Follow-up after treatment for early bladder cancer
After your treatment finishes, you'll have regular check-ups. These will usually take place every 3-6 months at first, and you’ll continue to have them for several years.
If you have any new symptoms, or symptoms that come back in between appointments (especially blood in your urine), let your doctor know straight away.
The most important test for follow-up is cystoscopy. Some people may also have their urine checked for cancer cells.
You will have regular cystoscopies to monitor how well treatment has worked, and to check that no new cancers are growing in the bladder. The cystoscopy will be done in the outpatient department under local anaesthetic.
If you have non-invasive bladder cancer that has a low risk of coming back, you’ll probably have two cystoscopies 3-6 months after treatment. After this, you’ll usually have one once a year until your urologist decides to discharge you.
If the risk of the cancer coming back is high, you’ll have more frequent cystoscopies and longer follow-up (possibly for life). Your specialist will explain more about this.
If the cancer comes back
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It’s not uncommon for bladder cancer to come back in the lining of the bladder. If this happens, it can usually be removed with an operation. Some people may be given chemotherapy into the bladder. If you’ve had intravesical chemotherapy before, you may be given BCG treatment. Non-invasive bladder cancer that comes back in the bladder can still be cured or controlled for a long time.
In some people, the cancer may start to grow into the muscle layer of the bladder (invasive bladder cancer). If this happens, the urologist will usually recommend an operation to remove the bladder.
A cystectomy may also be advised when treatment with BCG isn’t working or if the cancer keeps coming back. Some people may have radiotherapy (high-energy rays to destroy cancer cells) to the bladder instead of a cystectomy.
The aim of surgery and radiotherapy is to cure the cancer before it spreads into or through the muscle layer. If bladder cancer spreads outside the bladder to other organs in the body (secondary or metastatic cancer), it can no longer be cured.
Your urologist, cancer specialist or specialist nurse will discuss this with you and explain what the treatments involve.