Treatment for Non-Muscle Invasive Bladder Cancer

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Non-muscle invasive bladder cancer is when the tumor(s) have not spread into the bladder muscle. These tumors are Stage 0 (which can be further divided into stage 0a and stage 0is/Tis) or Stage I (1) bladder cancer. Learn more about staging.

Ask your health care team about the short- and long-term side effects your treatment may cause and how to cope with those side effects. You will also want to know what symptoms you should let your urology care team know about right away.

Treatment for Stage 0a

If you have a stage 0a, your doctor will perform a TransUrethral Resection of Bladder Tumor (TURBT) that removes the tumor. This will be the only cancer treatment you need. But because bladder cancer has a high risk of coming back, you will need to see your urologist regularly for cystoscopies and other follow-up tests.

If the cancer does comes back, it’s usually the same grade and stage and is treated with another TURBT.

Treatment for Stage 0is/Tis and Stage I (1)

LIke stage 0a, treatment for stage 0is/Tis and stage I (1) bladder cancer begins with a TURBT to remove the tumor. But to help keep these cancers from coming back, you may also need intravesical therapy—a treatment that is put directly into the bladder using a catheter.

Bladder Graphic 1.4
Cancer Research UK, Diagram showing drug treatment into the bladder, CC BY-SA 4.0

Intravesical treatment options include:

  • BCG (Bacille Calmette-Guérin), a type of immunotherapy that is given several times, over a few weeks.
  • Chemotherapy, typically given within 24 hours of the TURBT.

Side effects of intravesical therapy include:

  • Bladder irritation or pain
  • Burning during urination
  • Urgency to urinate
  • Frequent urination
  • Bladder infections
  • Blood or blood clots in your urine

Some side effects are more common among people treated with BCG. These include:

  • Fatigue
  • Flu-like symptoms
  • On rare occasions, an autoimmune disorder
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Adapted from Diagram showing early stage bladder cancer by Cancer Research UK, CC BY-SA 4.0

Clinical Trials

Patients with non-muscle and muscle-invasive bladder cancer, may want to consider clinical trials as treatment options. These research studies might be investigating new drugs, new drug combinations, or new surgical or radiation techniques. Or, they might be looking at ways to help cancer survivors.

Regular Follow Up

Bladder cancer has a high risk of coming back. You will need to have routine follow-up tests and exams to find a recurrence as early as possible.

  • If you have a Stage 0a noninvasive papillary tumor, the TURB-T that removes the tumor will be the only treatment you need. However, you will need to see your urologist regularly for cystoscopies and other follow-up tests. 
  • If you have Stage 0is or Stage I (1), your urologist may have you come back about 4 to 6 weeks for another TURBT. Then, you will have additional cystoscopies and other tests every three months.
  • If your cancer doesn’t come back, follow-up visits can be spaced longer apart, such as every 6 months or once a year.

If you are at high risk for recurrence or you have many recurrences, your doctor may recommend that you have your bladder removed. This is called a cystectomy. Visit Treatment for Muscle-Invasive Bladder Cancer to learn more.

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