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Future Treatment Options

Reviewed by: HU Medical Review Board | Last review date: September 2017.

Because bladder cancer is a relatively common cancer that affects so many people in the United States and around the world, there is a great deal of research being carried out on the disease. Areas of research include:

  • Robotic cystectomy
  • Immunotherapy drugs
  • Targeted therapy
  • Proton beam therapy
  • Photodynamic therapy
  • Gene therapy

What is a robotic cystectomy?

A new type of surgery called robotic cystectomy is currently being studied.1,2 Some people with bladder cancer will need surgery to remove the bladder, which is called a cystectomy. The standard way to perform a cystectomy is for the surgeon to make a single incision (cut) in the skin, through which the bladder is removed. In robotic cystectomy, the surgeon controls a very advanced computer system with robotic arms to perform the surgery through several smaller incisions rather than one larger one. This type of technology is already being used to perform surgery for other types of cancers, so researchers are working to find out if this works as well as standard surgery for bladder cancer.

What are immunotherapy drugs?

There is a large area of research looking at new medicines to help treat bladder cancer and lower the risk that bladder cancer will come back after treatment (recurrence).1,2Immunotherapy is a new and promising area of research into bladder cancer treatments. Immunotherapy drugs affect the body’s immune system to help it fight cancer. The immune system in the body works by protecting the body from diseases and infections. New immunotherapy drugs called immune checkpoint inhibitors work by helping the body to attack cancer cells. Immunotherapy drugs that have been approved for certain types of bladder cancer and are continuing to be studied include:

What is targeted therapy?

Another new type of medicines are called targeted therapies. These are designed to target only the cells and tissues that help cancer cells to grow, while minimizing damage to the other healthy cells. For some people with cancer who need chemotherapy as part of their treatment, targeted therapies may be recommended instead. They tend to have different side effects than standard chemotherapy drugs do. Researchers are testing some of these types of drugs to see if they are effective in treating bladder cancer, including lapatinib (Tykerb) and erlotinib (Tarceva). Targeted therapies are also being studied in combination with radiation therapy or chemotherapy to see if the combined treatments have an effect against bladder cancer.

What is proton beam therapy?

Proton beam therapy is a special type of radiation therapy treatment.3 Standard radiation therapy uses beams of energy, such as X-rays, to treat tumors. Proton therapy is a similar process, but it uses a different type of energy made up of proton particles. Proton therapy is not commonly used in the United States. Studies have shown that it may be effective in treating some types of cancer. Some researchers think that proton beam therapy causes fewer side effects than standard radiation therapy, because the proton beam can be targeted more closely on the tumor and has less of an effect on the surrounding body tissues. However, more research will be needed to find out if it is more effective than standard radiation therapy in treating bladder cancer.

What is photodynamic therapy?

A new treatment called photodynamic therapy is also being studied to find out if it is effective in treating certain types of bladder cancer that are located in the lining of the bladder.2 In this type of therapy, a drug that is sensitive to light is injected into the patient’s blood, where it collects in the cancer cells for several days. Afterwards, an instrument is inserted into the bladder that delivers a beam of laser light to the lining of the bladder where the cancer cells are located. The light works by activating the drug so that it kills the cancer cells in the bladder, while minimizing damage to the healthy cells. This type of treatment can only affect cancer cells that are in the bladder lining, not cancer cells that have grown into the wall of the bladder.

What is gene therapy?

Another very new type of treatment that is starting to be studied in bladder cancer is called gene therapy.2 This therapy works by affecting the genes located inside of the cancer cells using a special type of virus engineered by scientists in the lab. The virus infects the cancer cells and injects them with a gene that helps the body’s immune system to attack cancer cells more effectively.

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