Materiały źródłowe

• #1 Bladder Cancer Treatment – NCI

  https://www.cancer.gov/types/bladder/treatment

  Different types of treatment are available for bladder cancer. You and your cancer care team will work together to decide your treatment plan, which may include more than one type of treatment. […] Surgery is the main treatment for bladder cancer. The type of surgery depends on where the cancer is located. Other treatments may be given in addition to surgery: […] Treatment given before surgery is called preoperative therapy or neoadjuvant therapy. Chemotherapy may be given before surgery to shrink the tumor and reduce the amount of tissue that needs to be removed during surgery. […] Treatment given after surgery, to lower the risk that the cancer will come back, is called adjuvant therapy. After the doctor removes all the cancer that can be seen, some patients may be given chemotherapy, radiation therapy, immunotherapy, and/or targeted therapy to kill any cancer cells that are left.

• #1 Bladder Cancer Treatment – NCI

  https://www.cancer.gov/types/bladder/treatment

  Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Bladder cancer is sometimes treated with external beam radiation therapy. […] Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given alone or with other types of treatment. […] Systemic chemotherapy for bladder cancer is when chemotherapy drugs are injected into a vein. […] For bladder cancer, chemotherapy may be intravesical, meaning it is put into the bladder through a tube inserted into the urethra. […] Immunotherapy helps a person’s immune system fight cancer. […] Systemic immunotherapy drugs used to treat urothelial cancer (a type of bladder cancer) include:

• #1 Bladder Cancer Treatment – NCI

  https://www.cancer.gov/types/bladder/treatment

  These drugs work in more than one way to kill cancer cells. […] Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells. […] Targeted therapies used to treat bladder cancer include: […] For some people, joining a clinical trial may be an option. […] Some of the tests that were done to diagnose or stage the cancer may be repeated. Some tests will be repeated to see how well the treatment is working.

• #2 Treating Bladder Cancer | Bladder Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/treating.html

  If youve been diagnosed with bladder cancer, youll likely need more tests so your doctors can learn more about your cancer. Your treatment team will then discuss your options with you. Its important to weigh the benefits of each treatment option against the possible risks and side effects. […] Depending on the stage of the cancer and other factors, treatment options for people with bladder cancer can include: Bladder Cancer Surgery, Intravesical Therapy for Bladder Cancer, Chemotherapy for Bladder Cancer, Radiation Therapy for Bladder Cancer, Immunotherapy for Bladder Cancer, Targeted Therapy Drugs for Bladder Cancer. […] Surgery, alone or with other treatments, is used to treat most bladder cancers. […] Early-stage bladder tumors can often be removed. But a major concern in people with early-stage bladder cancer is that new cancers often form in other parts of the bladder over time. Removing the entire bladder (with a radical cystectomy) is one way to lower the risk of the cancer coming back, but it causes major side effects. If the entire bladder is not removed, other treatments may be used to try to lower the risk of new cancers.

• #2 Treating Bladder Cancer | Bladder Cancer Treatment | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/treating.html

  Surgery is also often part of the treatment for more advanced bladder cancers, although other treatments are typically used as well, sometimes even before surgery. […] Its important to discuss all of your treatment options, including goals and possible side effects, with your doctors to help make the decision that best fits your needs. […] Clinical trials are carefully controlled research studies that are done to get a closer look at promising new treatments or procedures. Clinical trials are one way to get state-of-the-art cancer treatment. […] You may hear about alternative or complementary methods to relieve symptoms or treat your cancer that your doctors havent mentioned. […] Complementary methods are treatments that are used along with your regular medical care. Alternative treatments are used instead of standard medical treatment.

• #3 Bladder cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109

  Treatment options for bladder cancer depend on a number of factors, including the type of cancer, grade of the cancer and stage of the cancer, which are taken into consideration along with your overall health and your treatment preferences. […] Bladder cancer treatment may include: Surgery, to remove the cancer cells; Chemotherapy in the bladder (intravesical chemotherapy), to treat cancers that are confined to the lining of the bladder but have a high risk of recurrence or progression to a higher stage; Chemotherapy for the whole body (systemic chemotherapy), to increase the chance for a cure in a person having surgery to remove the bladder, or as a primary treatment when surgery isn’t an option; Radiation therapy, to destroy cancer cells, often as a primary treatment when surgery isn’t an option or isn’t desired; Immunotherapy, to trigger the body’s immune system to fight cancer cells, either in the bladder or throughout the body; Targeted therapy, to treat advanced cancer when other treatments haven’t helped.

• #3 Bladder cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109

  Approaches to bladder cancer surgery might include: Transurethral resection of bladder tumor (TURBT). TURBT is a procedure to diagnose bladder cancer and to remove cancers confined to the inner layers of the bladder those that aren’t yet muscle-invasive cancers. […] Cystectomy is surgery to remove all or part of the bladder. […] Neobladder reconstruction. After a radical cystectomy, your surgeon must create a new way for urine to leave your body (urinary diversion). […] Chemotherapy uses drugs to kill cancer cells. Chemotherapy treatment for bladder cancer usually involves two or more chemotherapy drugs used in combination. […] Radiation therapy uses beams of powerful energy, such as X-rays and protons, to destroy the cancer cells. […] Immunotherapy is a drug treatment that helps your immune system to fight cancer.

• #3 Bladder cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109

  What are my treatment options? […] The treatment options depend on the grade and stage of your tumor. If you have a high-grade, non-muscle-invasive bladder cancer, we generally treat that with a transurethral resection of the bladder tumor, followed by intravesicle therapy, either with chemotherapy or immunotherapy, like BCG. If you have an invasive carcinoma, such as a muscle-invasive cancer, we generally treat that with upfront cisplatin-based combination chemotherapy, followed by removal of the bladder or radiation. There are quality of life and toxicity considerations with each of those options, and it’s up to the individual to decide which is right for them. Adjuvant immunotherapy is a type of treatment that’s given after surgery to help mitigate the risk of cancer recurrence down the road. Patients who have stage 4 bladder cancer are generally treated with first-line cisplatin-based combination chemotherapy.

• #3 Bladder cancer – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109

  Targeted therapy drugs focus on specific weaknesses present within cancer cells. […] In certain situations, people with muscle-invasive bladder cancer who don’t want to undergo surgery to remove the bladder may consider trying a combination of treatments instead. Known as trimodality therapy, this approach combines TURBT, chemotherapy and radiation therapy. […] Bladder cancer may recur, even after successful treatment. Because of this, people with bladder cancer need follow-up testing for years after successful treatment.

• #4 Patient education: Bladder cancer treatment; non-muscle invasive (superficial) cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bladder-cancer-treatment-non-muscle-invasive-superficial-cancer-beyond-the-basics/print

  Patient education: Bladder cancer treatment; non-muscle invasive (superficial) cancer (Beyond the Basics) […] The optimal treatment for urothelial bladder cancer depends on the cancer’s stage and grade: […] Approximately 70 percent of all new cases of bladder cancer are classified as non-muscle invasive, also called superficial bladder cancer. The initial treatment for this stage of bladder cancer is surgical removal of the tumor through a cystoscope, called transurethral resection of bladder tumor (TURBT). This is often followed by adjuvant (additional) therapy, which reduces the chances of the cancer recurring. […] The most common first treatment of non-muscle invasive bladder cancer is surgery to remove any abnormal-appearing areas inside the bladder; this is called transurethral resection of bladder tumor (TURBT).

• #5 Bladder Cancer Treatment & Management: Approach Considerations, Transurethral Resection of Bladder Tumors (TURBT), Treatment of Non–Muscle-Invasive Disease (Ta, T1, CIS)

  https://emedicine.medscape.com/article/438262-treatment

  The EAU guidelines recommend that patients with intermediate- and high-risk tumors receive intravesical BCG after transurethral resection of bladder tumors (TURBT) to reduce the risk of tumor recurrence. For optimal efficacy, BCG must be given on a maintenance schedule; 3-year maintenance is more effective than 1-year to prevent recurrence of high-risk tumors, but not of intermediate-risk tumors. […] […] Endoscopic TURBT is the first-line intervention to diagnose, stage, and treat visible tumors. TURBT is not effective for CIS, because the disease is often so diffuse and difficult to visualize that complete surgical removal may not be feasible. It is critically important to surgically remove all nonmuscle-invasive disease prior to beginning intravesical therapy. When a combination of papillary tumor and CIS is present, the papillary tumor is removed before treatment of the CIS is initiated. […]

• #5 Bladder Cancer Treatment & Management: Approach Considerations, Transurethral Resection of Bladder Tumors (TURBT), Treatment of Non–Muscle-Invasive Disease (Ta, T1, CIS)

  https://emedicine.medscape.com/article/438262-treatment

  Nevertheless, Chedgy and Black consider cystectomy and trimodality therapy to be complementary. They observe that many patients considered ineligible for radical cystectomy may be candidates for trimodality therapy, especially if radiosensitization is performed with 5-fluorouracil and mitomycin. […] […] In contrast, Mitin recommends considering trimodality therapy as the first option for patients with muscle-invasive bladder cancer, with cystectomy reserved for patients who are unable or unwilling to undergo bladder preservation or for salvage in the case of local recurrence. Mitin cites literature demonstrating similar or better outcomes compared with cystectomy and excellent quality of life, with low rates of radiation-induced adverse effects. […] […] Trimodality therapy carries a significant local recurrence rate, however, which necessitates thorough and frequent cystoscopic follow-up. Local recurrence requiring salvage cystectomy is usually identified within the first 3 years. Morbidity and mortality rates with salvage cystectomy are remarkably similar to those with first-line radical cystectomy, but reconstructive options with salvage cystectomy may be limited by the presence of irradiated bowel, which may be unacceptable for a continent reservoir or a neobladder creation. […]

• #5 Bladder Cancer Treatment & Management: Approach Considerations, Transurethral Resection of Bladder Tumors (TURBT), Treatment of Non–Muscle-Invasive Disease (Ta, T1, CIS)

  https://emedicine.medscape.com/article/438262-treatment

  The treatment of nonmuscle-invasive (Ta, T1, carcinoma in situ [CIS]) and muscle-invasive bladder cancer should be differentiated. Treatments within each category include surgical and medical approaches. European Association of Urology (EAU) and National Comprehensive Cancer Network (NCCN) guidelines for nonmuscle-invasive bladder cancer (NMIBC) strongly recommend stratifying risk of recurrence and progression and using risk tables to determine appropriate treatment. […] […] The two principal treatment choices in muscle-invasive bladder cancer are radical cystectomy and transurethral resection of bladder tumor (TURBT) followed by concurrent radiation therapy and systemic chemotherapy (trimodality therapy). Each choice has its advocates. […] […] Chedgy and Black propose that radical cystectomy should be considered the gold-standard treatment for muscle-invasive bladder cancer. They cite recommendations from European and United States guidelines, as well as published literature showing a 75% 5-year cancer-specific survival for all stages of bladder cancer treated with cystectomy, while noting that the published literature on trimodality therapy shows evidence of inferior survival and frequent treatment failure, with almost one-third of patients eventually requiring a salvage cystectomy. […]

• #6 Bladder Cancer Treatment: Treatment – Patient Information [NCI] | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.bladder-cancer-treatment-treatment-patient-information-nci.ncicdr0000062705

  The types of surgery done to treat bladder cancer are: Transurethral resection (TUR) with fulguration. During TUR with fulguration, the doctor inserts a cystoscope (a thin lighted tube) into the bladder through the urethra. A tool with a small wire loop on the end is then used to remove the cancer or to burn the tumor away with high-energy electricity. This is known as fulguration. Partial cystectomy is surgery to remove part of the bladder. This may be done for patients who have a low-grade tumor that has invaded the wall of the bladder but is limited to one area of the bladder. Because only a part of the bladder is removed, patients are able to urinate normally after recovering from this surgery. This is also called segmental cystectomy. Radical cystectomy with urinary diversion is surgery to remove the bladder and any lymph nodes and nearby organs that contain cancer. This surgery may be done when the bladder cancer invades the muscle layers or when non-muscle-invasive bladder cancer involves a large part of the bladder.

• #7 Immunotherapy after surgery helps people with high-risk bladder cancer live cancer-free longer | National Institutes of Health (NIH)

  https://www.nih.gov/news-events/news-releases/immunotherapy-after-surgery-helps-people-high-risk-bladder-cancer-live-cancer-free-longer

  Immunotherapy after surgery helps people with high-risk bladder cancer live cancer-free longer. Adjuvant pembrolizumab helps people with muscle-invasive bladder cancer remain cancer free longer than with observation alone. Results from a large clinical trial show that treatment with an immunotherapy drug may nearly double the length of time people with high-risk, muscle-invasive bladder cancer are cancer-free following surgical removal of the bladder. Researchers found that postsurgical treatment with pembrolizumab (Keytruda) was superior compared with observation. This study shows that pembrolizumab can offer patients another treatment option to help keep their disease from coming back. In 2021, FDA approved nivolumab (Opdivo) as an adjuvant therapy for people with high-risk, muscle-invasive bladder cancer after a clinical trial showed that this immune checkpoint inhibitor doubled the median length of time patients remained cancer-free compared with a placebo. In the current trial, researchers investigated whether the immune checkpoint inhibitor pembrolizumab would also be effective as an adjuvant treatment. After a median follow-up of almost four years, patients in the pembrolizumab group remained cancer-free for a median of 29.6 months, compared with 14.2 months for the observation group. Pembrolizumab was well tolerated. The researchers concluded that PD-L1 status should not be used to select patients for treatment with pembrolizumab, as both groups benefited from adjuvant pembrolizumab. Research teams are already building on the study’s findings by exploring adjuvant treatment using various combinations of drugs with immune checkpoint inhibitors.

• #8 Patient education: Bladder cancer treatment; muscle invasive cancer (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/bladder-cancer-treatment-muscle-invasive-cancer-beyond-the-basics/print

  An important part of radical cystectomy is removal of all lymph nodes in the pelvic region that could contain tumor cells. […] After your bladder is removed, the surgeon must create a new place for urine to be collected inside the body. This is called a „urinary diversion.” […] The preferred option for bladder preservation is chemotherapy plus radiation (chemoradiotherapy), which is given after transurethral resection of bladder tumor (TURBT); together this is often called trimodal therapy. […] Chemoradiotherapy (also known as trimodal therapy [TMT]) is a treatment that involves using radiation therapy to the bladder and pelvis along with chemotherapy. […] Partial cystectomy is a surgical procedure in which the tumor and some surrounding bladder tissue are removed, allowing you to keep the remaining healthy bladder. […] For patients with metastatic cancer, treatment options include immunotherapy (medications that work with your immune system to attack cancer cells), targeted therapy (medications that specifically target tumor cells), and chemotherapy.

• #9 Bladder Cancer Treatment | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bladder/treatment

  Non-muscle invasive bladder cancer (NMIBC) can be treated with surgery followed by bacillus Calmette-Gurin (BCG) therapy. People often come to MSK for BCG treatment after their healthcare provider offered chemotherapy as the only treatment option for high-grade NMIBC. […] Surgery is a treatment for bladder cancer that has not spread to other parts of the body. For early-stage cancer, we use transurethral (TRANZ-yoo-REE-thrul) resection of a bladder tumor (TURBT). In this surgery, we remove the tumor using a tool in the cystoscope. […] For higher risk bladder cancer, often the best treatment is removing your bladder. This is called a radical cystectomy. We can often create a new bladder at the same time. This is called a neobladder. You will not need a pouch outside your body that collects urine.

• #9 Bladder Cancer Treatment | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bladder/treatment

  At MSK, radiation treatment is guided by very advanced imaging methods that are not available at most hospitals. This includes image-guided radiation therapy (IGRT), which can treat tumors with even more accuracy than regular radiation therapy. […] Immunotherapy triggers the bodys immune system to fight cancer cells. […] MSK is leading research on immunotherapy drugs called checkpoint inhibitors. This treatment can be used instead of chemotherapy. It also can be used after chemotherapy has been tried for advanced bladder cancer that has spread. For people who respond to checkpoint inhibitors, the drugs can have a longer impact than chemotherapy, with fewer side effects. […] The checkpoint inhibitor called pembrolizumab also can be used for non-muscle invasive bladder cancer (NMIBC). Its for people with NMIBC that has returned and is worse after BCG therapy.

• #9 Bladder Cancer Treatment | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bladder/treatment

  Most bladder cancer treatment is successful. But its important to be checked for signs of the cancer coming back. Youre still at risk for getting bladder cancer. Your care team will monitor you for any signs of cancer. […] During your follow-up care, you will see an MSK advanced practice provider (APP). One type of APP is a nurse practitioner (NP). Your NP has special training in follow-up care for people who had bladder cancer. They will monitor you for signs of cancer and help you manage any side effects after treatment. […] MSKs bladder cancer experts deliver high quality, compassionate cancer care. Our team of urinary oncology experts is among the most experienced in the world in all forms of bladder cancer treatment. MSK is ranked #1 in Urology Cancer Care by U.S. News World Report. MSK experts work very closely together to share treatment ideas. They help you start care right away, which can mean better treatment results.

• #10 Intravesical Therapy for Bladder Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/treating/intravesical-therapy.html

  There are 2 main types of medicines used in intravesical therapy: Immunotherapy and Chemotherapy. […] BCG is the most common intravesical immunotherapy for treating early-stage bladder cancer. […] Treatment with BCG can cause a wide range of symptoms. […] Adstiladrin can be used to treat NMIBC that is at high risk of returning and that isn’t being helped by treatment with BCG. […] Side effects from this medicine can include bladder symptoms such as pain or burning when urinating, blood in the urine, or having to go more often. […] For this treatment, a chemotherapy (chemo) drug is put right into the bladder through a catheter. […] The main side effects of intravesical chemo are irritation and a burning feeling in the bladder, and blood in the urine. […] A major advantage of giving chemo right into the bladder instead of injecting it into the bloodstream is that the drugs usually do not reach and affect other parts of the body.

• #10 Intravesical Therapy for Bladder Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/treating/intravesical-therapy.html

  Intravesical therapy is used mainly for some early-stage bladder cancers that are still only in or very close to the inner lining of the bladder, where almost all bladder cancers start. […] Drugs given directly into the bladder affect the cells lining the inside of the bladder but have very little effect on cells elsewhere. This means that intravesical therapy isn’t likely to be helpful in treating cancer cells that have grown deeply into the bladder wall, or cancer cells in other parts of the body. […] A TURBT is often done both to confirm the diagnosis of bladder cancer and to see how deeply it has invaded into the bladder wall. Often, a single dose of intravesical chemotherapy is given within a day of the TURBT. This can help lower the risk of bladder tumors coming back later. […] Most often, intravesical therapy is used after a TURBT.

• #10 Intravesical Therapy for Bladder Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/bladder-cancer/treating/intravesical-therapy.html

  If further intravesical treatments (immunotherapy or chemotherapy) are needed, they’re usually started a few weeks later. […] For some low-risk cancers, no further treatment might be needed. […] For intermediate- and high-risk cancers, intravesical therapy is often given weekly for about 6 weeks, and then less often (for about a year for intermediate-risk cancer or up to 3 years for high-risk cancer). […] Your doctor will talk with you about a treatment schedule based on your bladder cancer and how it responds to treatment. […] These cancers have reached the muscle layer of the bladder wall. […] If a TURBT is done as the initial surgery (which isn’t often for MIBC), a dose of intravesical chemotherapy is often given within 24 hours. […] More advanced bladder cancers are rarely treated with intravesical therapy.

• #11

• #12 Treatments for stage 2 and stage 3 bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/treatment/stage-2-and-3

  The following are treatment options for stage 2 and stage 3 bladder cancer. […] Before any treatment starts, your healthcare team will suggest treatments based on your needs and work with you to develop the best treatment plan. Most often the whole bladder needs to be removed. But sometimes it may be possible to keep the bladder, which is called a bladder-preserving approach. The order you receive treatments depends on if you are offered a bladder-preserving approach or not. […] Chemotherapy is almost always offered for stage 2 and stage 3 bladder cancer. It is often given before radical cystectomy surgery, but it can be given after surgery if it wasn’t already used. Chemotherapy may also be used alone if surgery can’t be done. […] Chemotherapy is given as a systemic therapy through a needle into a vein. A combination of chemotherapy drugs that includes cisplatin is standard treatment for stage 2 and stage 3 bladder cancer.

• #12 Treatments for stage 2 and stage 3 bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/treatment/stage-2-and-3

  Targeted therapy is sometimes used to treat locally advanced bladder cancer. Targeted therapy uses drugs to target specific molecules (such as proteins) on or inside cancer cells to stop the growth and spread of cancer and limit harm to normal cells. Erdafitinib (Balversa) can be used to treat locally advanced bladder cancer that has mutations in the FGFR2 or FGFR3 gene and doesn’t respond to chemotherapy. […] Immunotherapy helps to strengthen or restore the immune system’s ability to fight cancer. You may be offered an immune checkpoint inhibitor for stage 2 or 3 bladder cancer that: is still growing during or after chemotherapy that includes the drug cisplatin, comes back within 12 months of finishing chemotherapy, can’t be treated with surgery or chemotherapy, has a high risk of coming back after surgery.

• #13 Bacillus Calmette-Guérin (BCG) Therapy for Bladder Cancer | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/bladder/treatment/bacillus-calmette-guerin-therapy

  Bacillus Calmette-Gurin (buh-SIH-lus KAL-met-gay-RIN) therapy is a type of immunotherapy that treats bladder tumors. Its the most common kind of intravesical immunotherapy used to treat early-stage bladder cancer. Intravesical (IN-truh-VEH-sih-kul) is when the drugs go right into your bladder through a tube placed in your urethra. […] The BCG in this drug is inactivated tuberculosis (TB) bacteria made from a type of Mycobacterium bovis. This is a liquid drug that goes into your bladder through a catheter (small tube) placed in your urethra. BCG triggers an inflammatory response in your bladder that stops the tumor from coming back. […] MSK offers BCG treatment is an alternative to chemotherapy for high grade non-muscle invasive bladder cancer (NMIBC). People often come to MSK for BCG treatment after their healthcare provider offered chemotherapy as the only treatment option.

• #14 Bladder Cancer Treatment | Cxbladder

  https://www.cxbladder.com/us/patients/bladder-cancer-faqs/treatment/

  Radiotherapy uses high-energy waves to kill cancer cells. […] Immunotherapy helps the body’s immune system recognize and attack cancer cells. […] Bacillus Calmette-Guerin (BCG) is a weakened form of the bacterium that causes tuberculosis (TB) and was originally used for TB vaccination. […] Immune checkpoint inhibitors help to restore the immune response against cancer cells and are a major development in treatment, but only about 20% of bladder cancer patients will benefit. […] Targeted therapies are designed to target features of cancer cells that differ from healthy cells, such as gene alterations or cell-surface proteins. […] At diagnosis, a disease stage from 0 to 4 is assigned by combining information on the tumor (T), lymph nodes (N) and any metastasis (M); stage 0 is superficial cancer and stage 4 means cancer has spread to other parts of the body.

• #14 Bladder Cancer Treatment | Cxbladder

  https://www.cxbladder.com/us/patients/bladder-cancer-faqs/treatment/

  If you or a loved one have been diagnosed with bladder cancer, you undoubtedly have many questions about what comes next. The best treatment for each person depends on the type of bladder cancer, their overall health and personal priorities, so your doctor will discuss an individual treatment plan. […] Treatment for bladder cancer depends on the tumor characteristics and the disease stage, which identifies whether the tumor is superficial (only in the bladder lining) or invasive (growing into the underlying connective tissue or muscle layers), and whether it has spread beyond the bladder. Depending on the stage and grade of disease most patients will have surgery, often followed by radiation therapy and medical treatment (such as BCG and/or chemotherapy drugs). […] Several new treatments for bladder cancer such as immune checkpoint inhibitors and targeted therapies have become available in recent years.

• #15 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=34&contentid=17223-1

  These medicines target certain proteins that keep immune system cells from killing cancer cells. When these proteins are blocked, your immune system is able to stop tumor growth, make tumors grow at a slower rate, or kill cancer cells. […] Antibody-drug conjugates (ADCs) are another type of immunotherapy. They consist of monoclonal antibodies that are linked to chemo medicines. Once inside the body, the monoclonal antibody part acts like a homing device, taking the chemo medicine right to the cancer cells. Two types of ADCs are enfortumab vedotin and sacituzumab govitecan.

• #16 6 Innovative Bladder Cancer Treatment Options | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/bladder-cancer/bladder-cancer-treatment.html

  Chemotherapy can be used with surgery when bladder cancer has a high risk of metastasis. Bladder tumors that have invaded the muscle wall and have the potential to spread can benefit from chemotherapy before surgery. […] Antibody drug conjugates link cancer fighting drugs like chemotherapy with antibodies designed in a lab to recognize cancer cells. This combination delivers powerful doses of medication while limiting negative side effects. […] Immune checkpoint inhibitors are a type of immunotherapy. They stop the immune system from turning off before cancer is completely eliminated. […] For bladder cancer, immune checkpoint inhibitors are currently used only for stage IV cancer. Clinical trials are underway to study the use of these drugs in other settings. […] Targeted therapy drugs are designed to stop or slow the growth or spread of cancer. This happens on a cellular level.

• #17 Transformative advances in bladder cancer treatment – Mayo Clinic

  https://www.mayoclinic.org/medical-professionals/cancer/news/transformative-advances-in-bladder-cancer-treatment/mac-20579793

  Transformative advances in bladder cancer treatment […] Bladder cancer treatment has undergone remarkable advancements over the past decade, driven by innovative clinical trials and new therapeutic options. These developments are not only enhancing patient outcomes but also offering bladder-sparing alternatives. […] One of the most significant advancements in bladder cancer treatment is the Food and Drug Administration’s 2023 approval of a combination therapy involving enfortumab vedotin and pembrolizumab (EV/pembro) for locally advanced or metastatic urothelial bladder cancer. […] Clinical trials are at the forefront of advancing bladder cancer treatment, offering new hope and improved outcomes for patients. […] The landscape of bladder cancer treatment has evolved significantly, offering patients more options and better outcomes. Clinical trials continue to play a pivotal role in these advancements, providing new therapies and improving existing ones.

• #18 Bladder Cancer Treatment – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK66044/

  The types of surgery done to treat bladder cancer are: Transurethral resection (TUR) with fulguration, Partial cystectomy, Radical cystectomy with urinary diversion. […] Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Bladder cancer is sometimes treated with external beam radiation therapy. This type of radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer. Radiation therapy may be given alone or with other types of treatment, such as chemotherapy. […] Chemotherapy (also called chemo) uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given alone or with other types of treatment. The way the chemotherapy is given depends on the type and stage of the cancer being treated.

• #18 Bladder Cancer Treatment – PDQ Cancer Information Summaries – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK66044/

  Immunotherapy helps a person’s immune system fight cancer. Your doctor may suggest biomarker tests to help predict your response to certain immunotherapy drugs. […] Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells. Your doctor may suggest biomarker tests to help predict your response to certain targeted therapy drugs. […] Treatment of bladder cancer that has recurred (come back) depends on previous treatment and where the cancer has come back. Treatment may include systemic chemotherapy, an immunotherapy drug, a targeted therapy drug, surgery for non-muscle-invasive or localized tumors, which may be followed by immunotherapy and chemotherapy, radiation therapy as palliative therapy.

• #19 How We Treat Bladder Cancer | Dana-Farber Cancer Institute

  https://www.dana-farber.org/cancer-care/types/bladder-cancer/treatment

  Active surveillance (also known as „watchful waiting”) is a crucial part of any treatment plan for bladder cancer patients. Bladder cancer tends to return, even if the cancer is an early-stage or non-invasive diagnosis. […] Surgical approaches to the treatment of bladder cancer include: Transurethral resection of the bladder tumor (TURBT): Uses special instruments attached to a cystoscope to cut the tumor and remove it with an electrical cautery device or laser. […] Medical oncologists are doctors who study cancer tumors and deliver chemotherapy (drugs that eliminate cancer cells or stop them from dividing). […] Chemotherapy for bladder cancer may be given at any stage of the disease to control the tumor or ease the surgical process. Chemotherapy can be used before or after surgery, or in combination with radiation as a bladder-sparing treatment. […] Immunotherapy is a type of treatment that uses the patient’s immune system to fight cancer cells. […] Immunotherapy is usually suggested for early, superficial bladder cancers. The standard immunotherapy treatment for superficial cancer involves the bacteria Bacillus Calmette-Guerin (BCG). […] Dana-Farber Brigham Cancer Center offers one of the largest and most active clinical trial programs available, including clinical trials for patients with bladder cancer. […] Radiation may be used to treat certain bladder cancer patients, but it is not recommended for most patients, as bladder cancer often requires many radiation treatments. […] Radiation therapy is most common for stage II cases of bladder cancer where the cancer has invaded the muscle, but not spread. […] Our radiation oncologists deliver the most advanced radiation treatments for bladder cancer, including 3D imaging radiation therapy, also called intensity-modulated radiation therapy (IMRT).

• #20 Bladder Cancer Treatment & Pharmacologic Management

  https://www.cancertherapyadvisor.com/ddi/bladder-cancer-treatment-pharmacologic-management/

  Targeted therapies are designed to block specific genetic or molecular pathways that are disrupted in cancer cells. Examples include gene therapies and kinase inhibitors. […] As the name suggests, combination therapies combine multiple FDA-approved pharmacotherapies to optimize treatment of a disease. This is most frequently recommended as systemic chemotherapy during late-stage disease. […] Different treatments are recommended based on stage of disease, size of lesion, and responsiveness to previous treatment. […] Guidelines for the pharmacotherapeutic treatment of bladder cancer consider the following factors: Size of the tumor, Whether the tumor has invaded the muscle, What surrounding organs have been invaded, Whether the cancer has spread to local lymph nodes, Whether and the extent to which the tumor has metastasized, Previous treatments (including surgery and radiation therapy), Previous responsiveness to treatments, Individual health history.

• #21 Treatments for bladder cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/bladder/treatment

  If you have bladder cancer, your healthcare team will create a treatment plan just for you. It will be based on your health and specific information about the cancer. When deciding which treatments to offer for bladder cancer, your healthcare team will consider: […] Surgery and immunotherapy are the main treatments for stage 0 bladder cancer. […] Surgery and chemotherapy are the main treatments for stages 2 and 3 bladder cancer. […] Surgery and chemotherapy are the main treatments for stage 4 bladder cancer. […] Treatment of recurrent bladder cancer depends mainly on where the cancer recurs and past treatment. […] Surgery is the primary treatment for bladder cancer. […] Immunotherapy is commonly used to treat bladder cancer. It helps strengthen the immune system to fight cancer.

• #22 Intravesical Therapy for Bladder Cancer | BCAN

  https://bcan.org/intravesical-therapy/

  Adstiladrin is a gene therapy approved for patients with carcinoma in situ (CIS) who did not respond to BCG. Delivered directly into the bladder, Adstiladrin introduces a gene called interferon alpha-2b, which activates immune cells to target and kill cancer cells. […] Anktiva is an immunotherapy that enhances the immune response against bladder cancer by activating a protein called interleukin-15. Its approved for patients with CIS who didnt respond to BCG and is used together with BCG to boost its effectiveness. […] Chemotherapy (chemo) drugs can be put right into the bladder through a catheter. These drugs kill actively growing cancer cells. Intravesical chemotherapy is a treatment for bladder cancer that also puts special medicine directly into the bladder using a thin tube called a catheter. This type of chemotherapy is usually used when another treatment called BCG does not work.

• #23 Bladder Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/bladder/hp/bladder-treatment-pdq

  Treatment of nonmuscle-invasive bladder cancers (Ta, Tis, T1) is based on risk stratification. Essentially all patients are initially treated with transurethral resection (TUR) of the bladder tumor, followed by a single immediate instillation of intravesical chemotherapy (mitomycin is typically used in the United States). […] Standard treatment for patients with muscle-invasive bladder cancers whose goal is cure is either neoadjuvant multiagent cisplatin-based chemotherapy followed by radical cystectomy and urinary diversion or radiation therapy with concomitant chemotherapy. […] Radical cystectomy is a standard treatment option for stage II and stage III bladder cancer, and its effectiveness at prolonging survival increases if it is preceded by cisplatin-based multiagent chemotherapy.

• #23 Bladder Cancer Treatment (PDQ®) – NCI

  https://www.cancer.gov/types/bladder/hp/bladder-treatment-pdq

  Enfortumab vedotin plus pembrolizumab is a first-line therapy option for patients without a contraindication. […] The combination of the two agents showed a promising response rate and duration of response, leading to a single-arm phase II trial and then a comparison with chemotherapy in a randomized, controlled, phase III trial. […] For many years, cisplatin-based chemotherapy was the standard-of-care first-line systemic treatment for patients with stage IV urothelial carcinoma who were eligible to receive cisplatin. […] Immunotherapy has emerged as a treatment alternative for patients with recurrent bladder cancer. […] Patients with symptomatic tumors should consider palliative radiation therapy. […] The prognosis for any patient with progressive or recurrent invasive bladder cancer is generally poor. Management of recurrence depends on previous therapy, sites of recurrence, and individual patient considerations. […] There are clinical trials suitable for patients with all stages of bladder cancer. Whenever possible, patients should consider clinical trials designed to improve upon standard therapy.

• #24 Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA/ASCO/ASTRO/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/bladder-cancer-non-metastatic-muscle-invasive-guideline

  For patients with newly diagnosed muscle-invasive bladder cancer, curative treatment options should be discussed before determining a plan of therapy that is based on both patient comorbidity and tumor characteristics. Patient evaluation should be completed using a multidisciplinary approach. (Clinical Principle) […] Utilizing a multidisciplinary approach, clinicians should offer cisplatin-based neoadjuvant chemotherapy (NAC) to eligible radical cystectomy patients prior to cystectomy. (Strong Recommendation; Evidence Level: Grade B) […] Patients who have not received cisplatin-based NAC and have pT3-4and/or N+ disease at cystectomy should be offered adjuvant cisplatin-based chemotherapy or adjuvant immunotherapy. Patients who have received cisplatin-based chemotherapy and have pT2-4and/or N+ at cystectomy should be offered adjuvant immunotherapy. (Moderate Recommendation; Evidence Level: Grade C)

• #24 Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA/ASCO/ASTRO/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/bladder-cancer-non-metastatic-muscle-invasive-guideline

  In patients who have a non-muscle invasive recurrence after bladder preserving therapy, clinicians may offer either local measures, such as TURBT with intravesical therapy, or radical cystectomy with bilateral pelvic lymphadenectomy. (Moderate Recommendation; Evidence Level: Grade C) […] Clinicians should obtain chest imaging and cross-sectional imaging of the abdomen and pelvis with CT or magnetic resonance imaging (MRI) at 6-12 month intervals for 2-3 years and then may continue annually. (Expert Opinion) […] Following therapy for muscle-invasive bladder cancer, patients should undergo laboratory assessment at three to six month intervals for two to three years and then annually thereafter. (Expert Opinion) […] In patients undergoing radical cystectomy with a retained urethra, clinicians should monitor the urethral remnant for recurrence. (Expert Opinion)

• #24 Treatment of Non-Metastatic Muscle-Invasive Bladder Cancer: AUA/ASCO/ASTRO/SUO Guideline – American Urological Association

  https://www.auanet.org/guidelines-and-quality/guidelines/bladder-cancer-non-metastatic-muscle-invasive-guideline

  Clinicians should discuss with patients how they are coping with their bladder cancer diagnosis and treatment and should recommend that patients consider participating in a cancer support group or consider receiving individual counseling. (Expert Opinion) […] Clinicians should encourage bladder cancer patients to adopt healthy lifestyle habits, including smoking cessation, exercise, and a healthy diet, to improve long-term health and QOL. (Expert Opinion) […] In patients diagnosed with variant histology, clinicians should consider unique clinical characteristics that may require divergence from standard evaluation and management for urothelial carcinoma. (Expert Opinion)

• #25 Advances in diagnosis and treatment of bladder cancer | The BMJ

  https://www.bmj.com/content/384/bmj-2023-076743

  The CheckMate 274 phase 3 trial compared one year of adjuvant nivolumab with placebo after R0 radical resection of high risk muscle invasive urothelial carcinoma. […] Various bladder sparing options have been explored that could benefit very carefully selected patients. […] Outside of the US, cisplatin based chemotherapy remains the gold standard treatment for metastatic urothelial carcinoma. […] Immune checkpoint inhibitors have emerged as a treatment option for metastatic urothelial carcinoma. […] Erdafitinib, a pan-FGFR inhibitor, is the only tyrosine kinase inhibitor currently approved by the FDA for treating advanced or metastatic urothelial carcinoma. […] Antibody-drug conjugates have begun to revolutionize the management of urothelial cancer.

• #26 Bladder Cancer Treatment Advances: What’s the Latest?  | Dana-Farber Cancer Institute

  https://blog.dana-farber.org/insight/2024/05/bladder-cancer-treatment-advances-whats-the-latest/

  Approved therapies include: Gene therapy and medical technology. […] A gene therapy called nadofaragene firadenovec (Adstiladrin). This gene therapy is a targeted form of immunotherapy. […] An immune therapy called nogapendekin alfa inbakicept (Anktiva). This therapy boosts the activity of another immune stimulating substance called interleukin-15. […] These two new therapies are joining another available immune therapy called pembrolizumab. […] A lot of progress has been made with immunotherapy. […] Another therapy, called cretostimogene, is showing promising results in phase 3 clinical trials. […] Other advanced therapies are also on the horizon, and multiple combinations of therapies are being tested in clinical trials. […] These new therapies are giving patients many exciting alternatives that are safe and dont dramatically lower quality of life.

• #27 Treatment options for muscle invasive bladder cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/bladder-cancer/treatment/invasive/decisions

  Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. […] You might have chemotherapy: before surgery or radiotherapy – this is called neoadjuvant chemotherapy; alongside radiotherapy, to make the radiotherapy work better – this is called chemoradiotherapy; after surgery, if you didn’t have it before – this is called adjuvant chemotherapy; as your main treatment, if your cancer is advanced (metastatic). […] Radiotherapy uses high energy rays to destroy cancer cells. […] You usually have radiotherapy with chemotherapy (chemoradiotherapy). […] Immunotherapy uses our immune system to fight cancer. […] A team of doctors and other professionals discuss the best treatment and care for you. […] Your doctor might ask you to choose between: surgery to remove your bladder or chemoradiotherapy; different ways of collecting urine after surgery if you are having surgery.

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