Although great headway is being made in the field of biomarker studies, at this point in time pathological assessment of stage and grade is still the best index of prognosis in common use. Stage is determined by the depth to which the tumor has penetrated the bladder wall, and assessment of invasion of lymph nodes and other surrounding organs and tissues. The grade is determined by pathology tests, showing how abnormal or aggressive the cells of biopsy specimens appear, and how closely a tumor resembles normal tissue of its same type. The choice of treatment depends on the type of tumor and the stage of disease when it is found, however, age, health, and personal preferences are also factors. The four main types of treatments for bladder cancer are surgery, chemotherapy, immunotherapy and radiation.
Transurethral resection is the primary treatment for most tumors.
It is a minimally invasive surgical technique where tumors are removed through the urethra via an endoscope equipped with a special tool on the end for excision of tissue. Cauterization prevents excessive bleeding. Chemotherapy used to treat bladder cancer can be either local or systemic. Intravesical chemotherapy is placed directly into the bladder and is therefore considered local chemotherapy. This type of chemotherapy is typically used to treat earlier stages of bladder cancer.