Treatment Options by Stage

Stage 0 (Papillary Carcinoma and Carcinoma in Situ)

Treatment of stage 0 may include the following:

• Transurethral resection with fulguration.
• Transurethral resection with fulguration followed by intravesical biologic therapy or chemotherapy.
• Segmental cystectomy.
• Radical cystectomy.
• A clinical trial of photodynamic therapy.
• A clinical trial of biologic therapy.
• A clinical trial of chemoprevention therapy given after treatment so the condition will not recur (come back).

Stage I

Treatment of stage I bladder cancer may include the following:

• Transurethral resection with fulguration.
• Transurethral resection with fulguration followed by intravesical biologic therapy or chemotherapy.
• Segmental or radical cystectomy.
• Radiation implants with or without external radiation therapy.
• A clinical trial of chemoprevention therapy given after treatment to stop cancer from recurring (coming back).

Stage II

Treatment of stage II bladder cancer may include the following:

• Radical cystectomy with or without surgery to remove pelvic lymph nodes.
• Combination chemotherapy followed by radical cystectomy.
• External radiation therapy combined with chemotherapy.
• Radiation implants before or after external radiation therapy.
• Transurethral resection with fulguration.
• Segmental cystectomy.

Stage III

Treatment of stage III bladder cancer may include the following:

• Radical cystectomy with or without surgery to remove pelvic lymph nodes.
• Combination chemotherapy followed by radical cystectomy.
• External radiation therapy combined with chemotherapy.
• External radiation therapy with radiation implants.
• Segmental cystectomy.

Stage IV

Treatment of stage IV bladder cancer may include the following:

• Radical cystectomy with surgery to remove pelvic lymph nodes.
• External radiation therapy (may be as palliative therapy to relieve symptoms and improve quality of life).
• Urinary diversion as palliative therapy to relieve symptoms and improve quality of life.
• Cystectomy as palliative therapy to relieve symptoms and improve quality of life.
• Chemotherapy alone or after local treatment (surgery or radiation therapy).