How is bladder cancer treated?
Every patient at Miami Cancer Institute receives a personalized treatment plan. If you are diagnosed with bladder cancer, a urologist will evaluate and manage your care. A patient with advanced bladder cancer that is muscle invasive may also be seen by a urologic oncology surgeon, radiation oncologist and medical oncologist.
Our philosophy is to find the plan that not only treats the cancer, but also fits you as a patient. Your team will consider your specific diagnosis and type of tumor, the stage of disease, size and location of tumor and whether it has spread to other parts of your body. We also work closely with physical therapists, nurses, nutritionists and psychosocial experts to ensure we address any potential side effects of treatment.
Surgery may be needed to treat bladder cancer, and we will work together with you to develop an effective surgical plan. Our surgeons' goal is to preserve as much of your bladder as possible, or recreate your bladder if needed.
Surgery may involve removing the tumor using an instrument inserted through the urethra (transurethral resection). This method is typically used for early stage bladder cancer that has not spread.
If the bladder cancer is invasive or has spread, surgery may involve removing your entire bladder, a procedure known as a radical cystectomy, and surrounding lymph nodes.
In some cases, we may be able to use minimally invasive robotic surgery to remove your bladder. This procedure, known as a robotic radical cystectomy, uses several small incisions in your abdomen rather than one large, open incision.
Robotic surgery, or robot-assisted surgery, uses a camera, computer and very small surgical tools that are attached to robotic arms. This special equipment helps surgeons access tumors in tight spaces through small incisions with greater precision.
During a robotic radical cystectomy, your surgeon will use the robotic surgery system to remove your bladder. The robotic arms help guide the camera and surgical tools through the small incisions to your bladder. This type of surgery has many benefits, including less blood loss, less pain and quicker recovery time.
If we remove your bladder, our surgeons will create a new bladder using part of the small intestine. This procedure is called neobladder reconstruction. This reconstructed bladder will be in the same place as a normal bladder.
If the surgeon is not able to create a neobladder, he or she may create an opening in your abdomen through which urine can drain. This is called a urostomy. The urine will drain through the opening and into a pouch called an ostomy bag, which you can then drain into a toilet.
Keep in mind that there are several factors that may influence how your bladder is reconstructed or replaced. Your surgical team will work with you to discuss options and find what works best for you.
Depending on the location and stage of your tumor, your care team may decide to use other treatments, including:
- Chemotherapy – this treatment uses medicine – or several medicines – to kill cancer cells. Chemotherapy may be given before or after surgery.
- Radiation therapy – this treatment uses image-guided radiation to kill cancer cells.
- Immunotherapy – this treatment uses medicines that stimulate an immune response to destroy cancer cells.
A multidisciplinary team of cancer experts including surgeons, medical oncologists, radiation oncologists, plastic reconstructive surgeons, pathologists, radiologists, genetic counselors, medical geneticists, social workers, patient navigators and clinical trials staff meet weekly to discuss select complex cases and determine the best course of care.
Miami Cancer Institute can provide access to clinical trials not widely available elsewhere. Clinical trials find new ways to treat and diagnose cancer and are ongoing. If an appropriate trial is available, we will talk to you about the benefits and risks.
Patient Support Services
Taking care of the whole patient is an important component of providing personalized cancer care. Integrated into the fabric of the Miami Cancer Institute, the Cancer Patient Support Center addresses the psychological, physical, social and spiritual needs of our patients during cancer treatment and beyond.