Locally Advanced, Invasive Bladder Cancer Treatment

Localized, invasive bladder cancer occurs when the cancer has spread to the muscle layer of the bladder. For most patients, treatment typically requires surgery along with chemotherapy to eliminate microscopic cancer in the patient's body.

At the University of Chicago Medicine, our bladder cancer team specializes in treating invasive bladder cancer and welcomes complex cases and high-risk patients, including those who are not surgical candidates due to pre-existing medical conditions. Our team offers comprehensive bladder cancer treatment through combined chemotherapy and radiation as an alternative to radical cystectomy.

Radical Cystectomy

Once bladder cancer has progressed to the muscle of the organ, cystectomy is often the standard, first-line treatment to remove tumors and prevent the cancer from metastasizing (spreading to other organs).

Urologists at the UChicago Medicine have extensive, proven experience in cystectomy surgery. Our surgeons are leaders in cystectomy innovation and perform more radical cystectomies a month than any other institution in the Midwest region, ensuring our patients can feel confident that they are in capable hands for their procedure.

Depending on your diagnosis, you doctor may recommend a partial or radical cystectomy.

• Partial: When a partial cystectomy is performed, the portion of the bladder containing the cancer is removed. For a patient to be a good candidate for this procedure, they must have a small tumor that has invaded the muscle layer but is completely confined to one area of the bladder. Typically, only 5 percent of patients with muscle invasive bladder cancer are appropriate candidates for partial cystectomy.
• Radical: A radical cystectomy is performed when a patient has tumors located in multiple areas of the bladder muscle layer, and the entire bladder must be taken out. After the bladder is removed, your surgeon will perform a urinary diversion to provide a new method for urine to leave the body. There are three major types of diversions: neobladder, ileal conduit urinary diversion and continent cutaneous pouch.

Chemotherapy

For patients with invasive bladder cancer, chemotherapy can be administered before surgery (neoadjuvant) in an effort to shrink any tumors in the bladder prior to operating. Chemotherapy can also be used after surgery (adjuvant) to kill any undetected, microscopic cancer cells that have spread beyond the bladder.

Radiation Therapy

Radiation therapy uses high-energy radiation from X-rays to shrink tumors and is typically administered in combination with other therapies, such as chemotherapy or surgery. Radiation therapy requires precision in order to maximize the benefits. By using the latest targeting systems, our radiation oncologists can accurately direct high-dose radiation while preserving healthy tissue.

As an alternative to radical cystectomy, radiation therapy can be used in combination with chemotherapy to serve as a bladder-sparing treatment for patients. The duration and dose of radiation treatments are tailored to each patient based on their individual diagnosis. For invasive bladder cancer, radiation therapy is typically administered five days per week for five to seven weeks.