Most bladder cancer patients will need surgery to help treat their cancer. Your doctor will talk to you about the type of surgery that is right for your specific cancer. Surgical procedures may include a transurethral resection of the bladder tumor (TURBT) or a radial cystectomy.

• Transurethral resection of the bladder tumor (TURBT). You will be asleep during a TURBT procedure. Your surgeon will place a small scope through the urinary opening and into the bladder. The surgeon will work from the inside to remove bladder cancer. This minimally invasive procedure does not require an incision. You may need a catheter to drain urine for a few days after the procedure. 
• Radical cystectomy. One in four patients will need a radical cystectomy to treat bladder cancer. Your surgeon will make an incision in the lower abdomen to remove your bladder. Then, your surgeon will reconstruct the urinary tract. Sometimes, the bladder can be rebuilt. This procedure is called a neobladder operation. Many patients, however, will have an external bag for urine. Your urologist will talk to you about each of these procedures, and what is best for you. 

Radiation therapy is also sometimes used to treat bladder cancer. You will meet with a radiation oncologist to talk about the risks and benefits of radiation. Your doctor will also explain what to expect during radiation therapy. 

A machine aims high-energy rays from outside the body to the specific location of the tumor. This can be done with precision so that radiation does not damage other areas of the body. Most patients have radiation daily for about five to seven weeks. The length and frequency of your radiation will depend on your specific cancer. 

Daily sessions last about 15-30 minutes. Before you start radiation, you will attend a treatment planning session. The radiation therapists will make a cast for you, which will help hold you in position during your radiation sessions. Imaging tests, including a CT scan and an MRI, may be run. These tests help identify the precise location of your tumor. You will be given a very small tattoo to show the radiation therapist exactly where to aim the external radiation beam during your session. 

The entire planning session will take 2 1/2 hours. Be sure to follow all your doctor’s orders before your planning session. It may affect your treatment start date if you do not listen to instructions prior to your appointment. 

Some patients with bladder cancer may need chemotherapy or immunotherapy. These treatments kill cancer cells everywhere in your body. Your medical oncologist will talk to you about the plan that is right for you. 

You will need a complete physical exam before starting either of these treatments to check your blood counts, heart strength and overall health. 

Chemotherapy and immunotherapy are given in the Penn State Cancer Infusion Therapy location which is located in the Cancer Institute adjacent to the main entrance to the Medical Center in Suite T1300. Our staff will bring you to an infusion room, where you will receive your treatment. Medicine is injected directly into your blood stream through an intravenous line. Treatment can take anywhere from two to five hours, depending on your specific plan. A team of medical professionals will monitor you throughout your treatment to check for side effects. 

Symptoms of bladder cancer include:

• Blood in the urine (hematuria)
• Pain during urination or more frequent urination
• Pain in the lower part of abdomen or back

If you experience any of these symptoms, schedule an appointment with your doctor. Your doctor will do a complete examination, including asking about your personal and family medical history and a physical exam. You will also have a urinalysis, where a sample of urine will be collected and checked for blood or other abnormalities.

You may also need additional diagnostic testing, including:

• Urine cytology
• Cystoscopy
• Blue Light Cystoscopy (BLC™) with Cysview®
• Urine biomarker test
• CT (computerized tomography) urogram

These tests will help your urologic oncologist understand the extent of your cancer. After your tests are complete, you and your doctor will work together to create a treatment plan that is right for you.