Treatment decisions

You may be offered the choice of having either surgery or radiotherapy as your main treatment. Chemotherapy is usually given before both of these treatments.

Surgery and radiotherapy may work as well as each other, but each has its own benefits and disadvantages. Deciding what treatment to have can be difficult. Your doctors, specialist nurse and stoma nurse will talk to you about the different treatments and their effects. They can answer any questions you have to help you reach a decision.

Make sure you have the information you need, so you feel confident about making the right decision for you. You may also want to talk it over with family and close friends.

The table below shows the main differences between surgery and radiotherapy.

You may also find it helpful to read our information about making treatment decisions.

Table about surgery and radiotherapy

You may find it helps to look at this table again after you have read about surgery and radiotherapy.

SurgeryRadiotherapy
What does the treatment involve?

You will be in hospital for 7 to 21 days.

You’ll need a general anaesthetic.

You’ll need surgery to make a new way for you to pass urine. This is called a urinary diversion.

A urinary diversion can take time to get used to. It may affect your body image.

It can take 3 to 6 months to return to full fitness.

You may need chemotherapy too.

You will need to travel to the hospital each weekday, for 4 to 7 weeks for treatment.

Common side effects during treatment include bladder irritation (passing urine more often and urgently) and diarrhoea.

Radiotherapy is not usually as physically demanding as surgery.

You may need chemotherapy too.

Some people may need surgery to remove the bladder if the cancer comes back.

Effects on bladder function

You will have a new way to pass urine, which will take time to get used to.

You will be able to pass urine in the normal way.

Some people find that their bladder reduces in size. This means they need to pass urine more often.

Effects on the bowel

Bowel complications may sometimes happen after surgery. But these usually get better with time.

Sometimes, the bowel may be permanently affected by radiotherapy (late effects).

This means you may have bowel motions more often and have diarrhoea.

Effects on sex life

Men have a high risk of not being able to get or keep an erection after surgery.

Women may have a shorter vagina due to surgery. This can make penetrative sex more difficult or uncomfortable, or cause changes in sexual sensation.

Some men may find radiotherapy makes it more difficult to get an erection.

Some women may find that radiotherapy narrows their vagina. This can make sex more difficult or uncomfortable.

Back to Understanding your diagnosis

Just been diagnosed

Just been diagnosed with cancer? We're here for you every step of the way. There are many ways we can help.

Staging and grading

Doctors will stage and grade the cancer using further tests. This helps them to choose the most appropriate type of treatment.

My Cancer Treatment

Macmillan is supporting a new online tool to help you make decisions about your treatment and care. The tool currently only covers England.

Treatment overview

The main treatments for invasive bladder cancer are chemotherapy, surgery to remove the bladder and radiotherapy.