How is high-grade bladder cancer treated if it recurs?

Karim Chamie, MD
High-grade bladder cancer tumors have a high propensity of recurring. If they do recur, another round of Bacillus Calmette-Guérin (BCG) in the bladder may help. Your doctor may also try interferon in combination with BCG. Gemcitabine and valrubicin are also options. If the cancer keeps coming back, patients should strongly consider a radical cystectomy, which is a removal of the entire bladder, surrounding fatty tissues, and regional lymph nodes. When the bladder is removed, urine is then diverted to a neobladder (a new bladder made of intestine), a catheterizable pouch, or an ileal conduit. 

Another treatment is radiation therapy along with chemotherapy. The radiation should be directed at the bladder and surrounding structures five days per week for six to eight weeks. Chemotherapy in combination with either radiation or surgery can last anywhere from six weeks to six months, depending on the type of program a person is on.
The decision to pursue aggressive treatment such as surgical removal of the bladder (or radiation therapy) vs intravesical instillation of chemotherapy depends on the grade, so someone with a high-grade T1 should have a cystectomy, while a person with a high-grade Ta may require other treatments. Additionally, bladder cancers that come back more frequently have a worse prognosis than those that take longer

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.