Stage 0 (Papillary Carcinoma and Carcinoma in Situ)
Stage I Bladder Cancer
Stage II Bladder Cancer
Stage III Bladder Cancer
Stage IV Bladder Cancer

A link to a list of current clinical trials is included for each treatment section. For some types or stages of cancer, there may not be any trials listed. Check with your doctor for clinical trials that are not listed here but may be right for you.

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).

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage 0 bladder cancer ¹. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

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).
• A clinical trial of intravesical therapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage I bladder cancer ³. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage II bladder cancer ⁴. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

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.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage III bladder cancer ⁵. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

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).
• A clinical trial of chemotherapy.

Check for U.S. clinical trials from NCI's PDQ Cancer Clinical Trials Registry that are now accepting patients with stage IV bladder cancer ⁶. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug. General information about clinical trials is available from the NCI Web site ².

Glossary Terms

Treatment to boost or restore the ability of the immune system to fight cancer, infections, and other diseases. Also used to lessen certain side effects that may be caused by some cancer treatments. Agents used in biological therapy include monoclonal antibodies, growth factors, and vaccines. These agents may also have a direct antitumor effect. Also called biological response modifier therapy, biotherapy, BRM therapy, and immunotherapy.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

The use of drugs, vitamins, or other agents to try to reduce the risk of, or delay the development or recurrence of, cancer.

Treatment with drugs that kill cancer cells.

A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis, or treatment of a disease. Also called clinical study.

Treatment using more than one anticancer drug.

Surgery to remove all or part of the bladder (the organ that holds urine) or to remove a cyst (a sac or capsule in the body).

A type of radiation therapy that uses a machine to aim high-energy rays at the cancer from outside of the body. Also called external-beam radiation therapy.

A procedure to destroy tissue (such as a tumor) using an electric current. Also called electrofulguration.

A substance or object that is put in the body as a prosthesis, or for treatment or diagnosis.

A type of radiation therapy in which radioactive material sealed in needles, seeds, wires, or catheters is placed directly into or near a tumor. Also called brachytherapy, internal radiation therapy, and radiation brachytherapy.

Within the bladder.

Treatment that affects cells in the tumor and the area close to it.

A rounded mass of lymphatic tissue that is surrounded by a capsule of connective tissue. Lymph nodes filter lymph (lymphatic fluid), and they store lymphocytes (white blood cells). They are located along lymphatic vessels. Also called lymph gland.

Treatment given to relieve the symptoms and reduce the suffering caused by cancer and other life-threatening diseases. Palliative cancer therapies are given together with other cancer treatments, from the time of diagnosis, through treatment, survivorship, recurrent or advanced disease, and at the end of life.

Having to do with the pelvis (the lower part of the abdomen located between the hip bones).

Treatment with drugs that become active when exposed to light. These activated drugs may kill cancer cells.

The overall enjoyment of life. Many clinical trials assess the effects of cancer and its treatment on the quality of life. These studies measure aspects of an individual’s sense of well-being and ability to carry out various activities.

Energy released in the form of particle or electromagnetic waves. Common sources of radiation include radon gas, cosmic rays from outer space, medical x-rays, and energy given off by a radioisotope (unstable form of a chemical element that releases radiation as it breaks down and becomes more stable).

The use of high-energy radiation from x-rays, gamma rays, neutrons, protons, and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Also called irradiation and radiotherapy.

Surgery to remove all of the bladder (the organ that holds urine) as well as nearby tissues and organs.

Cancer that has recurred (come back), usually after a period of time during which the cancer could not be detected. The cancer may come back to the same place as the original (primary) tumor or to another place in the body. Also called recurrence.

Surgery to remove part of the bladder (the organ that holds urine). Also called partial cystectomy.

The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer, and whether the cancer has spread from the original site to other parts of the body.

Abnormal cells are found on tissue lining the inside of the bladder. These abnormal cells may become cancer and spread into nearby normal tissue. Stage 0 is divided into stage 0a (papillary carcinoma) and stage 0is (carcinoma in situ), depending on the type of tumor. Stage 0a may look like tiny mushrooms growing from the lining of the bladder. Stage 0is is a flat tumor on the tissue lining the inside of the bladder.

Cancer has spread to the connective tissue layer below the inner lining of the bladder.

Cancer has spread to either the inner layer or outer layer of the muscle wall of the bladder.

Cancer has spread from the bladder to the fatty layer of tissue surrounding it, and may have spread to the reproductive organs (prostate, uterus, vagina).

Cancer has spread from the bladder to the wall of the abdomen or pelvis. Cancer may have spread to one or more lymph nodes or to other parts of the body.

A procedure to remove or repair a part of the body or to find out whether disease is present. An operation.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.

Treatment.

Surgery performed with a special instrument inserted through the urethra. Also called TUR.

A surgical procedure to make a new way for urine to leave the body. It may involve redirecting urine into the colon, using catheters to drain the bladder, or making an opening in the abdomen and collecting urine in a bag outside the body.