Bladder Cancer: Diagnosis, Treatment and Support Programs

Bladder Cancer Diagnosis Treatment and Support2
This page was originally published December 28, 2022 and updated June 29, 2024.

If you or someone you care about is facing a diagnosis of bladder cancer we understand that this is a challenging time and it’s completely natural to feel overwhelmed. You may be experiencing a flurry of emotions, compounded by a barrage of medical terms and decisions about treatment options. We’ve always said, knowledge is power. In this guide, we’ll provide you with an overview of diagnostics, explore current treatment paths, and introduce you to the many national support programs that are available to assist you through this journey. The aim is to arm you with knowledge, because understanding your condition is a significant step towards managing it. You are not alone in this journey; reach out to the nonprofit organizations throughout the USA that stand ready to help you with financial and emotional support. If you need help locating services, please reach out to us for help. ❤️

Diagnosing Bladder Cancer

As the National Cancer Institute describes, the diagnosis of bladder cancer typically begins with a physical exam and medical history review by a doctor. If bladder cancer is suspected, several tests may be ordered to confirm the diagnosis. These include urine tests, imaging tests such as CT scans or ultrasounds, and cystoscopy – a procedure that involves inserting a thin tube with a camera into the bladder to look for abnormal growths. A biopsy may also be taken during cystoscopy to determine the type and grade of bladder cancer.

While the initial diagnostic procedures are fundamental, sometimes, additional tests might be necessary to determine the stage of the bladder cancer, which refers to how far the cancer has spread. Staging is crucial in planning the appropriate course of treatment. Tests that help in staging include a transurethral resection (TURBT), which involves removing a tumor from the bladder wall for examination, or an Intravenous Pyelogram, an X-ray procedure that offers detailed images of the urinary system.

Sometimes doctors might also recommend a Bone Scan if they suspect that cancer has spread to the bones, or a Chest X-ray to check for metastasis to the lungs. Your healthcare team will discuss these tests with you, explaining their purpose and what you can expect during each procedure. Remember, medical tests and procedures can be stressful, but they are instrumental in creating an effective treatment strategy.

Your medical team will provide you with the results as soon as they’re available. Keep in mind that waiting for results can be a stressful time. It can be helpful to seek support from loved ones, or professional counselors during this period.

Bladder Cancer Treatment

The treatment of bladder cancer depends on several factors, including the type and stage of cancer, as well as the individual’s overall health. The main treatment options include surgery, chemotherapy, radiation therapy, and immunotherapy. Surgery is often the first line of treatment for early-stage bladder cancer, while more advanced cases may require a combination of treatments. Your doctor will work with you to develop a personalized treatment plan that best fits your needs.

Surgery for Bladder Cancer

Surgery is often the cornerstone of bladder cancer treatment. The type of surgical procedure depends on the stage and grade of the cancer. For non-invasive bladder cancers, a transurethral resection (TURBT) may be performed to remove tumors from the bladder’s lining. In more invasive cancers, a procedure called a radical cystectomy might be necessary, which involves the removal of the entire bladder, and possibly nearby lymph nodes and other organs where the cancer may have spread.

For muscle-invasive bladder cancers, partial or radical cystectomy is often required. Partial cystectomy involves removing only a portion of the bladder, while a radical cystectomy involves removing the entire bladder and possibly nearby lymph nodes, prostate in men, and uterus in women. The type of surgery will depend on how far the cancer has spread.

When a radical cystectomy is performed, you will need a new way to store and eliminate urine. This may involve creating a neobladder from a piece of intestine, which acts as a new bladder, or an ileal conduit, which is a small pouch that holds urine. Both procedures have their pros and cons, and your doctor will discuss these with you in detail.

Laparoscopic and robot-assisted surgeries are also increasingly common for treating bladder cancer. These minimally invasive procedures use small incisions, reducing healing time and minimizing scarring.

Remember, all surgeries carry risks. It is important to discuss these risks with your doctor, as well as the potential benefits, before making a decision. It may also be beneficial to seek a second opinion or speak with others who have undergone similar procedures.

After surgery, you will typically stay in the hospital for a period of time to recover. The length of stay varies depending on the type of surgery and your overall health. Upon discharge, you may need to use medical equipment to help with urination, and you may need temporary or long-term assistance at home.


Chemotherapy uses drugs to kill cancer cells. It can be administered before surgery (neoadjuvant chemotherapy) to shrink tumors and make surgical removal easier, or after surgery (adjuvant chemotherapy) to kill any remaining cancer cells. Chemotherapy might also be the primary treatment if surgery isn’t an option, or in conjunction with radiation therapy.

Chemotherapy for bladder cancer can be administered in two ways – intravesical or systemic.

Intravesical chemotherapy involves delivering the chemotherapy drugs directly into the bladder through a catheter. This method is commonly used for non-invasive bladder cancers or cancers that are only on the bladder’s surface. Since the drugs are applied directly to the bladder, they generally do not reach other parts of the body, thereby reducing the risk of systemic side effects.

Systemic chemotherapy, on the other hand, is used when the cancer has invaded the muscle layer of the bladder or spread to other parts of the body. This involves administering chemotherapy drugs orally or through an IV, allowing them to enter the bloodstream and attack cancer cells throughout the body.

The drugs used, dosages, and duration of chemotherapy treatment can vary greatly depending on the specific circumstances of each patient, including the stage and grade of the cancer, the patient’s overall health, and their response to treatment. Common chemotherapy drugs used for bladder cancer include cisplatin, gemcitabine, and methotrexate, among others.

Radiation Therapy

Radiation therapy uses high-energy radiation to destroy cancer cells. It can be used alone in early-stage bladder cancer or together with chemotherapy in more advanced stages. While it doesn’t involve surgery, it does have potential side effects, including fatigue, skin reactions, and potential changes to bowel and bladder function.

One common type of radiation therapy used in bladder cancer treatment is external beam radiation therapy (EBRT). In this method, a machine directs a beam of high-energy particles at your cancer. You would typically receive EBRT once a day, five days a week, for several weeks.

EBRT is often combined with chemotherapy in a process known as chemoradiation. The chemotherapy makes the cancer cells more susceptible to the radiation. EBRT can also be used to alleviate symptoms in patients with advanced or metastatic bladder cancer.

Another radiation therapy option is brachytherapy, or internal radiation. This involves placing radiation sources (in the form of seeds, ribbons, or capsules) inside the bladder, close to the cancer cells. This allows for a higher dose of radiation to be delivered directly to the cancer, while minimizing exposure to healthy tissues. Brachytherapy is typically used in early-stage bladder cancer or for patients who cannot undergo surgery.

The choice of treatment depends on several factors, including the type and stage of bladder cancer, your overall health and preferences. Your healthcare team will work with you to choose the most suitable treatment options.


Immunotherapy, or biological therapy, is a newer type of bladder cancer treatment that uses the body’s immune system to fight cancer. Bacillus Calmette-Guérin (BCG) is one such immunotherapy that’s introduced directly into the bladder through a catheter. Other types of immunotherapy, known as checkpoint inhibitors, work by interfering with the mechanism that cancer cells use to hide from the immune system.

Checkpoint inhibitors constitute a category of immunotherapy that functions by blocking proteins on the cancer cells, or proteins on the T cells that the immune system uses to kill cancer. When these proteins are blocked, the “brakes” are released on the immune system, enabling it to recognize and attack cancer cells more effectively. Some of the checkpoint inhibitors that have shown promise in treating bladder cancer include pembrolizumab (Keytruda), atezolizumab (Tecentriq), and nivolumab (Opdivo).

Immunotherapy signifies a promising direction in bladder cancer treatment, harnessing the body’s own defense mechanism to fight the disease. Despite its potential side effects, its capacity to target cancer cells specifically minimizes damage to healthy cells, often making it a preferred route of treatment. Like all treatments, its suitability depends on the patient’s overall health, the type and stage of the cancer, and other factors. Your healthcare team will work with you to decide if immunotherapy is the right option for your situation.

Each of these treatments carries its own set of benefits and potential side effects. It’s essential to discuss these aspects with your medical team to make an informed decision about your treatment. Your quality of life, personal preferences, and long-term prognosis are all important factors to consider when choosing a treatment approach.

Ongoing Research and Development

In the relentless pursuit of better treatment options for bladder cancer, ongoing research and development, as well as clinical trials, play a pivotal role. These initiatives are critical in expanding our understanding of the disease, uncovering new treatment options, and improving existing therapies.

Many investigational drug studies are underway, seeking to identify new drugs or drug combinations that could enhance the effectiveness of bladder cancer treatment. These studies typically involve preclinical testing – in the lab and on animals – before advancing to clinical trials involving human participants.

Considerable effort is being directed towards expanding the applications of immunotherapy in treating bladder cancer. Researchers are investigating how to make immunotherapy more effective, understand why some patients respond better than others, and find ways to reduce side effects.

Clinical Trials

Clinical trials are instrumental in bringing new treatments from the laboratory to the clinic. These trials test the safety and effectiveness of new treatments or new ways to use existing treatments. Patients who participate in clinical trials have the opportunity to access leading-edge treatments before they are widely available. However, they must also be prepared for unknown side effects and the possibility that the new treatment may not work as expected.

There are numerous clinical trials currently taking place for bladder cancer around the world, focusing on everything from novel chemotherapy and radiation therapy strategies to new surgical techniques and targeted therapies. Each of these trials contributes valuable knowledge to the field and has the potential to revolutionize bladder cancer treatment.

Ongoing research and clinical trials are an integral part of advancing bladder cancer treatment. They offer hope for more effective treatment options and ultimately, a cure for this disease. Your healthcare team can help you understand if participating in a clinical trial could be a valuable part of your treatment plan.

National Support Programs

Facing a diagnosis of bladder cancer can be overwhelming and isolating. It’s important to remember that you are not alone in this journey. There are numerous support programs available to help you cope with the physical, emotional, and financial challenges that come with a diagnosis of bladder cancer. These programs

PAF Metastatic Bladder Cancer Copay Fund

The Patient Advocate Foundation (PAF) Metastatic Bladder Cancer Copay Fund is an initiative aimed at providing financial support to eligible patients to help ease the burden of treatment expenses. Its main goal is to alleviate the financial stress associated with the cost of care, allowing patients to focus more on their recovery and less on financial constraints.

This financial assistance program by the Patient Advocate Foundation helps cover the costs of co-pays, co-insurance & deductibles for bladder cancer patients. Eligible applicants must reside and receive treatment in the United States and earn less than 400% of Federal Poverty Level guidelines (FPL). Maximum award $7500 per year. To apply, visit this link.

This fund is just one example of how the Patient Advocate Foundation is working to provide crucial support and resources to patients in need. Their efforts highlight the importance of financial assistance programs in the fight against cancer, as they can significantly improve a patient’s quality of life and treatment experience. Reach out for assistance.

Opdivo (Nivolumab) Prescription Assistance Program

The Opdivo (Nivolumab) Prescription Assistance program is a critical resource for patients who have been prescribed this powerful immunotherapy drug. This medication is often used in the treatment of various types of cancer, including metastatic bladder cancer. However, its cost can be significant, and this is where the prescription assistance program comes in.

The program is designed to provide comprehensive support to patients, making the process of accessing and affording Opdivo easier. It provides benefits investigations, assisting patients in understanding what their insurance covers and how much they may need to pay out-of-pocket. This transparent information helps patients plan for expenses associated with their treatment.

This program provides support to patients who have been prescribed Opdivo, offering benefits investigations, prior authorization assistance, and appeal process support. They also offer co-pay assistance to eligible patients based on financial need. Call (800) 861-0048 8 am to 8 pm ET, Monday – Friday for help over the phone or complete the request form here on the website.

BCAN Professional Navigator Program

The BCAN (Bladder Cancer Advocacy Network) Professional Navigator Program is a valuable tool dedicated to serving the bladder cancer community. This patient-focused initiative provides essential support to individuals on their cancer journey, offering a lifeline during a challenging period.

The program connects individuals with experienced oncology social workers who understand the unique challenges faced by bladder cancer patients and their loved ones. These professionals are specifically trained to handle a variety of queries and issues related to the physical, emotional, and logistical aspects of managing bladder cancer.

The BCAN Professional Navigator helpline connects callers to experienced oncology social workers specialized in addressing the unique challenges faced by the bladder cancer community. The team at the call center is equipped to cater to the emotional, logistical, and informational needs of patients and their families. Services are free of charge. Call (833) 275-4222 toll free for help over the phone or visit the website for more.

Next Steps

Bladder cancer can be a challenging diagnosis, but there are various diagnostic tools, treatment options, ongoing research efforts, and support programs available to help patients manage their condition. Whether it’s financial assistance or emotional support you need

Remember, you are not alone in this journey, and there are resources and support systems available to help you through. Don’t hesitate to reach out and ask for help when you need it. You deserve all the support you can get as you navigate through this difficult time. So, if you or someone you know has been diagnosed with bladder cancer, remember that help is available. From financial assistance to emotional support and resources, visit our resource list for organizations across the nation that dedicated to helping those affected by this form of cancer. 

More Help for Bladder Cancer Patients and Families

Looking for more support and resources for bladder cancer patients and families in the USA? Check out our comprehensive national directory that lists a variety of free and low-cost programs, products, and services specifically designed for those affected by bladder cancer. From financial assistance to emotional support, our directory is a valuable tool for finding help and guidance during this difficult time. For more assistance, please visit our national directory with many free and low-cost programs, products and services for bladder cancer patients in the USA. ❤️

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