573 lines
No EOL
132 KiB
HTML
573 lines
No EOL
132 KiB
HTML
<?xml version="1.0" encoding="utf-8"?>
|
|
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
|
|
|
|
<head><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
|
|
<!-- AppResources meta begin -->
|
|
<meta name="paf-app-resources" content="" />
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- AppResources meta end -->
|
|
|
|
<!-- TemplateResources meta begin -->
|
|
<meta name="paf_template" content="" />
|
|
|
|
<!-- TemplateResources meta end -->
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-part" /><meta name="ncbi_acc" content="NBK66044" /><meta name="ncbi_domain" content="pdqcis" /><meta name="ncbi_report" content="record" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK66044.9/" /><meta name="ncbi_pagename" content="Bladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf" /><meta name="ncbi_bookparttype" content="chapter" /><meta name="ncbi_app" content="bookshelf" />
|
|
<!-- Logger end -->
|
|
|
|
<title>Bladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf</title>
|
|
|
|
<!-- AppResources external_resources begin -->
|
|
<link rel="stylesheet" href="/core/jig/1.15.2/css/jig.min.css" /><script type="text/javascript" src="/core/jig/1.15.2/js/jig.min.js"></script>
|
|
|
|
<!-- AppResources external_resources end -->
|
|
|
|
<!-- Page meta begin -->
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="PDQ Cancer Information Summaries [Internet]" /><meta name="citation_title" content="Bladder Cancer Treatment (PDQ®)" /><meta name="citation_publisher" content="National Cancer Institute (US)" /><meta name="citation_date" content="2018/05/03" /><meta name="citation_author" content="PDQ Adult Treatment Editorial Board" /><meta name="citation_pmid" content="26389479" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK66044/" /><meta name="citation_keywords" content="bladder cancer" /><meta name="citation_keywords" content="bladder cancer" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Bladder Cancer Treatment (PDQ®)" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Cancer Institute (US)" /><meta name="DC.Contributor" content="PDQ Adult Treatment Editorial Board" /><meta name="DC.Date" content="2018/05/03" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK66044/" /><meta name="description" content="Treatment of bladder cancer depends on the stage of the cancer. Treatment options include different types of surgery (transurethral resection, radical and partial cystectomy, and urinary diversion), radiation therapy, chemotherapy, and immunotherapy. Learn more about how bladder cancer is treated." /><meta name="og:title" content="Bladder Cancer Treatment (PDQ®)" /><meta name="og:type" content="book" /><meta name="og:description" content="Treatment of bladder cancer depends on the stage of the cancer. Treatment options include different types of surgery (transurethral resection, radical and partial cystectomy, and urinary diversion), radiation therapy, chemotherapy, and immunotherapy. Learn more about how bladder cancer is treated." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK66044/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/pdqcis/CDR0000062705/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK66044/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
|
|
|
|
<!-- Page meta end -->
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico" /><meta name="ncbi_phid" content="CE8E2F7B7C95D9710000000000880063.m_13" />
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3985586/3808861/4121862/3974050/3917732/251717/4216701/14534/45193/4113719/3849091/3984811/3751656/4033350/3840896/3577051/3852958/4008682/4207974/4206132/4062871/12930/3964959/3854974/36029/4128070/9685/3549676/3609192/3609193/3609213/3395586.css" /><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3411343/3882866.css" media="print" /></head>
|
|
<body class="book-part">
|
|
<div class="grid">
|
|
<div class="col twelve_col nomargin shadow">
|
|
<!-- System messages like service outage or JS required; this is handled by the TemplateResources portlet -->
|
|
<div class="sysmessages">
|
|
<noscript>
|
|
<p class="nojs">
|
|
<strong>Warning:</strong>
|
|
The NCBI web site requires JavaScript to function.
|
|
<a href="/guide/browsers/#enablejs" title="Learn how to enable JavaScript" target="_blank">more...</a>
|
|
</p>
|
|
</noscript>
|
|
</div>
|
|
<!--/.sysmessage-->
|
|
<div class="wrap">
|
|
<div class="page">
|
|
<div class="top">
|
|
<div id="universal_header">
|
|
<section class="usa-banner">
|
|
<div class="usa-accordion">
|
|
<header class="usa-banner-header">
|
|
<div class="usa-grid usa-banner-inner">
|
|
<img src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png" alt="U.S. flag" />
|
|
<p>An official website of the United States government</p>
|
|
<button class="non-usa-accordion-button usa-banner-button" aria-expanded="false" aria-controls="gov-banner-top" type="button">
|
|
<span class="usa-banner-button-text">Here's how you know</span>
|
|
</button>
|
|
</div>
|
|
</header>
|
|
<div class="usa-banner-content usa-grid usa-accordion-content" id="gov-banner-top" aria-hidden="true">
|
|
<div class="usa-banner-guidance-gov usa-width-one-half">
|
|
<img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg" alt="Dot gov" />
|
|
<div class="usa-media_block-body">
|
|
<p>
|
|
<strong>The .gov means it's official.</strong>
|
|
<br />
|
|
Federal government websites often end in .gov or .mil. Before
|
|
sharing sensitive information, make sure you're on a federal
|
|
government site.
|
|
</p>
|
|
</div>
|
|
</div>
|
|
<div class="usa-banner-guidance-ssl usa-width-one-half">
|
|
<img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg" alt="Https" />
|
|
<div class="usa-media_block-body">
|
|
<p>
|
|
<strong>The site is secure.</strong>
|
|
<br />
|
|
The <strong>https://</strong> ensures that you are connecting to the
|
|
official website and that any information you provide is encrypted
|
|
and transmitted securely.
|
|
</p>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
<div class="usa-overlay"></div>
|
|
<header class="ncbi-header" role="banner" data-section="Header">
|
|
|
|
<div class="usa-grid">
|
|
<div class="usa-width-one-whole">
|
|
|
|
<div class="ncbi-header__logo">
|
|
<a href="/" class="logo" aria-label="NCBI Logo" data-ga-action="click_image" data-ga-label="NIH NLM Logo">
|
|
<img src="https://www.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg" alt="NIH NLM Logo" />
|
|
</a>
|
|
</div>
|
|
|
|
<div class="ncbi-header__account">
|
|
<a id="account_login" href="https://account.ncbi.nlm.nih.gov" class="usa-button header-button" style="display:none" data-ga-action="open_menu" data-ga-label="account_menu">Log in</a>
|
|
<button id="account_info" class="header-button" style="display:none" aria-controls="account_popup" type="button">
|
|
<span class="fa fa-user" aria-hidden="true">
|
|
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" width="20px" height="20px">
|
|
<g style="fill: #fff">
|
|
<ellipse cx="12" cy="8" rx="5" ry="6"></ellipse>
|
|
<path d="M21.8,19.1c-0.9-1.8-2.6-3.3-4.8-4.2c-0.6-0.2-1.3-0.2-1.8,0.1c-1,0.6-2,0.9-3.2,0.9s-2.2-0.3-3.2-0.9 C8.3,14.8,7.6,14.7,7,15c-2.2,0.9-3.9,2.4-4.8,4.2C1.5,20.5,2.6,22,4.1,22h15.8C21.4,22,22.5,20.5,21.8,19.1z"></path>
|
|
</g>
|
|
</svg>
|
|
</span>
|
|
<span class="username desktop-only" aria-hidden="true" id="uname_short"></span>
|
|
<span class="sr-only">Show account info</span>
|
|
</button>
|
|
</div>
|
|
|
|
<div class="ncbi-popup-anchor">
|
|
<div class="ncbi-popup account-popup" id="account_popup" aria-hidden="true">
|
|
<div class="ncbi-popup-head">
|
|
<button class="ncbi-close-button" data-ga-action="close_menu" data-ga-label="account_menu" type="button">
|
|
<span class="fa fa-times">
|
|
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 48 48" width="24px" height="24px">
|
|
<path d="M38 12.83l-2.83-2.83-11.17 11.17-11.17-11.17-2.83 2.83 11.17 11.17-11.17 11.17 2.83 2.83 11.17-11.17 11.17 11.17 2.83-2.83-11.17-11.17z"></path>
|
|
</svg>
|
|
</span>
|
|
<span class="usa-sr-only">Close</span></button>
|
|
<h4>Account</h4>
|
|
</div>
|
|
<div class="account-user-info">
|
|
Logged in as:<br />
|
|
<b><span class="username" id="uname_long">username</span></b>
|
|
</div>
|
|
<div class="account-links">
|
|
<ul class="usa-unstyled-list">
|
|
<li><a id="account_myncbi" href="/myncbi/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_myncbi">Dashboard</a></li>
|
|
<li><a id="account_pubs" href="/myncbi/collections/bibliography/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_pubs">Publications</a></li>
|
|
<li><a id="account_settings" href="/account/settings/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_settings">Account settings</a></li>
|
|
<li><a id="account_logout" href="/account/signout/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_logout">Log out</a></li>
|
|
</ul>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
</div>
|
|
</header>
|
|
<div role="navigation" aria-label="access keys">
|
|
<a id="nws_header_accesskey_0" href="https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys" class="usa-sr-only" accesskey="0" tabindex="-1">Access keys</a>
|
|
<a id="nws_header_accesskey_1" href="https://www.ncbi.nlm.nih.gov" class="usa-sr-only" accesskey="1" tabindex="-1">NCBI Homepage</a>
|
|
<a id="nws_header_accesskey_2" href="/myncbi/" class="set-base-url usa-sr-only" accesskey="2" tabindex="-1">MyNCBI Homepage</a>
|
|
<a id="nws_header_accesskey_3" href="#maincontent" class="usa-sr-only" accesskey="3" tabindex="-1">Main Content</a>
|
|
<a id="nws_header_accesskey_4" href="#" class="usa-sr-only" accesskey="4" tabindex="-1">Main Navigation</a>
|
|
</div>
|
|
<section data-section="Alerts">
|
|
<div class="ncbi-alerts-placeholder"></div>
|
|
</section>
|
|
</div>
|
|
<div class="header">
|
|
<div class="res_logo"><h1 class="res_name"><a href="/books/" title="Bookshelf home">Bookshelf</a></h1><h2 class="res_tagline"></h2></div>
|
|
<div class="search"><form method="get" action="/books/"><div class="search_form"><label for="database" class="offscreen_noflow">Search database</label><select id="database"><optgroup label="Recent"><option value="books" selected="selected" data-ac_dict="bookshelf-search">Books</option><option value="pcsubstance">PubChem Substance</option><option value="pubmed">PubMed</option><option value="clinvar" class="last">ClinVar</option></optgroup><optgroup label="All"><option value="gquery">All Databases</option><option value="assembly">Assembly</option><option value="biocollections">Biocollections</option><option value="bioproject">BioProject</option><option value="biosample">BioSample</option><option value="books" data-ac_dict="bookshelf-search">Books</option><option value="clinvar">ClinVar</option><option value="cdd">Conserved Domains</option><option value="gap">dbGaP</option><option value="dbvar">dbVar</option><option value="gene">Gene</option><option value="genome">Genome</option><option value="gds">GEO DataSets</option><option value="geoprofiles">GEO Profiles</option><option value="gtr">GTR</option><option value="ipg">Identical Protein Groups</option><option value="medgen">MedGen</option><option value="mesh">MeSH</option><option value="nlmcatalog">NLM Catalog</option><option value="nuccore">Nucleotide</option><option value="omim">OMIM</option><option value="pmc">PMC</option><option value="protein">Protein</option><option value="proteinclusters">Protein Clusters</option><option value="protfam">Protein Family Models</option><option value="pcassay">PubChem BioAssay</option><option value="pccompound">PubChem Compound</option><option value="pcsubstance">PubChem Substance</option><option value="pubmed">PubMed</option><option value="snp">SNP</option><option value="sra">SRA</option><option value="structure">Structure</option><option value="taxonomy">Taxonomy</option><option value="toolkit">ToolKit</option><option value="toolkitall">ToolKitAll</option><option value="toolkitbookgh">ToolKitBookgh</option></optgroup></select><div class="nowrap"><label for="term" class="offscreen_noflow" accesskey="/">Search term</label><div class="nowrap"><input type="text" name="term" id="term" title="Search Books. Use up and down arrows to choose an item from the autocomplete." value="" class="jig-ncbiclearbutton jig-ncbiautocomplete" data-jigconfig="dictionary:'bookshelf-search',disableUrl:'NcbiSearchBarAutoComplCtrl'" autocomplete="off" data-sbconfig="ds:'no',pjs:'no',afs:'no'" /></div><button id="search" type="submit" class="button_search nowrap" cmd="go">Search</button></div></div></form><ul class="searchlinks inline_list"><li>
|
|
<a href="/books/browse/">Browse Titles</a>
|
|
</li><li>
|
|
<a href="/books/advanced/">Advanced</a>
|
|
</li><li class="help">
|
|
<a href="/books/NBK3833/">Help</a>
|
|
</li><li class="disclaimer">
|
|
<a target="_blank" data-ga-category="literature_resources" data-ga-action="link_click" data-ga-label="disclaimer_link" href="https://www.ncbi.nlm.nih.gov/books/about/disclaimer/">Disclaimer</a>
|
|
</li></ul></div>
|
|
</div>
|
|
|
|
|
|
|
|
<!--<component id="Page" label="headcontent"/>-->
|
|
|
|
</div>
|
|
<div class="content">
|
|
<!-- site messages -->
|
|
<!-- Custom content 1 -->
|
|
<div class="col1">
|
|
|
|
</div>
|
|
|
|
<div class="container">
|
|
<div id="maincontent" class="content eight_col col">
|
|
<!-- Custom content in the left column above book nav -->
|
|
<div class="col2">
|
|
|
|
</div>
|
|
|
|
<!-- Book content -->
|
|
|
|
|
|
<!-- Custom content between navigation and content -->
|
|
<div class="col3">
|
|
|
|
</div>
|
|
|
|
<div class="document">
|
|
<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="Table of Contents Page" href="/books/n/pdqcis/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-pdqcis-lrg.png" alt="Cover of PDQ Cancer Information Summaries" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>PDQ Cancer Information Summaries [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK66044_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK66044_dtls__"><div>Bethesda (MD): <a href="http://www.cancer.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Cancer Institute (US)</a>; 2002-.</div></div><div class="half_rhythm"></div><div class="bk_noprnt"><form method="get" action="/books/n/pdqcis/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div></div></div></div>
|
|
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK66044_"><span class="title" itemprop="name">Bladder Cancer Treatment (PDQ®)</span></h1><div class="subtitle whole_rhythm">Patient Version</div><p class="contrib-group"><span itemprop="author">PDQ Adult Treatment Editorial Board</span>.</p><p class="small">Published online: May 3, 2018.</p></div><div class="jig-ncbiinpagenav body-content whole_rhythm" data-jigconfig="allHeadingLevels: ['h2'],smoothScroll: false" itemprop="text"><div id="_abs_rndgid_" itemprop="description"><p id="CDR0000062705__260">This PDQ cancer information summary has current information about the treatment of bladder cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p><p id="CDR0000062705__261">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board.</p></div><div id="CDR0000062705__87"><h2 id="_CDR0000062705__87_">General Information About Bladder Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062705__88">Bladder cancer is a disease in which malignant (cancer) cells
|
|
form in the tissues of the bladder.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__94">Smoking can affect the risk of bladder cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__98">Signs and symptoms of bladder cancer include blood in the urine and
|
|
pain during urination. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__102">Tests that examine the urine and bladder are used to
|
|
help detect (find) and diagnose bladder cancer.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__106">Certain factors affect prognosis (chance of recovery) and treatment options.</a></div></li></ul></div><div id="CDR0000062705__88"><h3>Bladder cancer is a disease in which malignant (cancer) cells
|
|
form in the tissues of the bladder.</h3><p id="CDR0000062705__90"> The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> is a hollow <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organ</a> in the lower part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>. It is shaped like a small balloon and has a muscular wall that
|
|
allows it to get larger or smaller to store <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> made by the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046325/" class="def">kidneys</a>. There are two kidneys, one on each side of the backbone, above the waist. Tiny tubules in the kidneys filter and clean the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>. They take out waste products and make urine. The urine passes from each kidney through a long tube called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046638/" class="def">ureter</a> into the bladder. The bladder holds the urine until it passes through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a> and leaves the body. </p><div id="CDR0000062705__259" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Anatomy%20of%20the%20male%20urinary%20system%20(left%20panel)%20and%20female%20urinary%20system%20(right%20panel)%20showing%20the%20kidneys%2C%20ureters%2C%20bladder%2C%20and%20urethra&p=BOOKS&id=499580_CDR0000765031.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000765031.jpg" alt="Anatomy of the male urinary system (left panel) and female urinary system (right panel); two-panel drawing showing the right and left kidneys, the ureters, the bladder filled with urine, and the urethra. The inside of the left kidney shows the renal pelvis. An inset shows the renal tubules and urine. Also shown are the prostate and penis (left panel) and the uterus (right panel)." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Anatomy of the male urinary system (left panel) and female urinary system (right panel) showing the kidneys, ureters, bladder, and urethra. Urine is made in the renal tubules and collects in the renal pelvis of each kidney. The urine flows from the kidneys through the ureters to the bladder. The urine is stored in the bladder until it leaves the body through the urethra.</p></div></div><p id="CDR0000062705__91">There are three types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444968/" class="def">bladder cancer</a> that begin in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the lining of the
|
|
bladder. These <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancers</a> are named for the
|
|
type of cells that become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a> (cancerous):</p><ul id="CDR0000062705__92"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046629/" class="def">Transitional
|
|
cell carcinoma</a>: Cancer that begins in cells in the innermost <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> layer of the bladder. These cells are able to stretch when the bladder is full and shrink when it is emptied. Most bladder cancers begin in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046630/" class="def">transitional cells</a>. Transitional cell carcinoma can be low-<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045702/" class="def">grade</a> or high-grade:<dl id="CDR0000062705__237" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin">Low-grade transitional cell carcinoma often <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurs</a> (comes back) after treatment, but rarely spreads into the muscle layer of the bladder or to other parts of the body. </p></dd><dt>-</dt><dd><p class="no_top_margin">High-grade transitional cell carcinoma often recurs (comes back) after treatment and often spreads into the muscle layer of the bladder, to other parts of the body, and to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>. Almost all deaths from bladder cancer are due to high-grade disease.</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046595/" class="def">Squamous
|
|
cell carcinoma</a>: Cancer that begins in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046056/" class="def">squamous cells</a>,
|
|
which are thin, flat cells that may form in the bladder after long-term <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045364/" class="def">infection</a> or irritation.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046216/" class="def">Adenocarcinoma</a>: Cancer that begins in
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046386/" class="def">glandular</a> cells that are found in the lining of the bladder. This is a very rare type of bladder cancer. </div></li></ul><p id="CDR0000062705__93"> Cancer that is in the lining of the bladder is called
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044305/" class="def">superficial</a> bladder cancer. Cancer that has spread through the lining of the bladder and invades the muscle wall of the bladder or has spread to nearby organs and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045741/" class="def">invasive</a> bladder cancer.</p><p id="CDR0000062705__199">See the following <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044271/" class="def">PDQ</a> summaries for more information:</p><ul id="CDR0000062705__200"><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000276462/">Renal Cell Cancer Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000343585/">Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000304478/">Bladder and Other Urothelial Cancers Screening</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062878/#CDR0000062878__126">Unusual Cancers of Childhood Treatment</a></div></li></ul></div><div id="CDR0000062705__94"><h3>Smoking can affect the risk of bladder cancer. </h3><p id="CDR0000062705__sm_CDR0000751733_8"><div class="milestone-start" id="CDR0000062705__sm_CDR0000751733_4"></div>Anything that increases your chance of getting a disease
|
|
is called a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045873/" class="def">risk factor</a>. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. Talk to your doctor if you think you may be at risk for bladder cancer.</p><p id="CDR0000062705__sm_CDR0000751733_9">Risk factors for bladder cancer include the following:</p><ul id="CDR0000062705__sm_CDR0000751733_7"><li class="half_rhythm"><div>Using <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000439432/" class="def">tobacco</a>, especially smoking <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000748148/" class="def">cigarettes</a>.</div></li><li class="half_rhythm"><div>Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000302456/" class="def">family history</a> of bladder cancer.</div></li><li class="half_rhythm"><div>Having certain changes in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045693/" class="def">genes</a> that are linked to bladder cancer.</div></li><li class="half_rhythm"><div>Being exposed to paints, dyes, metals, or petroleum products in the workplace.</div></li><li class="half_rhythm"><div> Past treatment with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a> to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> or with certain anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>, such as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045253/" class="def">cyclophosphamide</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045267/" class="def">ifosfamide</a>.</div></li><li class="half_rhythm"><div>Taking <i>Aristolochia fangchi</i>, a Chinese <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463714/" class="def">herb</a>.</div></li><li class="half_rhythm"><div>Drinking water from a well that has high levels of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044303/" class="def">arsenic</a>.</div></li><li class="half_rhythm"><div>Drinking water that has been treated with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044424/" class="def">chlorine</a>.</div></li><li class="half_rhythm"><div>Having a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a> of bladder infections, including bladder infections caused by <i>Schistosoma haematobium</i>.</div></li><li class="half_rhythm"><div>Using <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044093/" class="def">urinary</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> for a long time.</div></li></ul><p id="CDR0000062705__sm_CDR0000751733_10">Older age is a risk factor for most cancers. The chance of getting cancer increases as you get older.<div class="milestone-end"></div></p></div><div id="CDR0000062705__98"><h3>Signs and symptoms of bladder cancer include blood in the urine and
|
|
pain during urination. </h3><p id="CDR0000062705__100">These and other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000750109/" class="def">signs</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> may be caused by bladder cancer or by other <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">conditions</a>. Check with your doctor if you have any of the following:</p><ul id="CDR0000062705__101"><li class="half_rhythm"><div>Blood in the urine (slightly rusty to bright red in
|
|
color).</div></li><li class="half_rhythm"><div>Frequent urination.</div></li><li class="half_rhythm"><div>Pain during urination.</div></li><li class="half_rhythm"><div>Lower back pain.</div></li></ul></div><div id="CDR0000062705__102"><h3>Tests that examine the urine and bladder are used to
|
|
help detect (find) and diagnose bladder cancer.</h3><p id="CDR0000062705__104">The following tests and procedures may be used:</p><ul id="CDR0000062705__105"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270871/" class="def">Physical exam</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689078/" class="def">history</a></b>: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
|
|
</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446199/" class="def">Internal exam</a></b>: An exam of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a> and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046555/" class="def">rectum</a>. The doctor inserts lubricated, gloved fingers
|
|
into the vagina and/or rectum to feel for lumps.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046641/" class="def">Urinalysis</a></b>: A test to check the color of urine and its contents, such as sugar, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046124/" class="def">red blood cells</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045993/" class="def">white blood cells</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270872/" class="def">Urine cytology</a></b>: A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046590/" class="def">laboratory test</a> in which a sample of urine is checked under a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000638184/" class="def">microscope</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a> cells.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045988/" class="def">Cystoscopy</a></b>: A procedure to look inside the bladder and urethra to check for abnormal areas. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046455/" class="def">cystoscope</a> is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000572035/" class="def">lens</a> for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.<div id="CDR0000062705__218" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Cystoscopy&p=BOOKS&id=499580_CDR0000649521.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000649521.jpg" alt="Cystoscopy; drawing shows a side view of the lower pelvis containing the bladder, uterus, and rectum. Also shown are the vagina and anus. The flexible tube of a cystoscope (a thin, tube-like instrument with a light and a lens for viewing) is shown passing through the urethra and into the bladder. Fluid is used to fill the bladder. An inset shows a woman lying on an examination table with her knees bent and legs apart. She is covered by a drape. The doctor looks at an image of the inner wall of the bladder on a computer monitor." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Cystoscopy. A cystoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the urethra into the bladder. Fluid is used to fill the bladder. The doctor looks at an image of the inner wall of the bladder on a computer monitor.</p></div></div></div></li><li class="half_rhythm"><div>
|
|
<b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046333/" class="def">Intravenous pyelogram
|
|
</a> (IVP)</b>: A series of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> of the kidneys, ureters, and bladder to find out if cancer is present in these organs. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">contrast dye</a> is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a>. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045164/" class="def">Biopsy</a></b>: The removal of cells or tissues so they can be viewed under a microscope by a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046244/" class="def">pathologist</a> to check for signs of cancer. A biopsy for bladder cancer is usually done during cystoscopy. It may be possible to remove the entire <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> during biopsy.</div></li></ul></div><div id="CDR0000062705__106"><h3>Certain factors affect prognosis (chance of recovery) and treatment options.</h3><p id="CDR0000062705__194">The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045849/" class="def">prognosis</a> (chance of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000454708/" class="def">recovery</a>) depends on the following:</p><ul id="CDR0000062705__195"><li class="half_rhythm"><div>The <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer (whether it is superficial or invasive bladder cancer, and whether it has spread to other places in the body). Bladder cancer in the early stages can often be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000318813/" class="def">cured</a>.</div></li><li class="half_rhythm"><div>The
|
|
type of bladder cancer cells and how they look under a microscope. </div></li><li class="half_rhythm"><div>Whether there is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a> in other parts of the bladder.</div></li><li class="half_rhythm"><div>The patient’s age and general health.</div></li></ul><p id="CDR0000062705__247">If the cancer is superficial, prognosis also depends on the following:</p><ul id="CDR0000062705__248"><li class="half_rhythm"><div>How many tumors there are.</div></li><li class="half_rhythm"><div>The size of the tumors.</div></li><li class="half_rhythm"><div>Whether the tumor has recurred (come back) after treatment. </div></li></ul><p id="CDR0000062705__197">Treatment options depend on the stage of bladder cancer. </p></div></div><div id="CDR0000062705__109"><h2 id="_CDR0000062705__109_">Stages of Bladder Cancer</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062705__110">After bladder cancer has been diagnosed, tests are done
|
|
to find out if cancer cells have spread within the bladder or to other parts of
|
|
the body. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__206">There are three ways that cancer spreads in the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__251">Cancer may spread from where it began to other parts of the body.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__114">The following stages are used for bladder cancer:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062705__116">Stage 0 (Noninvasive Papillary Carcinoma and Carcinoma in Situ)</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__120">Stage I</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__123">Stage II</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__341">Stage III</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__346">Stage IV</a></div></li></ul></li></ul></div><div id="CDR0000062705__110"><h3>After bladder cancer has been diagnosed, tests are done
|
|
to find out if cancer cells have spread within the bladder or to other parts of
|
|
the body. </h3><p id="CDR0000062705__112">The process used to find out if <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread within the
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> lining and muscle or to other parts of the body is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046597/" class="def">staging</a>. The information gathered from the
|
|
staging process determines the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the disease. It is important to know
|
|
the stage in order to plan treatment. The following tests and
|
|
procedures may be used in the staging process: </p><ul id="CDR0000062705__113"><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046033/" class="def">CT scan</a> (CAT scan)</b>:
|
|
A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-ray</a> machine. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000409764/" class="def">dye</a> may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or swallowed to help the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissues</a> show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. To stage <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444968/" class="def">bladder cancer</a>, the CT scan may take pictures of the chest, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045788/" class="def">MRI</a> (magnetic
|
|
resonance imaging)</b>: A procedure that uses a magnet, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651209/" class="def">radio waves</a>, and a computer to make a series of detailed pictures of areas inside the body, such as the brain. This procedure is also called nuclear magnetic resonance imaging (NMRI).</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046140/" class="def">PET scan</a> (positron emission tomography scan)</b>: A procedure to find <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045772/" class="def">malignant</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> in the body. A small amount of radioactive glucose (sugar) is injected into a vein. The PET <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386220/" class="def">scanner</a> rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. This procedure is done to check whether there are malignant tumor cells in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000304687/" class="def">Chest x-ray</a></b>: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.</div></li><li class="half_rhythm"><div><b><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046499/" class="def">Bone scan</a></b>: A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. A very small amount of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> material is injected into a vein and travels through the bloodstream. The radioactive material collects in the bones with cancer and is detected by a scanner. </div></li></ul></div><div id="CDR0000062705__206"><h3>There are three ways that cancer spreads in the body.</h3><p id="CDR0000062705__206_69">Cancer can spread through <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a>, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045764/" class="def">lymph system</a>, and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270735/" class="def">blood</a>:</p><ul id="CDR0000062705__206_70"><li class="half_rhythm"><div>Tissue. The cancer spreads from where it began by growing into nearby areas.
|
|
</div></li><li class="half_rhythm"><div>Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000269462/" class="def">lymph vessels</a> to other parts of the body.
|
|
</div></li><li class="half_rhythm"><div>Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045020/" class="def">blood vessels</a> to other parts of the body.
|
|
</div></li></ul></div><div id="CDR0000062705__251"><h3>Cancer may spread from where it began to other parts of the body.</h3><p id="CDR0000062705__251_66">When cancer spreads to another part of the body, it is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046710/" class="def">metastasis</a>. Cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> break away from where they began (the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045847/" class="def">primary tumor</a>) and travel through the lymph system or blood.</p><ul id="CDR0000062705__251_67"><li class="half_rhythm"><div>Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044058/" class="def">metastatic</a> tumor) in another part of the body.</div></li><li class="half_rhythm"><div>Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.</div></li></ul><p id="CDR0000062705__253">The metastatic tumor is the same type of cancer as the primary tumor. For example, if bladder cancer spreads to the bone, the cancer cells in the bone are actually bladder cancer cells. The disease is metastatic bladder cancer, not bone cancer.</p><div id="CDR0000062705__354" class="box"><h3><span class="title">metastasis: how cancer spreads</span></h3><div class="caption"><p>Many cancer deaths are caused when cancer moves from the original tumor and spreads to other tissues and organs. This is called metastatic cancer. This animation shows how cancer cells travel from the place in the body where they first formed to other parts of the body.</p></div><p><a href="https://www.youtube.com/watch?v=fQwar_-QdiQ" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">YouTube</a></p></div></div><div id="CDR0000062705__114"><h3>The following stages are used for bladder cancer:</h3><div id="CDR0000062705__116"><h4>Stage 0 (Noninvasive Papillary Carcinoma and Carcinoma in Situ)</h4><div id="CDR0000062705__254" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%200%20bladder%20cancer&p=BOOKS&id=499580_CDR0000747928.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000747928.jpg" alt="Stage 0 bladder cancer; drawing shows the bladder, ureter, prostate, and urethra. First inset shows stage 0a (also called noninvasive papillary carcinoma) on the inner lining of the bladder. Second inset shows stage 0is (also called carcinoma in situ) on the inner lining of the bladder. Also shown are the layers of connective tissue and muscle tissue of the bladder and the layer of fat around the bladder." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage 0 bladder cancer. Abnormal cells are found in the tissue lining the inside of the bladder. Stage 0a (also called noninvasive papillary carcinoma) may look like long, thin growths growing from the lining of the bladder. Stage 0is (also called carcinoma in situ) is a flat tumor on the tissue lining the inside of the bladder.</p></div></div><p id="CDR0000062705__118">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000350363/" class="def">stage 0</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044636/" class="def">abnormal</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> are found in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> lining the
|
|
inside of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>. These abnormal cells may become <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> and spread into nearby normal tissue. Stage 0 is divided into stages 0a and 0is, depending on the type of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a>:</p><ul id="CDR0000062705__119"><li class="half_rhythm"><div>Stage 0a is also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455364/" class="def">noninvasive</a> papillary carcinoma, which may look like long, thin growths growing from the lining of the bladder.</div></li><li class="half_rhythm"><div>Stage 0is is also called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a>, which is a flat tumor on the tissue lining the inside of the bladder.</div></li></ul></div><div id="CDR0000062705__120"><h4>Stage I</h4><div id="CDR0000062705__255" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20I%20bladder%20cancer&p=BOOKS&id=499580_CDR0000749301.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000749301.jpg" alt="Stage I bladder cancer; drawing shows the bladder, ureter, prostate, and urethra. Inset shows cancer in the inner lining of the bladder and in the layer of connective tissue next to it. Also shown are the muscle layers of the bladder and the layer of fat around the bladder." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage I bladder cancer. Cancer has spread to the layer of connective tissue next to the inner lining of the bladder.</p></div></div><p id="CDR0000062705__122">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045122/" class="def">stage I</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
|
|
has formed and spread to the layer of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044013/" class="def">connective tissue</a> next to the inner lining of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>.</p></div><div id="CDR0000062705__123"><h4>Stage II</h4><div id="CDR0000062705__256" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20II%20bladder%20cancer&p=BOOKS&id=499580_CDR0000749308.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000749308.jpg" alt="Stage II bladder cancer; drawing shows the bladder, ureter, prostate, and urethra. Inset shows cancer in the inner lining of the bladder, the layer of connective tissue, and the muscle layers. Also shown is the layer of fat around the bladder." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage II bladder cancer. Cancer has spread to the layers of muscle tissue of the bladder.</p></div></div><p id="CDR0000062705__125">In <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045123/" class="def">stage II</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>
|
|
has spread to the layers of muscle <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046683/" class="def">tissue</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a>.</p></div><div id="CDR0000062705__341"><h4>Stage III</h4><p id="CDR0000062705__343"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045124/" class="def">Stage III</a> is divided into stages IIIA and IIIB.</p><ul id="CDR0000062705__344"><li class="half_rhythm"><div>In stage IIIA:<dl id="CDR0000062705__345" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> to the layer of fat surrounding the bladder and may have spread to the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046564/" class="def">reproductive organs</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046576/" class="def">seminal vesicles</a>, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a>, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a>) and cancer has not spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a>; or</p></dd><dt>-</dt><dd><p class="no_top_margin">cancer has spread from the bladder to one lymph node in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a> that is not near the common iliac <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440100/" class="def">arteries</a> (major arteries in the pelvis).</p></dd></dl><div id="CDR0000062705__351" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIA%20bladder%20cancer&p=BOOKS&id=499580_CDR0000749310.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000749310.jpg" alt="Stage IIIA bladder cancer; drawing shows cancer in the bladder and in (a) the layer of fat around the bladder and (b) one lymph node in the pelvis. Also shown are the right and left common iliac arteries and the prostate." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIA bladder cancer. Cancer has spread from the bladder to (a) the layer of fat around the bladder and may have spread to the prostate and/or seminal vesicles in men or the uterus and/or vagina in women, and cancer has not spread to lymph nodes; or (b) one lymph node in the pelvis that is not near the common iliac arteries.</p></div></div></div></li><li class="half_rhythm"><div>In stage IIIB, cancer has spread from the bladder to more than one lymph node in the pelvis that is not near the common iliac arteries or to at least one lymph node that is near the common iliac arteries.<div id="CDR0000062705__352" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IIIB%20bladder%20cancer&p=BOOKS&id=499580_CDR0000791435.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000791435.jpg" alt="Stage IIIB bladder cancer; drawing shows cancer in the bladder and in (a) more than one lymph node not near the common iliac artery and (b) one lymph node near the common iliac artery. Also shown are the right and left common iliac arteries." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IIIB bladder cancer. Cancer has spread from the bladder to (a) more than one lymph node in the pelvis that is not near the common iliac arteries; or (b) at least one lymph node that is near the common iliac arteries.</p></div></div></div></li></ul></div><div id="CDR0000062705__346"><h4>Stage IV</h4><div id="CDR0000062705__353" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Stage%20IVA%20and%20IVB%20bladder%20cancer&p=BOOKS&id=499580_CDR0000749892.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000749892.jpg" alt="Stage IVA and IVB bladder cancer; drawing shows cancer that has spread from the bladder to (a) the abdominal or pelvic wall and (b) lymph nodes above the common iliac arteries. Also shown is cancer that has spread to (c) other parts of the body, including the lung, liver, and bone." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Stage IVA and IVB bladder cancer. In stage IVA, cancer has spread from the bladder to (a) the wall of the abdomen or pelvis; or (b) lymph nodes above the common iliac arteries. In stage IVB, cancer has spread to (c) other parts of the body, such as the lung, liver, or bone.</p></div></div><p id="CDR0000062705__348"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045125/" class="def">Stage IV</a> is divided into stages IVA and IVB.</p><ul id="CDR0000062705__349"><li class="half_rhythm"><div>In stage IVA:<dl id="CDR0000062705__350" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has spread from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> to the wall of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046246/" class="def">pelvis</a>; or</p></dd><dt>-</dt><dd><p class="no_top_margin">cancer has spread to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> that are above the common iliac <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000440100/" class="def">arteries</a> (major arteries in the pelvis).</p></dd></dl></div></li><li class="half_rhythm"><div>In stage IVB, cancer has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, bone, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>.</div></li></ul></div></div></div><div id="CDR0000062705__132"><h2 id="_CDR0000062705__132_">Recurrent Bladder Cancer</h2><p id="CDR0000062705__133"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">Recurrent</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444968/" class="def">bladder cancer</a> is cancer that has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back) after it has been treated. The cancer may come back in the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> or in other parts of the body.
|
|
</p></div><div id="CDR0000062705__134"><h2 id="_CDR0000062705__134_">Treatment Option Overview</h2><div class="box"><h4><span class="title">Key Points for This Section</span></h4><ul><li class="half_rhythm"><div><a href="#CDR0000062705__135">There are different types of treatment for patients with bladder
|
|
cancer. </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__139">Four types of standard treatment are used:</a></div><ul><li class="half_rhythm"><div><a href="#CDR0000062705__141">Surgery </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__147">Radiation therapy
|
|
</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__150">Chemotherapy </a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__332">Immunotherapy</a></div></li></ul></li><li class="half_rhythm"><div><a href="#CDR0000062705__156">New types of treatment are being tested in clinical trials.
|
|
</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__355">Treatment for bladder cancer may cause side effects.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__208">Patients may want to think about taking part in a clinical trial.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__210">Patients can enter clinical trials before, during, or after starting their cancer treatment.</a></div></li><li class="half_rhythm"><div><a href="#CDR0000062705__212">Follow-up tests may be needed.</a></div></li></ul></div><div id="CDR0000062705__135"><h3>There are different types of treatment for patients with bladder
|
|
cancer. </h3><p id="CDR0000062705__137">Different types of treatment are available for patients with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444968/" class="def">bladder cancer</a>. Some treatments are <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard</a> (the currently used treatment), and some
|
|
are being tested in <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trials</a>.
|
|
A treatment clinical trial is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651211/" class="def">research study</a> meant to help
|
|
improve current treatments or obtain information on new treatments for patients
|
|
with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a>. When clinical trials show that a new treatment is better than the
|
|
standard treatment, the new
|
|
treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
|
|
</p></div><div id="CDR0000062705__139"><h3>Four types of standard treatment are used:</h3><div id="CDR0000062705__141"><h4>Surgery </h4><p id="CDR0000062705__143"> One of the following types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> may be done: </p><ul id="CDR0000062705__144"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045971/" class="def">Transurethral resection</a> (TUR) with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046393/" class="def">fulguration</a>: Surgery in which a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046455/" class="def">cystoscope</a> (a thin lighted tube) is inserted into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046501/" class="def">bladder</a> through the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046640/" class="def">urethra</a>.
|
|
A tool with a small wire loop on the end is then used to remove the
|
|
cancer or to burn the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumor</a> away with high-energy electricity. This is known as fulguration.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046547/" class="def">Radical cystectomy</a>: Surgery to remove the bladder and any
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045762/" class="def">lymph nodes</a> and nearby <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257523/" class="def">organs</a> that contain cancer. This surgery may be
|
|
done when the bladder cancer invades the muscle wall, or when <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044305/" class="def">superficial</a>
|
|
cancer involves a large part of the bladder. In men, the nearby organs that are
|
|
removed are the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046539/" class="def">prostate</a> and the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046576/" class="def">seminal vesicles</a>. In women, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046645/" class="def">uterus</a>, the
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046687/" class="def">ovaries</a>, and part of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046646/" class="def">vagina</a> are removed. Sometimes, when the cancer has
|
|
spread outside the bladder and cannot be completely removed, surgery to remove
|
|
only the bladder may be done to reduce <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046095/" class="def">urinary</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> caused by the cancer.
|
|
When the bladder must be removed, the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044306/" class="def">surgeon</a> creates another way for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046642/" class="def">urine</a> to
|
|
leave the body. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044425/" class="def">Partial cystectomy</a>: Surgery to remove part of the
|
|
bladder. This surgery may be done for patients who have a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000386213/" class="def">low-grade</a> 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.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446222/" class="def">Urinary diversion</a>: Surgery to make a new way for
|
|
the body to store and pass urine.</div></li></ul><p id="CDR0000062705__146">After the doctor removes all the cancer that can be seen at the
|
|
time of the surgery, some patients may be given <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> after surgery to
|
|
kill any cancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046476/" class="def">cells</a> that are left. Treatment given after surgery, to lower the risk that the cancer will come back, is called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045587/" class="def">adjuvant therapy</a>.</p></div><div id="CDR0000062705__147"><h4>Radiation therapy
|
|
</h4><p id="CDR0000062705__149"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> is a cancer treatment that uses high-energy <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045944/" class="def">x-rays</a> or other types of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045072/" class="def">radiation</a> to kill cancer cells or keep them from growing. There are two types of radiation therapy:</p><ul id="CDR0000062705__262"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> uses a machine outside the body to send radiation toward the cancer.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046345/" class="def">Internal radiation therapy</a> uses a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046550/" class="def">radioactive</a> substance sealed in needles, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000257219/" class="def">seeds</a>, wires, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheters</a> that are placed directly into or near the cancer.</div></li></ul><p id="CDR0000062705__263">The way the radiation therapy is given depends on the type and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer being treated. External radiation therapy is used to treat bladder cancer.</p></div><div id="CDR0000062705__150"><h4>Chemotherapy </h4><p id="CDR0000062705__152">Chemotherapy is a cancer treatment that uses <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a> to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. When chemotherapy is taken by mouth or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044678/" class="def">injected</a> into a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000476471/" class="def">vein</a> or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000301626/" class="def">systemic chemotherapy</a>). When chemotherapy is placed directly into the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046483/" class="def">cerebrospinal fluid</a>, an organ, or a body <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000463703/" class="def">cavity</a> such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045070/" class="def">abdomen</a>, the drugs mainly affect cancer cells in those areas (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046559/" class="def">regional chemotherapy</a>). For bladder cancer, regional chemotherapy may be <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046340/" class="def">intravesical</a> (put into the bladder through a tube inserted into the urethra). The way the chemotherapy is given depends on the type and stage of the cancer being treated. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> is treatment using more than one anticancer drug. </p><p id="CDR0000062705__220">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/bladder" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Bladder Cancer</a> for more information.</p></div><div id="CDR0000062705__332"><h4>Immunotherapy</h4><p id="CDR0000062705__334"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a> is a treatment that uses the patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046356/" class="def">immune system</a> to fight cancer. Substances made by the body or made in a laboratory are used to boost, direct, or restore the body’s natural defenses against cancer. This type of cancer treatment is also called biotherapy or biologic therapy.</p><p id="CDR0000062705__335">PD-1 inhibitors are a type of immunotherapy used in the treatment of bladder cancer. PD-1 is a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046092/" class="def">protein</a> on the surface of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044928/" class="def">T cells</a> that helps keep the body’s immune responses in check. When PD-1 attaches to another protein called PDL-1 on a cancer cell, it stops the T cell from killing the cancer cell. PD-1 inhibitors attach to PDL-1 and allow the T cells to kill cancer cells.</p><p id="CDR0000062705__336"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000764538/" class="def">Pembrolizumab</a>, atezolizumab, <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000767747/" class="def">nivolumab</a>, avelumab, and durvalumab are types of PD-1 inhibitors.</p><div id="CDR0000062705__331" class="figure bk_fig"><div class="graphic"><a href="/core/lw/2.0/html/tileshop_pmc/tileshop_pmc_inline.html?title=Immune%20checkpoint%20inhibitor&p=BOOKS&id=499580_CDR0000774646.jpg" target="tileshopwindow" class="inline_block pmc_inline_block ts_canvas img_link" title="Click on image to zoom"><div class="ts_bar small" title="Click on image to zoom"></div><img src="/books/NBK66044.9/bin/CDR0000774646.jpg" alt="Immune checkpoint inhibitor; the panel on the left shows the binding of proteins PD-L1 (on the tumor cell) to PD-1 (on the T cell), which keeps T cells from killing tumor cells in the body. Also shown are a tumor cell antigen and T cell receptor. The panel on the right shows immune checkpoint inhibitors (anti-PD-L1 and anti-PD-1) blocking the binding of PD-L1 to PD-1, which allows the T cells to kill tumor cells." class="tileshop" title="Click on image to zoom" /></a></div><div class="caption"><p>Immune checkpoint inhibitor. Checkpoint proteins, such as PD-L1 on tumor cells and PD-1 on T cells, help keep immune responses in check. The binding of PD-L1 to PD-1 keeps T cells from killing tumor cells in the body (left panel). Blocking the binding of PD-L1 to PD-1 with an immune checkpoint inhibitor (anti-PD-L1 or anti-PD-1) allows the T cells to kill tumor cells (right panel).</p></div></div><p id="CDR0000062705__337">Bladder cancer may be treated with an intravesical immunotherapy called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045987/" class="def">BCG</a> (bacillus Calmette-Guérin). The BCG is given in a solution that is placed directly into the bladder using a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045637/" class="def">catheter</a> (thin tube). </p><p id="CDR0000062705__340">See <a href="https://www.cancer.gov/about-cancer/treatment/drugs/bladder" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Bladder Cancer</a> for more information.</p></div></div><div id="CDR0000062705__156"><h3>New types of treatment are being tested in clinical trials.
|
|
</h3><p id="CDR0000062705__165">Information about clinical trials is available from the
|
|
<a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI website</a>.</p></div><div id="CDR0000062705__355"><h3>Treatment for bladder cancer may cause side effects.</h3><p id="CDR0000062705__355_73">For information about <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> caused by treatment for cancer, see our <a href="https://www.cancer.gov/about-cancer/treatment/side-effects" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Side Effects</a> page.</p></div><div id="CDR0000062705__208"><h3>Patients may want to think about taking part in a clinical trial.</h3><p id="CDR0000062705__208_23">For some patients, taking part in a <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044930/" class="def">standard treatment</a>.</p><p id="CDR0000062705__208_24">Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.</p><p id="CDR0000062705__208_25">Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.</p></div><div id="CDR0000062705__210"><h3>Patients can enter clinical trials before, during, or after starting their cancer treatment.</h3><p id="CDR0000062705__210_29">Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurring</a> (coming back) or reduce the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046580/" class="def">side effects</a> of cancer treatment.</p><p id="CDR0000062705__210_30">Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trials search</a> webpage. Clinical trials supported by other organizations can be found on the <a href="https://clinicaltrials.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">ClinicalTrials.gov</a> website.</p></div><div id="CDR0000062705__212"><h3>Follow-up tests may be needed.</h3><p id="CDR0000062705__212_33">Some of the tests that were done to <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046450/" class="def">diagnose</a> the cancer or to find out the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045885/" class="def">stage</a> of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.</p><p id="CDR0000062705__212_34">Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> has changed or if the cancer has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a> (come back). These tests are sometimes called <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044671/" class="def">follow-up</a> tests or check-ups.</p><p id="CDR0000062705__229">Bladder cancer often <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurs</a> (comes back), even when the cancer is <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044305/" class="def">superficial</a>. <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000616060/" class="def">Surveillance</a> of the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046095/" class="def">urinary tract</a> to check for recurrence is standard after a diagnosis of bladder cancer. Surveillance is closely watching a patient’s <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000651193/" class="def">condition</a> but not giving any treatment unless there are changes in test results that show the condition is getting worse. During active surveillance, certain exams and tests are done on a regular schedule. Surveillance may include <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000354470/" class="def">ureteroscopy</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000689578/" class="def">imaging tests</a>. See <i><a href="/books/NBK66044.9/#CDR0000062705__113">staging tests</a></i>, above.</p></div></div><div id="CDR0000062705__166"><h2 id="_CDR0000062705__166_">Treatment Options by Stage </h2><p id="CDR0000062705__357">For information about the treatments listed below, see the <a href="#CDR0000062705__139">Treatment Option Overview</a> section.</p><div id="CDR0000062705__167"><h3>Stage 0 (Noninvasive Papillary Carcinoma and Carcinoma in Situ)</h3><p id="CDR0000062705__168">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000350363/" class="def">stage 0</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000455364/" class="def">noninvasive</a> papillary carcinoma and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046488/" class="def">carcinoma in situ</a>) may include the
|
|
following:</p><ul id="CDR0000062705__231"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045971/" class="def">Transurethral resection</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046393/" class="def">fulguration</a>. This may be followed by one of the following:<dl id="CDR0000062705__249" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046340/" class="def">Intravesical</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> given right after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"> Intravesical chemotherapy given right after surgery and then regular treatments with intravesical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044423/" class="def">BCG</a> or intravesical chemotherapy.</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044425/" class="def">Partial cystectomy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046547/" class="def">Radical cystectomy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000062705__TrialSearch_167_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062705__171"><h3>Stage I Bladder Cancer</h3><p id="CDR0000062705__172">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045122/" class="def">stage I bladder cancer</a> may include the following:
|
|
</p><ul id="CDR0000062705__232"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045971/" class="def">Transurethral resection</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046393/" class="def">fulguration</a>. This may be followed by one of the following:<dl id="CDR0000062705__250" class="temp-labeled-list"><dt>-</dt><dd><p class="no_top_margin"><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046340/" class="def">Intravesical</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a> given right after <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a>.</p></dd><dt>-</dt><dd><p class="no_top_margin"> Intravesical chemotherapy given right after surgery and then regular treatments with intravesical <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044423/" class="def">BCG</a> or intravesical chemotherapy.</p></dd></dl></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044425/" class="def">Partial cystectomy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046547/" class="def">Radical cystectomy</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000062705__TrialSearch_171_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062705__175"><h3>Stages II and III Bladder Cancer</h3><p id="CDR0000062705__176">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045123/" class="def">stages II</a> and <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045124/" class="def">III bladder cancer</a> may include the
|
|
following:</p><ul id="CDR0000062705__233"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046547/" class="def">Radical cystectomy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a> followed by radical cystectomy. A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446222/" class="def">urinary diversion</a> may be done.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044425/" class="def">Partial cystectomy</a> with or without chemotherapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045971/" class="def">Transurethral resection</a> with <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046393/" class="def">fulguration</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000062705__TrialSearch_175_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062705__183"><h3>Stage IV Bladder Cancer</h3><p id="CDR0000062705__184">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045125/" class="def">stage IV bladder cancer</a> that has not spread to other parts of the body may include the following:</p><ul id="CDR0000062705__234"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">Chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046547/" class="def">Radical cystectomy</a> alone or followed by chemotherapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046686/" class="def">External radiation therapy</a> with or without chemotherapy.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000446222/" class="def">Urinary diversion</a> or cystectomy as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to
|
|
relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li></ul><p id="CDR0000062705__235">Treatment of stage IV bladder cancer that has spread to other parts of the body, such as the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000270740/" class="def">lung</a>, bone, or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046312/" class="def">liver</a>, may include the following:</p><ul id="CDR0000062705__236"><li class="half_rhythm"><div>Chemotherapy with or without <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045755/" class="def">local treatment</a> (<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">surgery</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">radiation therapy</a>).</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a>.</div></li><li class="half_rhythm"><div>External radiation therapy as palliative therapy to
|
|
relieve symptoms and improve quality of life.</div></li><li class="half_rhythm"><div>Urinary diversion or cystectomy as palliative therapy to
|
|
relieve symptoms and improve quality of life.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of new anticancer <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000348921/" class="def">drugs</a>.</div></li></ul><p id="CDR0000062705__TrialSearch_183_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div></div><div id="CDR0000062705__187"><h2 id="_CDR0000062705__187_">Treatment Options for Recurrent Bladder Cancer</h2><p id="CDR0000062705__358">For information about the treatments listed below, see the <a href="#CDR0000062705__139">Treatment Option Overview</a> section.</p><p id="CDR0000062705__188">Treatment of <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045862/" class="def">recurrent</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000444968/" class="def">bladder cancer</a> depends on previous treatment
|
|
and where the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> has <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046556/" class="def">recurred</a>. Treatment for recurrent bladder cancer may
|
|
include the following: </p><ul id="CDR0000062705__189"><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045650/" class="def">Combination chemotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045729/" class="def">Immunotherapy</a>.</div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045570/" class="def">Surgery</a> for <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044305/" class="def">superficial</a> or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045754/" class="def">localized</a>
|
|
<a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000046634/" class="def">tumors</a>. Surgery may be followed by <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045617/" class="def">biologic therapy</a> and/or <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045214/" class="def">chemotherapy</a>. </div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044971/" class="def">Radiation therapy</a> as <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045815/" class="def">palliative therapy</a> to
|
|
relieve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045022/" class="def">symptoms</a> and improve <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045417/" class="def">quality of life</a>.</div></li><li class="half_rhythm"><div>A <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045961/" class="def">clinical trial</a> of a new treatment.</div></li></ul><p id="CDR0000062705__TrialSearch_187_19">Use our <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/search" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">clinical trial search</a> to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">General information</a> about clinical trials is also available.</p></div><div id="CDR0000062705__201"><h2 id="_CDR0000062705__201_">To Learn More About Bladder Cancer</h2><p id="CDR0000062705__202">For more information from the <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000044266/" class="def">National Cancer Institute</a> about bladder cancer, see the following:</p><ul id="CDR0000062705__221"><li class="half_rhythm"><div><a href="https://www.cancer.gov/types/bladder" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Bladder Cancer Home Page</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000304478/">Bladder and Other Urothelial Cancers Screening</a></div></li><li class="half_rhythm"><div><a href="/books/n/pdqcis/CDR0000062878/#CDR0000062878__126">Unusual Cancers of Childhood Treatment</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/drugs/bladder" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Drugs Approved for Bladder Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/treatment/types/immunotherapy/bio-therapies-fact-sheet" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Biological Therapies for Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Tobacco</a> (includes help with quitting)</div></li></ul><p id="CDR0000062705__201_40">For general <a href="/books/n/pdqcis/glossary/def-item/glossary_CDR0000045333/" class="def">cancer</a> information and other resources from the National Cancer Institute, see the following:</p><ul id="CDR0000062705__201_41"><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">About Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/diagnosis-staging/staging" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Staging</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/chemo-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Chemotherapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/publications/patient-education/radiation-therapy-and-you" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Radiation Therapy and You: Support for People With Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Coping with Cancer</a></div></li><li class="half_rhythm"><div><a href="https://www.cancer.gov/about-cancer/coping/questions" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Questions to Ask Your Doctor about Cancer</a></div></li><li class="half_rhythm"><div><a href="https://cancercontrol.cancer.gov/ocs/resources/survivors.html" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">For Survivors and Caregivers</a>
|
|
</div></li></ul></div><div id="CDR0000062705__AboutThis_1"><h2 id="_CDR0000062705__AboutThis_1_">About This PDQ Summary</h2><div id="CDR0000062705__AboutThis_2"><h3>About PDQ</h3><p id="CDR0000062705__AboutThis_3">Physician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine. Most summaries come in two versions. The health professional versions have detailed information written in technical language. The patient versions are written in easy-to-understand, nontechnical language. Both versions have cancer information that is accurate and up to date and most versions are also available in <a href="https://www.cancer.gov/espanol/publicaciones/pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Spanish</a>.</p><p id="CDR0000062705__AboutThis_4">PDQ is a service of the NCI. The NCI is part of the National Institutes of Health (NIH). NIH is the federal government’s center of biomedical research. The PDQ summaries are based on an independent review of the medical literature. They are not policy statements of the NCI or the NIH.</p></div><div id="CDR0000062705__AboutThis_5"><h3>Purpose of This Summary</h3><p id="CDR0000062705__AboutThis_6">This PDQ cancer information summary has current information about the treatment of bladder cancer. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.</p></div><div id="CDR0000062705__AboutThis_7"><h3>Reviewers and Updates</h3><p id="CDR0000062705__AboutThis_8">Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change.
|
|
</p><p id="CDR0000062705__AboutThis_9">The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the <a href="http://www.cancer.gov/publications/pdq/editorial-boards/adult-treatment" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PDQ Adult Treatment Editorial Board</a>.
|
|
</p></div><div id="CDR0000062705__AboutThis_10"><h3>Clinical Trial Information</h3><p id="CDR0000062705__AboutThis_11">A clinical trial is a study to answer a scientific question, such as whether one treatment is better than another. Trials are based on past studies and what has been learned in the laboratory. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. During treatment clinical trials, information is collected about the effects of a new treatment and how well it works. If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
|
|
</p><p id="CDR0000062705__AboutThis_12">Clinical trials are listed in PDQ and can be found online at <a href="https://www.cancer.gov/about-cancer/treatment/clinical-trials" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">NCI's website</a>. Many cancer doctors who take part in clinical trials are also listed in PDQ. For more information, call the Cancer Information Service 1-800-4-CANCER (1-800-422-6237).
|
|
</p></div><div id="CDR0000062705__AboutThis_13"><h3>Permission to Use This Summary</h3><p id="CDR0000062705__AboutThis_14">PDQ is a registered trademark. The content of PDQ documents can be used freely as text. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. However, a user would be allowed to write a sentence such as “NCI’s PDQ cancer information summary about breast cancer prevention states the risks in the following way: [include excerpt from the summary].”
|
|
</p><p id="CDR0000062705__AboutThis_15">The best way to cite this PDQ summary is:</p><p id="CDR0000062705__AboutThis_21">PDQ® Adult Treatment Editorial Board. PDQ Bladder Cancer Treatment. Bethesda, MD: National Cancer Institute. Updated <MM/DD/YYYY>. Available at: <a href="https://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">https://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq</a>. Accessed <MM/DD/YYYY>. [PMID: 26389479]</p><p id="CDR0000062705__AboutThis_16">Images in this summary are used with permission of the author(s), artist, and/or publisher for use in the PDQ summaries only. If you want to use an image from a PDQ summary and you are not using the whole summary, you must get permission from the owner. It cannot be given by the National Cancer Institute. Information about using the images in this summary, along with many other images related to cancer can be found in <a href="https://visualsonline.cancer.gov/" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Visuals Online</a>. Visuals Online is a collection of more than 2,000 scientific images.
|
|
</p></div><div id="CDR0000062705__AboutThis_17"><h3>Disclaimer</h3><p id="CDR0000062705__AboutThis_18">The information in these summaries should not be used to make decisions about insurance reimbursement. More information on insurance coverage is available on Cancer.gov on the <a href="https://www.cancer.gov/about-cancer/managing-care" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Managing Cancer Care</a> page.</p></div><div id="CDR0000062705__AboutThis_19"><h3>Contact Us</h3><p id="CDR0000062705__AboutThis_20">More information about contacting us or receiving help with the Cancer.gov website can be found on our <a href="https://www.cancer.gov/contact" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">Contact Us for Help</a> page. Questions can also be submitted to Cancer.gov through the website’s <a href="https://www.cancer.gov/contact/email-us" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">E-mail Us</a>.</p></div></div></div></div>
|
|
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK66044</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/26389479" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">26389479</a></span></div></div></div>
|
|
|
|
</div>
|
|
|
|
<!-- Custom content below content -->
|
|
<div class="col4">
|
|
|
|
</div>
|
|
|
|
|
|
<!-- Book content -->
|
|
|
|
<!-- Custom contetnt below bottom nav -->
|
|
<div class="col5">
|
|
|
|
</div>
|
|
</div>
|
|
|
|
<div id="rightcolumn" class="four_col col last">
|
|
<!-- Custom content above discovery portlets -->
|
|
<div class="col6">
|
|
<div id="ncbi_share_book"><a href="#" class="ncbi_share" data-ncbi_share_config="popup:false,shorten:true" ref="id=NBK66044&db=books">Share</a></div>
|
|
|
|
</div>
|
|
<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK66044.9/?report=reader">PubReader</a></li><li><a href="/books/NBK66044.9/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK66044" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK66044" style="display:none" title="Cite this Page"><div class="bk_tt">PDQ Adult Treatment Editorial Board. Bladder Cancer Treatment (PDQ®): Patient Version. 2018 May 3. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. <span class="bk_cite_avail"></span></div></div></li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Version History</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter shutter_closed" title="Show/hide content" remembercollapsed="true" pgsec_name="version_history" id="Shutter"></a></div><div class="portlet_content" style="display: none;"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><span class="bk_col_itm"><a href="/books/NBK66044.23/">NBK66044.23</a></span> September 12, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK66044.22/">NBK66044.22</a></span> March 1, 2024</li><li><span class="bk_col_itm"><a href="/books/NBK66044.21/">NBK66044.21</a></span> November 28, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK66044.20/">NBK66044.20</a></span> April 27, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK66044.19/">NBK66044.19</a></span> February 16, 2023</li><li><span class="bk_col_itm"><a href="/books/NBK66044.18/">NBK66044.18</a></span> March 25, 2022</li><li><span class="bk_col_itm"><a href="/books/NBK66044.17/">NBK66044.17</a></span> December 16, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK66044.16/">NBK66044.16</a></span> August 6, 2021</li><li><span class="bk_col_itm"><a href="/books/NBK66044.15/">NBK66044.15</a></span> July 10, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66044.14/">NBK66044.14</a></span> May 8, 2020</li><li><span class="bk_col_itm"><a href="/books/NBK66044.13/">NBK66044.13</a></span> October 30, 2019</li><li><span class="bk_col_itm"><a href="/books/NBK66044.12/">NBK66044.12</a></span> December 27, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.11/">NBK66044.11</a></span> December 19, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.10/">NBK66044.10</a></span> October 19, 2018</li><li><span class="bk_col_itm">NBK66044.9</span> May 3, 2018 (Displayed Version)</li><li><span class="bk_col_itm"><a href="/books/NBK66044.8/">NBK66044.8</a></span> April 27, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.7/">NBK66044.7</a></span> March 28, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.6/">NBK66044.6</a></span> March 23, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.5/">NBK66044.5</a></span> March 9, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.4/">NBK66044.4</a></span> January 29, 2018</li><li><span class="bk_col_itm"><a href="/books/NBK66044.3/">NBK66044.3</a></span> April 27, 2017</li><li><span class="bk_col_itm"><a href="/books/NBK66044.2/">NBK66044.2</a></span> July 7, 2016</li><li><span class="bk_col_itm"><a href="/books/NBK66044.1/">NBK66044.1</a></span> July 1, 2015</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>In this Page</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="page-toc" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="#CDR0000062705__87" ref="log$=inpage&link_id=inpage">General Information About Bladder Cancer</a></li><li><a href="#CDR0000062705__109" ref="log$=inpage&link_id=inpage">Stages of Bladder Cancer</a></li><li><a href="#CDR0000062705__132" ref="log$=inpage&link_id=inpage">Recurrent Bladder Cancer</a></li><li><a href="#CDR0000062705__134" ref="log$=inpage&link_id=inpage">Treatment Option Overview</a></li><li><a href="#CDR0000062705__166" ref="log$=inpage&link_id=inpage">Treatment Options by Stage </a></li><li><a href="#CDR0000062705__187" ref="log$=inpage&link_id=inpage">Treatment Options for Recurrent Bladder Cancer</a></li><li><a href="#CDR0000062705__201" ref="log$=inpage&link_id=inpage">To Learn More About Bladder Cancer</a></li><li><a href="#CDR0000062705__AboutThis_1" ref="log$=inpage&link_id=inpage">About This PDQ Summary</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related publications</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK65962/">Health Professional Version</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389422" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Cervical Cancer Treatment: Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Cervical Cancer Treatment: Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389388" ref="ordinalpos=1&linkpos=2&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Melanoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Adult Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389462" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Spirituality in Cancer Care (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Spirituality in Cancer Care (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Supportive and Palliative Care Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389278" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Neuroblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Neuroblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/26389197" ref="ordinalpos=1&linkpos=5&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.</a><span class="source">[PDQ Cancer Information Summari...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Retinoblastoma Treatment (PDQ®): Patient Version.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">PDQ Pediatric Treatment Editorial Board. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">PDQ Cancer Information Summaries. 2002</em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=26389479" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=26389479" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c963b1b15b832ebc84439e">Bladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries</a><div class="ralinkpop offscreen_noflow">Bladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c963a5f4a390645ea86e7a">Bladder Cancer Treatment - PDQ Cancer Information Summaries</a><div class="ralinkpop offscreen_noflow">Bladder Cancer Treatment - PDQ Cancer Information Summaries<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_qry two_line"><a class="htb" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c9633da68b6b5afce3fa9c">PMC Links for Books (Select 4848140) <span class="number">(10)</span></a><div class="tertiary">PMC</div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c9633cf4a390645ea4a05c">Childhood Cardiac (Heart) Tumors Treatment (PDQ®) - PDQ Cancer Information Summa...</a><div class="ralinkpop offscreen_noflow">Childhood Cardiac (Heart) Tumors Treatment (PDQ®) - PDQ Cancer Information Summaries<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c9633aa68b6b5afce3ddd7">Childhood Cardiac Tumors Treatment (PDQ®) - PDQ Cancer Information Summaries</a><div class="ralinkpop offscreen_noflow">Childhood Cardiac Tumors Treatment (PDQ®) - PDQ Cancer Information Summaries<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
|
|
|
|
<!-- Custom content below discovery portlets -->
|
|
<div class="col7">
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
<!-- Custom content after all -->
|
|
<div class="col8">
|
|
|
|
</div>
|
|
<div class="col9">
|
|
|
|
</div>
|
|
|
|
<script type="text/javascript" src="/corehtml/pmc/js/jquery.scrollTo-1.4.2.js"></script>
|
|
<script type="text/javascript">
|
|
(function($){
|
|
$('.skiplink').each(function(i, item){
|
|
var href = $($(item).attr('href'));
|
|
href.attr('tabindex', '-1').addClass('skiptarget'); // ensure the target can receive focus
|
|
$(item).on('click', function(event){
|
|
event.preventDefault();
|
|
$.scrollTo(href, 0, {
|
|
onAfter: function(){
|
|
href.focus();
|
|
}
|
|
});
|
|
});
|
|
});
|
|
})(jQuery);
|
|
</script>
|
|
</div>
|
|
<div class="bottom">
|
|
|
|
<div id="NCBIFooter_dynamic">
|
|
<!--<component id="Breadcrumbs" label="breadcrumbs"/>
|
|
<component id="Breadcrumbs" label="helpdesk"/>-->
|
|
|
|
</div>
|
|
|
|
<div class="footer" id="footer">
|
|
<section class="icon-section">
|
|
<div id="icon-section-header" class="icon-section_header">Follow NCBI</div>
|
|
<div class="grid-container container">
|
|
<div class="icon-section_container">
|
|
<a class="footer-icon" id="footer_twitter" href="https://twitter.com/ncbi" aria-label="Twitter"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<defs>
|
|
<style>
|
|
.cls-11 {
|
|
fill: #737373;
|
|
}
|
|
</style>
|
|
</defs>
|
|
<title>Twitter</title>
|
|
<path class="cls-11" d="M250.11,105.48c-7,3.14-13,3.25-19.27.14,8.12-4.86,8.49-8.27,11.43-17.46a78.8,78.8,0,0,1-25,9.55,39.35,39.35,0,0,0-67,35.85,111.6,111.6,0,0,1-81-41.08A39.37,39.37,0,0,0,81.47,145a39.08,39.08,0,0,1-17.8-4.92c0,.17,0,.33,0,.5a39.32,39.32,0,0,0,31.53,38.54,39.26,39.26,0,0,1-17.75.68,39.37,39.37,0,0,0,36.72,27.3A79.07,79.07,0,0,1,56,223.34,111.31,111.31,0,0,0,116.22,241c72.3,0,111.83-59.9,111.83-111.84,0-1.71,0-3.4-.1-5.09C235.62,118.54,244.84,113.37,250.11,105.48Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_facebook" href="https://www.facebook.com/ncbi.nlm" aria-label="Facebook"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<title>Facebook</title>
|
|
<path class="cls-11" d="M210.5,115.12H171.74V97.82c0-8.14,5.39-10,9.19-10h27.14V52l-39.32-.12c-35.66,0-42.42,26.68-42.42,43.77v19.48H99.09v36.32h27.24v109h45.41v-109h35Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_linkedin" href="https://www.linkedin.com/company/ncbinlm" aria-label="LinkedIn"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<title>LinkedIn</title>
|
|
<path class="cls-11" d="M101.64,243.37H57.79v-114h43.85Zm-22-131.54h-.26c-13.25,0-21.82-10.36-21.82-21.76,0-11.65,8.84-21.15,22.33-21.15S101.7,78.72,102,90.38C102,101.77,93.4,111.83,79.63,111.83Zm100.93,52.61A17.54,17.54,0,0,0,163,182v61.39H119.18s.51-105.23,0-114H163v13a54.33,54.33,0,0,1,34.54-12.66c26,0,44.39,18.8,44.39,55.29v58.35H198.1V182A17.54,17.54,0,0,0,180.56,164.44Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_github" href="https://github.com/ncbi" aria-label="GitHub"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<defs>
|
|
<style>
|
|
.cls-11,
|
|
.cls-12 {
|
|
fill: #737373;
|
|
}
|
|
|
|
.cls-11 {
|
|
fill-rule: evenodd;
|
|
}
|
|
</style>
|
|
</defs>
|
|
<title>GitHub</title>
|
|
<path class="cls-11" d="M151.36,47.28a105.76,105.76,0,0,0-33.43,206.1c5.28,1,7.22-2.3,7.22-5.09,0-2.52-.09-10.85-.14-19.69-29.42,6.4-35.63-12.48-35.63-12.48-4.81-12.22-11.74-15.47-11.74-15.47-9.59-6.56.73-6.43.73-6.43,10.61.75,16.21,10.9,16.21,10.9,9.43,16.17,24.73,11.49,30.77,8.79,1-6.83,3.69-11.5,6.71-14.14C108.57,197.1,83.88,188,83.88,147.51a40.92,40.92,0,0,1,10.9-28.39c-1.1-2.66-4.72-13.42,1-28,0,0,8.88-2.84,29.09,10.84a100.26,100.26,0,0,1,53,0C198,88.3,206.9,91.14,206.9,91.14c5.76,14.56,2.14,25.32,1,28a40.87,40.87,0,0,1,10.89,28.39c0,40.62-24.74,49.56-48.29,52.18,3.79,3.28,7.17,9.71,7.17,19.58,0,14.15-.12,25.54-.12,29,0,2.82,1.9,6.11,7.26,5.07A105.76,105.76,0,0,0,151.36,47.28Z">
|
|
</path>
|
|
<path class="cls-12" d="M85.66,199.12c-.23.52-1.06.68-1.81.32s-1.2-1.06-.95-1.59,1.06-.69,1.82-.33,1.21,1.07.94,1.6Zm-1.3-1">
|
|
</path>
|
|
<path class="cls-12" d="M90,203.89c-.51.47-1.49.25-2.16-.49a1.61,1.61,0,0,1-.31-2.19c.52-.47,1.47-.25,2.17.49s.82,1.72.3,2.19Zm-1-1.08">
|
|
</path>
|
|
<path class="cls-12" d="M94.12,210c-.65.46-1.71,0-2.37-.91s-.64-2.07,0-2.52,1.7,0,2.36.89.65,2.08,0,2.54Zm0,0"></path>
|
|
<path class="cls-12" d="M99.83,215.87c-.58.64-1.82.47-2.72-.41s-1.18-2.06-.6-2.7,1.83-.46,2.74.41,1.2,2.07.58,2.7Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M107.71,219.29c-.26.82-1.45,1.2-2.64.85s-2-1.34-1.74-2.17,1.44-1.23,2.65-.85,2,1.32,1.73,2.17Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M116.36,219.92c0,.87-1,1.59-2.24,1.61s-2.29-.68-2.3-1.54,1-1.59,2.26-1.61,2.28.67,2.28,1.54Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M124.42,218.55c.15.85-.73,1.72-2,1.95s-2.37-.3-2.52-1.14.73-1.75,2-2,2.37.29,2.53,1.16Zm0,0"></path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_blog" href="https://ncbiinsights.ncbi.nlm.nih.gov/" aria-label="Blog">
|
|
<svg xmlns="http://www.w3.org/2000/svg" id="Layer_1" data-name="Layer 1" viewBox="0 0 40 40">
|
|
<defs><style>.cls-1{fill:#737373;}</style></defs>
|
|
<title>NCBI Insights Blog</title>
|
|
<path class="cls-1" d="M14,30a4,4,0,1,1-4-4,4,4,0,0,1,4,4Zm11,3A19,19,0,0,0,7.05,15a1,1,0,0,0-1,1v3a1,1,0,0,0,.93,1A14,14,0,0,1,20,33.07,1,1,0,0,0,21,34h3a1,1,0,0,0,1-1Zm9,0A28,28,0,0,0,7,6,1,1,0,0,0,6,7v3a1,1,0,0,0,1,1A23,23,0,0,1,29,33a1,1,0,0,0,1,1h3A1,1,0,0,0,34,33Z"></path>
|
|
</svg>
|
|
</a>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
|
|
<section class="container-fluid bg-primary">
|
|
<div class="container pt-5">
|
|
<div class="row mt-3">
|
|
<div class="col-lg-3 col-12">
|
|
<p><a class="text-white" href="https://www.nlm.nih.gov/socialmedia/index.html">Connect with NLM</a></p>
|
|
<ul class="list-inline social_media">
|
|
<li class="list-inline-item"><a href="https://twitter.com/NLM_NIH" aria-label="Twitter" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<style type="text/css">
|
|
.st20 {
|
|
fill: #FFFFFF;
|
|
}
|
|
|
|
.st30 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
</style>
|
|
<title>Twitter</title>
|
|
<g>
|
|
<g>
|
|
<g>
|
|
<path class="st20" d="M192.9,88.1c-5,2.2-9.2,2.3-13.6,0.1c5.7-3.4,6-5.8,8.1-12.3c-5.4,3.2-11.4,5.5-17.6,6.7 c-10.5-11.2-28.1-11.7-39.2-1.2c-7.2,6.8-10.2,16.9-8,26.5c-22.3-1.1-43.1-11.7-57.2-29C58,91.6,61.8,107.9,74,116 c-4.4-0.1-8.7-1.3-12.6-3.4c0,0.1,0,0.2,0,0.4c0,13.2,9.3,24.6,22.3,27.2c-4.1,1.1-8.4,1.3-12.5,0.5c3.6,11.3,14,19,25.9,19.3 c-11.6,9.1-26.4,13.2-41.1,11.5c12.7,8.1,27.4,12.5,42.5,12.5c51,0,78.9-42.2,78.9-78.9c0-1.2,0-2.4-0.1-3.6 C182.7,97.4,189.2,93.7,192.9,88.1z"></path>
|
|
</g>
|
|
</g>
|
|
<circle class="st30" cx="124.4" cy="128.8" r="108.2"></circle>
|
|
</g>
|
|
</svg></a></li>
|
|
<li class="list-inline-item"><a href="https://www.facebook.com/nationallibraryofmedicine" aria-label="Facebook" rel="noopener noreferrer" target="_blank">
|
|
<svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<style type="text/css">
|
|
.st10 {
|
|
fill: #FFFFFF;
|
|
}
|
|
|
|
.st110 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
</style>
|
|
<title>Facebook</title>
|
|
<g>
|
|
<g>
|
|
<path class="st10" d="M159,99.1h-24V88.4c0-5,3.3-6.2,5.7-6.2h16.8V60l-24.4-0.1c-22.1,0-26.2,16.5-26.2,27.1v12.1H90v22.5h16.9 v67.5H135v-67.5h21.7L159,99.1z"></path>
|
|
</g>
|
|
</g>
|
|
<circle class="st110" cx="123.6" cy="123.2" r="108.2"></circle>
|
|
</svg>
|
|
</a></li>
|
|
<li class="list-inline-item"><a href="https://www.youtube.com/user/NLMNIH" aria-label="Youtube" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<title>Youtube</title>
|
|
<style type="text/css">
|
|
.st4 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
|
|
.st5 {
|
|
fill: #FFFFFF;
|
|
}
|
|
</style>
|
|
<circle class="st4" cx="124.2" cy="123.4" r="108.2"></circle>
|
|
<g transform="translate(0,-952.36218)">
|
|
<path class="st5" d="M88.4,1037.4c-10.4,0-18.7,8.3-18.7,18.7v40.1c0,10.4,8.3,18.7,18.7,18.7h72.1c10.4,0,18.7-8.3,18.7-18.7 v-40.1c0-10.4-8.3-18.7-18.7-18.7H88.4z M115.2,1058.8l29.4,17.4l-29.4,17.4V1058.8z"></path>
|
|
</g>
|
|
</svg></a></li>
|
|
</ul>
|
|
</div>
|
|
<div class="col-lg-3 col-12">
|
|
<p class="address_footer text-white">National Library of Medicine<br />
|
|
<a href="https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323" class="text-white" target="_blank" rel="noopener noreferrer">8600 Rockville Pike<br />
|
|
Bethesda, MD 20894</a></p>
|
|
</div>
|
|
<div class="col-lg-3 col-12 centered-lg">
|
|
<p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br />
|
|
<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br />
|
|
<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p>
|
|
</div>
|
|
<div class="col-lg-3 col-12 centered-lg">
|
|
<p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br />
|
|
<a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br />
|
|
<a href="https://www.nlm.nih.gov/careers/careers.html" class="text-white">Careers</a></p>
|
|
</div>
|
|
</div>
|
|
<div class="row">
|
|
<div class="col-lg-12 centered-lg">
|
|
<nav class="bottom-links">
|
|
<ul class="mt-3">
|
|
<li>
|
|
<a class="text-white" href="//www.nlm.nih.gov/">NLM</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.nih.gov/">NIH</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.hhs.gov/">HHS</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.usa.gov/">USA.gov</a>
|
|
</li>
|
|
</ul>
|
|
</nav>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIConfigJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js?v=1"> </script>
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/static/js/hfjs2.js"> </script>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<!--/.page-->
|
|
</div>
|
|
<!--/.wrap-->
|
|
</div><!-- /.twelve_col -->
|
|
</div>
|
|
<!-- /.grid -->
|
|
|
|
<span class="PAFAppResources"></span>
|
|
|
|
<!-- BESelector tab -->
|
|
|
|
|
|
|
|
<noscript><img alt="statistics" src="/stat?jsdisabled=true&ncbi_db=books&ncbi_pdid=book-part&ncbi_acc=NBK66044&ncbi_domain=pdqcis&ncbi_report=record&ncbi_type=fulltext&ncbi_objectid=&ncbi_pcid=/NBK66044.9/&ncbi_pagename=Bladder Cancer Treatment (PDQ®) - PDQ Cancer Information Summaries - NCBI Bookshelf&ncbi_bookparttype=chapter&ncbi_app=bookshelf" /></noscript>
|
|
|
|
|
|
<!-- usually for JS scripts at page bottom -->
|
|
<!--<component id="PageFixtures" label="styles"></component>-->
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal107 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3879255/4121861/3501987/4008961/3893018/3821238/4062932/4209313/4212053/4076480/3921943/3400083/3426610.js" snapshot="books"></script></body>
|
|
</html> |