Treatment decisions for bladder cancer
Making treatment decisions
The main treatments for muscle-invasive or locally advanced bladder cancer are:
- Surgery to remove the bladder (a cystectomy)
- Radical radiotherapy.
Your doctor may ask you to choose which treatment you would prefer. The aim of both treatments is to cure the cancer. They may both be effective. It is good to think about the possible benefits and disadvantages of treatment to help you make the right decision for you. The information below may help you do this. We also have general information about making treatment decisions that you may find helpful.
Talking to other people who have already had surgery or radiotherapy can also help. Your specialist nurse may know whether there is a local cancer support group, where you can talk to someone who has had similar treatment.
Or you can visit our Online Community to talk to people affected by bladder cancer, share your experience, and ask an expert your questions.
During and after treatment
Surgery
- You will be in hospital for 4 to 14 days.
- You will have a general anaesthetic.
- You need to be well enough to cope with the operation.
- You will have tests on your heart and lungs before the operation.
- It may take 3 to 6 months to fully recover.
Radiotherapy
- You will travel to the hospital each day (not on weekends), for 4 to 7 weeks for treatment.
- You will not have a general anaesthetic.
- Radiotherapy is not usually as physically demanding as surgery.
- If the cancer comes back after radiotherapy, you may be able to have surgery to remove the bladder. But the effects of radiotherapy may make surgery more complicated. Your doctor can talk to you about this.
Effects on bladder function
Surgery
- You will need surgery to make a new way for you to pass urine. This is called a urinary diversion. This will take time to get used to.
Radiotherapy
- You pass urine in the same way as before treatment.
- Bladder irritation is a common side effect during treatment.
- Sometimes, the bladder may be permanently affected by the late effects of radiotherapy. For example, you may find that your bladder reduces in size. This means you need to pass urine more often.
Effects on the bowel
Surgery
- Bowel complications may sometimes happen after surgery. But these usually get better with time.
Radiotherapy
- Sometimes, the bowel may be permanently affected by the late effects of radiotherapy. This means you may have bowel movements (poo) more often and have diarrhoea.
Effects on sex life
Surgery
- Men have a high risk of not being able to get or keep an erection after surgery. This is called erectile dysfunction, or ED.
- Women may have a shorter vagina due to surgery. This can make vaginal penetrative sex more difficult or cause changes in sensation.
Radiotherapy
- 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.