Bladder Cancer

Treatment by Bladder Cancer Experts

People with bladder cancer are cared for by compassionate and experienced bladder cancer experts at Wellstar. Each patient has access to comprehensive cancer care services and treatment plans personalized to their unique diagnosis.

Our multidisciplinary teams that care for people with bladder cancer include urologists, radiation oncologists, medical oncologists, pathologists and a robust support services team.

Our experts have experts

As a member of the Mayo Clinic Care Network, Wellstar gives our bladder cancer specialists the opportunity to eConsults — virtual second opinions — from Mayo Clinic specialists at no additional cost to the patient.

Nationally recognized care

Wellstar is accredited by the American College of Surgeons (ACS) Commission on Cancer (CoC) and received the Outstanding Achievement Award, the highest honor awarded to a cancer program in the United States.

Patient satisfaction

Our patients give Wellstar physicians high satisfaction scores thanks to our team’s compassion and expertise, commitment to getting your treatment started quickly and a robust network of patient support.

Bladder Cancer Diagnosis

Our bladder cancer experts help people get diagnosed and start treatment in a timely manner at Wellstar.

Symptoms of bladder cancer

It is important to be evaluated by a physician when there is blood in the urine and there is no known cause for it, such as passing a kidney stone or fighting a bladder infection. Other symptoms of bladder cancer include frequent urination, painful urination and back pain.

Tests to evaluate for bladder cancer

Physicians use several tests to evaluate for bladder cancer, including:

A urine sample being analyzed to look for cancer cells.;
A physical examination with a thin scope with a lens. Your urologist will pass the scope through the urethra to visually examine the inside of your bladder in a procedure known as a cystoscopy.
Taking a tissue sample. During the cystoscopy, a special tool can shave out a cell sample to test for bladder cancer. This is known as a transurethral resection of bladder tumor (TURBT) and can also treat early-stage or superficial bladder cancer by removing the cancer at the time of the biopsy.
Imaging tests, such as computerized tomography (CT) urogram or retrograde pyelogram, that allow physicians to examine the structure of the urinary tract. These detailed X-rays help physicians identify cancer.
More imaging to stage the cancer. When it is confirmed that someone has bladder cancer, more tests may be needed to stage it — or determine if it has spread to other parts of the body. These tests may include a CT scan, magnetic resonance imaging (MRI), positron emission tomography (PET), bone scan and chest X-ray. Wellstar Kennestone Hospital was one of the first hospitals in the country to install a state-of-the-art digital PET/CT.

Staging Bladder Cancer

After diagnosing bladder cancer, pathologists must stage the cancer. They look at important details gathered from the different tests to learn the size of the tumor, how aggressive it is and if the cancer has spread, and how far. This information is vital to building the most effective treatment plan.

Your physician may refer to your bladder cancer as high-grade or low-grade cancer, which refers to the appearance of the cells and the likelihood of their future behavior.

Low-grade (LG) cancer cells usually grow more slowly and are less likely to penetrate the muscular wall of the bladder.
High-grade (HG) cancer cells tend to be more aggressive and have a higher likelihood of spreading to the muscular wall of the bladder and other parts of the body.

The following terms also help your bladder cancer doctors explain the size and location of the tumor or how advanced it is. While this is not an all-inclusive list, these are the most common terms our patients hear:

Ta: Superficial cancer that has grown toward the hollow center of the bladder that is low-grade and non-aggressive.
Tis: This stage is known as carcinoma in situ (also referred to as CIS), describing a flat tumor that is growing on the lining of the bladder, but has not penetrated the tissue or the muscle.
T1: This stage describes when cancer has moved into the middle layer of the bladder but has not spread to nearby lymph nodes or to distant sites.
T2: This is when the tumor is in the muscle of the bladder.

Treatment for Bladder Cancer

Most bladder cancers are diagnosed at an early stage. In fact, we find the majority of bladder cancers when they are superficial and easily treatable. However, it is very common for bladder cancer to come back. It is important to follow up with your physician at the recommended intervals so bladder cancer that returns can be treated before it turns into something more serious. Our physicians employ the use of cystoscopy and urine cytology and CT scans to monitor people with moderate to high-risk bladder cancer at specific intervals of time.

Transurethral resection of bladder tumor (TURBT)

The procedure to biopsy, diagnose and stage bladder cancer is also a first-line treatment to remove the cancer. During a transurethral resection of bladder tumor (TURBT), superficial cancer is removed from the inner lining of the bladder, layer by layer. This procedure is performed with a resectoscope, inserted into the bladder through the urethra, and requires no incisions.

It is common for our urologists to also treat the bladder locally with chemotherapy at the same time as the procedure. Also known as intravesical chemotherapy, studies show this helps reduce the risk of the cancer returning.

A TURBT is often the only treatment needed for people with low-grade, non-aggressive bladder cancer. If it comes back, a TURBT can be performed again to remove the cancer. Someone with fast-growing bladder cancer that is non-invasive may have this procedure multiple times. For these patients, it can be more effective when combined with other therapies, such as intravesical Bacillus Calmette-Guerin therapy (BCG).

Bacillus Calmette-Guerin immunotherapy

The most common type of immunotherapy for bladder cancer is called Bacillus Calmette-Guerin (BCG) therapy. It is also known as intravesical BCG or simply BCG. When combined with TURBT, it is the most effective treatment for non-invasive bladder cancer.

During BCG therapy, a liquid solution with live bacterium related to cow tuberculosis is placed into the bladder through a catheter. It helps the body’s immune system destroy any cancer cells that remain in the bladder after they are removed during a TURBT. This type of immunotherapy is typically given to patients once a week over a six-week period to clear microscopic cancer that remains on the bladder. Data shows this therapy can delay tumor growth to a more advanced stage, decrease the need for surgical removal of the bladder at a later time and improve overall survival.

Sometimes maintenance BCG therapy is recommended to delay the recurrence of cancer over time.

BCG is typically recommended for people with high-grade, non-invasive bladder cancer, or bladder cancer that has penetrated the middle layer of the bladder.

Other therapies for bladder cancer

When bladder cancer is in advanced stages, our physicians practice the latest evidence-based treatment options that aim for a cure. In most cases, patients will have a combination of treatments.

Chemotherapy & surgery

Surgery combined with systemic chemotherapy is one of the most effective treatments with the best clinical outcomes in hopes to cure bladder cancer in more advanced stages. With this treatment path, chemotherapy can be given before or after surgery.

Chemotherapy & radiation

When someone with advanced bladder cancer is not a candidate for surgery, systemic chemotherapy in combination with radiation is an alternative therapy that can be administered in hopes to cure their cancer. Radiation therapy delivers targeted energy from X-rays or radioactive sources to destroy cancer cells in a localized area.

Chemotherapy & immunotherapy

For the most advanced forms of bladder cancer, the most effective treatment options to control the cancer are chemotherapy, immunotherapy and targeted therapy, which can be given independently or in combination. They are typically administered through an IV in an infusion center.

Clinical trials

The Wellstar Research Institute and Northwest Georgia Oncology Centers work closely with select local and national partners to enroll patients in clinical trials, often providing groundbreaking treatments years before FDA approval. In recent years, the Wellstar Research Institute and Northwest Georgia Oncology Centers have participated in clinical trials that have led to the approval of immunotherapy for specific cancer types.

Radical or partial cystectomy

In rare cases, these procedures may be considered for someone with advanced bladder cancer:

In a radical cystectomy, the bladder and surrounding tissues and lymph nodes are removed. In men, the prostate and seminal vesicles are also removed. Women with bladder cancer who have this surgery also have their ovaries, fallopian tubes, uterus, anterior vaginal wall and urethra removed. This surgery is paired with reconstructive surgery to be able to pass and store urine.
In a partial cystectomy, surgeons only remove the part of the bladder that has a single cancerous tumor.

Support services

People with cancer have access to an incredible network of support at Wellstar. While you navigate your diagnosis and treatment, our support groups, one-on-one support and education can improve your quality of life in many ways. The goal of our comprehensive support program is for patients to heal medically, physically and emotionally during treatment and beyond.

It may be beneficial to work with:

A registered oncology dietitian, who helps people maximize their nutrition and well-being before, during and after treatment
An oncology social worker, who helps people undergoing treatment improve their quality of life with counseling, education and connections to resources
An oncology psychologist or psychiatrist, who works with people to manage the emotional side of cancer
A palliative care physician, who offers complex symptom management
Cancer rehabilitation specialists, who evaluate and treat people for physical challenges related to cancer
A genetic counselor, who helps people with rare syndromes linked to cancer to understand their disease, make informed decisions about treatment and lifestyle choices, and discuss how results may affect their family members.

No matter which type of support a patient needs, we’re here to help you and your loved ones face cancer with confidence.

Quitting tobacco

Tobacco use is one of the primary causes of bladder cancers and many other health conditions. People with bladder cancer may benefit from support to quit smoking, vaping or using tobacco.

Effective and free support to quit is available from BecomeAnEX. The program is run by Truth Initiative, the largest non-profit public health organization dedicated to helping people quit tobacco, and the Mayo Clinic Nicotine Dependence Center. People who follow the “EX” plan are four times more likely to quit.

To get started, visit becomeanex.org or call 1 (877) 270-STOP (7867).

The Georgia Tobacco Quit Line at [LINK]smokefree.gov[LINK] also offers support.