Treating superficial bladder cancer

TURBT surgery

To confirm a suspected malignant bladder tumour, the first step is to obtain a tissue sample from the tumour. As with cystoscopy, to achieve this the tumour is usually removed completely via the urethra using an electrified loop (resectoscope). This procedure is known as TURBT.

Further treatment for bladder cancer depends on the extent of the tumour, the degree of malignancy (how aggressive the tumour is) and whether there are any secondary tumours (metastases).

Superficial malignant tumours (Ta and T1 tumours)

In the case of more extensive tumours, highly aggressive tumours or where it is suspected that there may still be some tumour cells remaining, a second TURBT procedure will be performed 4 to 6 weeks later. During this procedure, the surgeon will check whether there are any bits of tumour remaining at the base or margins of the tumour site.

For more extensive or recurrent tumours, it may be advisable to follow this with (adjuvant) intravesical therapy with mitomycin C or BCG (Bacillus Calmette-Guerin). This is intended to reduce the likelihood that the tumour will come back. This ‘instillation therapy’ is performed as an outpatient procedure.