the different types of bladder cancer?

There are two types of bladder cancer. The type you have will affect your course of treatment, as they are managed differently.

• Non-muscle invasive (superficial) bladder cancer is the more common type and affects the lining of the bladder.
• Muscle invasive (non-superficial) bladder occurs when non-muscle invasive bladder cancer progresses and involves the muscle of the bladder.

How is non-muscle invasive bladder cancer treated?

The treatment of non-muscle invasive (superficial) bladder cancer involves removing the tissue from the lining of the bladder that contains abnormal growth. This happens during a diagnostic procedure called a cystoscopy. During this procedure, a thin tube with a camera (a cystoscope) is inserted into the bladder via the urethra and tools can be passed through it to remove the abnormal tissue.

Once treated, patients have regular check-ups to assess their bladder. At these check-ups, they’ll be evaluated for any reoccurrence of abnormal growth in the bladder lining. In some cases, additional treatments such as BCG (a type of immunotherapy drug) or intravesical chemotherapy can be used to prevent reoccurrence.

How is muscle-invasive bladder cancer treated?

Muscle-invasive bladder cancer is treated with either surgery or radiotherapy. The objective of both these treatments being to remove any cancerous tissue and therefore remove the disease entirely.

In the case of surgery, the bladder is usually removed. With radiotherapy, the cancer cells will be destroyed, leaving healthy cells and tissue with minimal damage.

To reduce the likelihood of reoccurrence after surgery, a patient may be recommended a course of chemotherapy before surgery. Chemotherapy can also improve the outcome in people with early muscle-invasive bladder cancer.

What’s the best bladder cancer treatment?

The best treatment for bladder cancer depends on the type of cancer that you have.

If you have developed muscle-invasive bladder cancer that has recurred after surgery, your medical team will test your tumour for immune activation (this test can be medically referred to as PDL1 testing). If your tumour doesn’t show signs of immune activation, you’ll be recommended to have a course of chemotherapy, followed by a period of observation and then, if the tumour grows again, immunotherapy could be considered.

Clinical research

Whether you have developed muscle-invasive or non-muscle invasive bladder cancer, please ask your clinical team if they have any ongoing clinical research that you could take part in. Clinical trials could allow you to have treatments such as molecularly targeted treatments for bladder cancer, which focus on targeting individual cancer growths’ genes, proteins and/or tissues.

Dr Mark Tuthill is a medical oncologist in Oxford and very highly practised in the treatment of various cancers. Visit Dr Tuthill’s profile to learn more and to book a consultation.