Bladder Cancer

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Our bladder cancer specialists use the latest medical and surgical advances to treat bladder cancer at every stage, including noninvasive, invasive and metastatic. Sophisticated techniques target treatment of your bladder tumor and minimize disruption to healthy tissue. If needed, our skilled surgeons perform complex surgeries and reconstructions to preserve function. Our oncologists and urologists regularly test new therapies and explore substances called biomarkers to better understand bladder cancer and how it responds to different treatments. Our goal is to improve your quality of life and your survival.

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Bladder Cancer Treatments

Intravesical (In-Bladder) Therapy

Targets treatment of early-stage bladder cancer that has not spread into the muscle layer of the bladder. Chemotherapy, immunotherapy, and other anticancer drugs that kill cancer cells are administered directly to the bladder through a catheter. This reduces exposure of healthy tissue to these drugs. We are currently the only site in the U.S. to use heat (hyperthermia) to treat noninvasive bladder cancer.

Transurethral Surgery

The most common surgery for early-stage bladder cancer is performed daily here. It is easy on patients because no incision is needed as we guide a thin medical tube into the urethra (the natural channel that leads from outside the body to the bladder) and into the bladder, so that laser rays or electrical current can target and kill tumor cells and abnormal tissues.


Removes all or part of the bladder and is the most common treatment when bladder cancer spreads to the muscle layer. 

Radical Cystectomy with Reconstruction

Removes your whole bladder, as well as nearby lymph nodes if cancer has spread. Your own intestinal tissue is used to replace your bladder. To ensure all cancer has been removed, this surgery normally involves removing the prostate gland in men. For women, it may include the removal of ovaries, fallopian tubes, uterus, and a small part of the vagina. Reconstruction includes the formation of a new passageway for urine to leave your body after your bladder is removed. This is called urinary diversion. We offer three options:

  • Ileal conduit (urostomy): A small piece of intestine drains the urine into a bag on the abdomen.
  • Right colon pouch (Indiana pouch): A piece of large intestine is used to create an internal urine reservoir that is drained by passing a catheter into the body every 3-4 hours.
  • Neobladder (Studer bladder): A piece of small intestine is used to create an internal urine reservoir that is hooked into your urethra. This allows you to urinate normally.

Systemic Therapy

Systemic therapy is given before surgery and radiation in the form of chemotherapy or immunotherapy if your bladder cancer has spread to the bladder muscle or organs outside of the bladder. Chemotherapy and immunotherapy before surgery helps increase survival rates. 

Radiation Therapy

High-energy rays kill tumor cells. External radiation administered by a machine outside the body is most often used to treat bladder cancer. Radiation may be used as the main treatment for people who want to avoid bladder removal.

Our Locations

Duke Health offers locations throughout the Triangle. Find one near you.

Tests to Diagnose Bladder Cancer

Finding bladder cancer early and getting an accurate diagnosis is key to your health and outcomes.

Urine Cytology

Urine is analyzed under a microscope to check for cancer cells.


A narrow tube called a cytoscope is inserted into your bladder to let your doctor look carefully into your bladder and urethra, the tube through which urine exits the body. Your doctor may take a tissue sample at this time.

Advanced Imaging

Creates images of the structures in your urinary tract. Imaging may include specialized X-ray imaging (a pyelogram that uses dye to highlight bladder features) and CT scans of your urinary tract and nearby tissue. If you have confirmed bladder cancer, cancer-staging tests may include CT, MRI, bone scans and chest X-rays.

The Best Care for Bladder Cancer

A Nationally Ranked Program
We are a National Cancer Institute-designated Comprehensive Cancer Center. We are also part of the National Comprehensive Cancer Network (NCCN), an alliance of the nation’s leading cancer centers dedicated to improving care for our patients.

Expert, Personalized Care
We offer the treatments you need, from the least invasive to the most complex surgeries. We match your care to the type of bladder cancer you have, ensuring you receive the most effective treatments available.

More Options for Milder Treatments
If your cancer is within your bladder and has not spread into muscle layers, we offer more in-bladder surgical treatment options than most other cancer centers. This technique allows us to use your natural opening rather than making a surgical cut.

A Team of Specialists
Our urologic, radiation, and medical oncologists work together with ostomy and specialty nurses and psychologists to carefully monitor your cancer and your progress through treatment.

Access Clinical Trials at Duke

You may be eligible to participate in clinical trials that test advanced therapies before they become available.

Enhanced Recovery After Surgery
We are one of just a handful of U.S. centers that has an enhanced recovery program that adheres to guidelines to keep you healthier and get you back to the comfort of home sooner. This program is designed to reduce your in-hospital time and lessen the chance for complications, as well as monitor your need for pain medication and fluid levels for digestion.

Same-Day Scheduling
If you have a diagnosis of advanced bladder cancer, our doctors collaborate to offer same-day appointments for oncology, surgery, and imaging. Whenever possible, we see you within a week of you contacting us. You leave with a comprehensive treatment plan.

Support for You and Your Family
Our comprehensive cancer support services range from helping patients minimize the side effects of treatment to coping with the emotional and psychological effects of diagnosis and treatment. View all of our cancer support groups in our event calendar.

Best Cancer Hospital in North Carolina

Where you receive your cancer care is important. Duke University Hospital is proud of our team and the exceptional care they provide. They are why our cancer program is nationally ranked, and the highest-ranked program in North Carolina, according to U.S. News & World Report for 2023–2024.

This page was medically reviewed on 07/06/2023 by