Duke’s experienced physicians focus on diagnosing and treating bladder cancer while preserving normal function. Often, patients can be treated with minimally invasive surgery.
Our specialists draw upon decades of training and experience treating both routine and complex, unusual diseases.
Specialists in the fields of surgery, radiation oncology, medical oncology, radiology, and pathology work together to plan the most effective course of treatment for each individual using the latest, research-backed therapies available.
Novel treatments are available through a robust clinical trials program.
Whether used alone or in combination with other treatments, surgery is used to treat almost all cases of bladder cancer.
Transurethral surgery is the most common surgical treatment for early stage or superficial bladder cancers. No incision is required because the procedure is performed by passing an instrument with a wire loop on the end through the urethra (the tube that leads from outside the body to the bladder) and into the bladder. The loop emits either laser rays or electric current to burn away any tumors or abnormal tissues.
Cystectomy removes all or part of the bladder. This is the most common treatment when bladder cancer is invasive.
With a partial cystectomy, only part of the bladder is removed, which means the patient will not require reconstructive surgery. However, the bladder will be smaller and will hold less urine, requiring more frequent urination. A partial cystectomy is possible if the cancer has invaded the muscle but is not very large.
After transurethral surgery or partial cystectomy, there is still a chance that the tumor may recur in another part of the bladder, so patients will need frequent follow-up visits.
When the entire bladder is removed, the procedure is called a radical cystectomy and also involves removing nearby lymph nodes. For men, a radical cystectomy also involves removing the prostate; for women, it often involves removing the ovaries, the fallopian tubes, the uterus (womb), and a small part of the vagina.
After a radical cystectomy, reconstructive surgery will be used to create a new way for urine to pass from the body. There are several reconstructive options. Your surgeon may use a piece of your intestine to create a tube for urine to pass through to the outside of the body into a bag that must be emptied periodically.
Or, a piece of your intestine may be used to create a small reservoir for urine inside the body that can be drained through a hole in the abdomen, using a catheter. A third option is using a small piece of intestine to create a neobladder, which sits inside the body and drains through the ureters, allowing you to urinate normally.
Intravesical therapy is used to treat early stage bladder cancers. It involves administering a drug directly to the bladder through a catheter.
The drug may be an immunotherapy drug, which helps the body’s own immune system fight the cancer, or it may be a chemotherapy drug, which kills the cancer cells.
Immunotherapy drugs used in intravesical therapy for bladder cancer include Bacille Calmette-Guerin and interferon.
Chemotherapy may be used to treat bladder cancer before or after surgery or in combination with radiation.
It may be administered systemically, such as via a vein, or it may be given regionally, as in intravesical chemotherapy. Learn more about chemotherapy for urologic cancer.
During radiation therapy, radiation (high-energy rays) is used to kill tumor cells. External radiation administered by a machine outside the body is the type most often used to treat bladder cancer.
Radiation may be used after surgery, as the main treatment for people who can’t have surgery, or to help treat symptoms caused by advanced bladder cancers.
Learn how to make an appointment at the Duke Cancer Institute.
Physicians offering this service include: