Bladder Cancer

At your first appointment, your healthcare provider will do a physical exam and ask for a detailed medical history. They’ll also likely test your pee (urinalysis) to see if an infection is causing your symptoms.

If they think you might have cancer, your provider may do a cystoscopy. This test let’s your provider take a close look at what’s going on inside your body. They’ll insert a tube with a small camera on the end through your urethra (where your pee leaves your bladder and goes out of your body) to look inside your bladder for cancer cells. Don’t worry — you’ll get a numbing gel so you won’t feel any pain when they do this. And you’ll go home the same day.

If this test finds cancer, your provider will likely have you do a few imaging tests, like an MRI and CT scan, to get a closer look at what’s going on. You might also have a chest X-ray to check your lungs or a bone scan to see if the cancer has spread to your bones.

Meet Our Bladder Cancer Team

At Cleveland Clinic, your care team will include expert healthcare providers in many different specialties with a single, shared focus: you. 

Your bladder cancer care team could include:

• Urologists.
• Surgeons.
• Oncologists.
• Radiologists (imaging specialists).
• Pathologists (body tissue specialists).
• Anesthesiologists.
• Nurse practitioners.
• Physician assistants.
• Social workers.

Getting a second opinion for bladder cancer

Finding out you have bladder cancer can be shocking and overwhelming. So, it’s important to feel confident that you’ve chosen the right care team to help you navigate this journey. And sometimes, that means getting a second opinion.

At Cleveland Clinic, you can trust our highly skilled cancer providers to answer your questions and listen to your concerns. We can help confirm a diagnosis and offer our expert advice on treatment options. 

Worried you’ll upset your current provider by reaching out to us? We regularly consult with other providers, and we’ll never do anything to harm your relationship with them. 

And because we know that cancer doesn’t wait, we always try to get you in to see us as soon as possible. When it comes to your care, you want to feel in control. A second opinion can give you peace of mind knowing that you’re in the most capable and compassionate hands. 

Your treatment will depend on the stage of the cancer — how big it is and if it has spread outside your bladder to other parts of your body. You could have a combination of any or all treatments. Often, surgery is the first option, followed by chemotherapy, targeted therapy, immunotherapy or radiation therapy. Your providers will work with you to decide what they think will give you the best outcome.

Surgery

Depending on the cancer’s stage, your provider might choose to start with surgery as the first step of your treatment. 

Transurethral resection of a bladder tumor (TURBT)

This procedure removes cancer cells (tumor) with a special telescope (resectoscope) inserted into your bladder through your urethra. You’ll be asleep under anesthesia when they do this, so you won’t feel a thing. Your provider will either use high-energy electricity (fulgration) to destroy the tumor or remove it for more testing. After the tumor is removed, a pathologist will test it to see what type of tumor it is and what stage cancer you have.  

Radical cystectomy

If the cancer has spread into your bladder walls or outside of your bladder, your provider may recommend chemotherapy, followed by a radical cystectomy to remove your entire bladder. We often do this using robotic surgery tools, so you’ll have smaller cuts than an open surgery and (usually) a shorter recovery time. 

If we have to remove your bladder, we can rebuild your urinary tract so you can continue to remove pee from your body. This is called urinary diversion and there are several ways to do it. If you need this procedure, your providers will help you understand how it works and what to expect from life going forward. 

Chemotherapy

Having chemotherapy means you’ll get drugs that destroy cancer cells. Often, you’ll get these drugs through intravesical therapy, which means the chemo drugs are sent directly to your bladder through a tube in your urethra, instead of through a vein. This makes sure the drugs only reach your bladder, lowering the risk of damaging healthy tissue in your body.

Immunotherapy

Immunotherapy uses your immune system to attack cancer cells. Your provider might give you the Bacillus Calmette-Guérin (BCG) vaccine into your bladder, which helps boost your immune system to fight bladder cancer. 

Or they might use PD-1 and PD_L1 inhibitory therapy. These proteins are found on certain cells — one on T-cells that control your body’s immune response and one on cancer cells. Usually when these cells connect, the cancer can grow. But if we use this therapy, they don’t connect, and the T-cells can do their job. 

Radiation therapy

Sometimes, we can avoid removing your bladder by using radiation therapy and combining it with TURBT and chemotherapy. We’ll look at how fast your tumor is growing, as well as other factors, to decide if this is the right treatment for you.

Targeted therapy

Using targeted therapy, your providers focus on your genes. Sometimes, genetic changes can turn healthy cells into cancer cells. We can use drugs that target these changed cells and stop cancer from growing.

Taking the Next Step

A bladder cancer diagnosis can change your life in an instant. But knowing you have the best care team on your side can help you feel a little more at ease. At Cleveland Clinic, we’ll be with you every step of the way — from the day you step through our doors to follow-up care after treatment. Answering your questions and guiding you throughout the whole process, we work together to help you get the best possible care. You’ll never have to face any part of bladder cancer alone.