Bladder Cancer Treatment Options
Hackensack Meridian Health is New Jersey’s leading bladder cancer program with the most advanced treatment options, including robotic surgery and clinical trials of the latest therapeutics. Above all, our focus is preserving your bladder and urinary function while providing the best cancer outcome.
Your bladder cancer treatment will be determined by whether it’s grown into the muscle of the bladder wall. Beyond this, we personalize your treatment plan to target your precise tumor type based on its genetic profile, grade, stage and specific location.
- Non-Muscle Invasive Bladder Cancer: Confined to the inner lining of the bladder. Treatment usually is minimally invasive TUR (transurethral resection) to remove the tumor and preserve your bladder. We also may recommend intravesical therapy or immunotherapy to help prevent cancer from returning.
- Muscle-Invasive Bladder Cancer: Located deeper in the bladder wall and harder to treat. We take a multi-pronged approach with surgery in conjunction with immunotherapy, chemotherapy, image-guided radiation therapy (IGRT) or clinical trials.
Bladder Tumor Resection
Transurethral Resection (TUR) is a minimally invasive surgery to remove non-muscle invasive cancer while preserving the bladder. The surgeon inserts a cystoscope and wire tools through the urethra to the bladder, so no incisions are made. Cancer is removed using electrical current or laser. Hackensack Meridian Health is one of only two centers in the state offering blue light cystoscopy, that makes non-muscle invasive bladder cancer glow bright pink, so the urologist can see any remaining cancer cells to be removed. Blue light cystoscopy is proven to reduce the chance of cancer progressing or returning.
Robotic and Minimally Invasive SurgeryThe urologists at Hackensack Meridian Health are pioneers in robotic surgery and minimally invasive techniques for treating bladder cancer. Always, our goal is to provide you with the best cancer outcome while sparing as much of your bladder and urinary function as possible.
We were among the first in the tri-state area to perform robotic bladder cancer surgery. We’ve taken the procedure one step further with a single-port approach, which means all surgical tools and camera are inserted through a single incision. Hackensack University Medical Center was among the first hospitals in the world — and the first in New Jersey — to use the da Vinci SP® single-port robotic surgery system for urologic surgeries. Compared to traditional surgery, single-port robotic bladder cancer surgery offers:
- One incision, and less tissue damage
- Increased precision and flexibility for complex surgeries
- Decreased blood loss, reduced need for transfusions, and less risk of infection
- Less pain after surgery
- Smaller external and internal scars
- Shorter hospital stay
- Faster recovery and return to normal activities
Learn more about robotic surgery.
- Bladder Sparing Surgery (Partial Cystectomy): Robotic or minimally invasive surgery to remove only part of the bladder, while saving some of your bladder and nerves necessary for bladder control.
- Bladder Removal (Radical Cystectomy): Robotic or minimally invasive surgery to remove the entire bladder, along with the prostate in men and the uterus and fallopian tubes in women.
If the bladder needs to be removed, we often can build a new bladder. One of three methods may be used to provide a way for urine to exit your body.
- Ileal Conduit: A small segment of intestine is used to divert urine from the body through an opening next to the navel. This requires urine to be collected in an external device or bag.
- Neobladder Reconstruction: A segment of the small intestine is used to build a new bladder. This allows you to urinate normally without a bag or tube.
- Indiana Pouch: For patients who are not candidates for neobladder reconstruction but wish to avoid an external bag, an Indiana pouch is created with a small section of small intestine. Urine is collected inside the body. A small opening in the skin is made for a catheter to empty the reservoir.
- Six dedicated robotic urological systems, including New Jersey’s first da Vinci SP® single-port robot.
- Hackensack University Medical Center was among the first hospitals in the world to use the da Vinci SP® single-port robotic surgery system for urologic surgeries.
- More than 90 percent of major urology surgeries at Hackensack University Medical Center use robotic technology.
- Our urologists publish robotic surgery studies in academic journals and present at international conferences.
Hackensack Meridian Health offers unparalleled experience using intravesical therapy to treat non-muscle invasive bladder cancer and preserve your bladder. Intravesical therapy is a liquid drug delivered through a catheter directly into your bladder. It bathes the lining of the bladder to kill cancer cells or stimulate the body to fight the cancer. This prevents side effects that can occur with chemotherapy and other therapies that circulate throughout your body. Intravesical therapy includes:
- Bacillus Calmette Guerin (BCG): A form of immunotherapy that has proven effective for decades, BCG is inactive bacteria that prompts an immune response in the bladder. It is delivered in a series of six treatments.
- Intravesical Chemotherapy: For non-muscle invasive cancer, we may recommend intravesical chemotherapy following TUR to prevent cancer from returning. If cancer persists following BCG, you may be a candidate for a new intravesical therapy with anticancer drugs gemcitabine and docetaxel. Hackensack Meridian Health is among the first in New Jersey to offer intravesical therapy for bladder cancers that, despite initial treatment, have continued to grow but are not muscle invasive. This approach may prevent up to half of patients with persistent, non-muscle invasive cancer from needing their bladder removed.
Retired high school physics teacher Peter Kahan, 76, has impacted the lives of hundreds of students during his decades of teaching. Now one of his former students, Ravi Munver, M.D., a urologic oncologist and vice chair of the Department of Urology at Hackensack University Medical Center, is returning the favor, leading the team treating Peter for bladder cancer.
Other Bladder Cancer Treatments
If your non-muscle invasive bladder cancer has been unresponsive to treatment, you may be a candidate for checkpoint inhibitor immunotherapy as an alternative to bladder removal surgery.
Immune checkpoints are a natural part of the immune system. However, cancer blocks immune checkpoints and causes the body to attack healthy cells.
Checkpoint inhibitors are designed to prevent that process and allow the immune system to be more active in attacking cancer cells.
Chemotherapy uses medications to kill cancer cells. We offer the latest, most promising immunology approaches designed to treat your type of cancer. Our team of urologists works with medical oncology colleagues at the John Theurer Cancer Center to determine if systemic chemotherapy is appropriate for you.
Depending on your stage of bladder cancer, your treatment plan may include:
- Chemotherapy as the first line of treatment.
- Chemotherapy prior to surgery, to shrink your tumor or tumors.
- Chemotherapy following surgery, to kill any remaining cancer cells and prevent recurrence.
- Chemotherapy in combination with radiation therapy, as an alternative to surgically removing the bladder.
Advancements in radiation therapy now allow us to offer it in conjunction with chemotherapy as an alternative to surgically removing the bladder, for some patients who are candidates for this approach.
Our radiation therapy specialists are among the region’s most experienced in using image-guided radiation therapy (IGRT), which employs images taken before each radiation therapy session to precisely focus treatment on the exact location of the cancer cells. IGRT allows for the most effective dose of radiation while minimizing side effects and protecting healthy bladder tissue.
Our team of Urologists works with radiation oncology colleagues at the John Theurer Cancer Center to determine if radiation therapy is appropriate for you. Your personalized bladder cancer treatment plan may include:
- Radiation therapy before surgery, to shrink your tumor or tumors.
- Radiation therapy following surgery, to kill any remaining cancer cells and prevent recurrence.
- Radiation therapy in combination with chemotherapy, as an alternative to surgically removing the bladder.
- Radiation therapy as palliative treatment if you are unable to have surgery, to help control symptoms of advanced bladder cancer.
Some muscle-invasive bladder cancer can be difficult to treat. You may be a candidate for a clinical trial of a new treatment approach. Our patients have access to the widest range of bladder cancer clinical trials available in northern New Jersey. This includes exciting immunotherapy agents or combinations of chemotherapy drugs not available elsewhere. Clinical trials provide our patients today with the bladder cancer treatments of tomorrow.
Our award winning team of renowned surgeons, physicians, researchers and other health care specialists are able to provide you with exceptional urological expertise, advancements and cutting-edge technology to develop a highly- personalized plan for each and every one of our patients.