How Is Bladder Cancer Treated?

There are many different types of treatment for bladder cancer. Your care team will help determine what the best treatment is for you. This can depend on the stage and grade of your cancer, as well as other factors.¹

Surgery

Surgery is one of the most common treatments for bladder cancer. Types include:^1-3

• Transurethral resection (TUR) or transurethral resection of bladder tumor (TURBT) – DA doctor passes a thin tool with a telescope through the urethra into the bladder to remove the tumor. The doctor may also burn the area with an electric current (fulguration) or a laser (laser ablation).
• Partial cystectomy – This is surgery to remove part of the bladder.
• Radical cystectomy with urinary diversion – This removes the whole bladder, and sometimes nearby lymph nodes or organs that have cancer. The surgeon then creates a new way for the body to store and pass urine (urinary diversion).

Immunotherapy

Immunotherapy treatments are designed to help your own immune system fight cancer. In bladder cancer treatment, this includes systemic immunotherapy and intravesical immunotherapy.^1,3

Systemic immunotherapy travels throughout the whole body. Some are now approved for use before or after surgery to remove the bladder. Durvalumab is also approved with BCG for some early-stage cancers. Examples approved for bladder cancer in the United States include:^1,3-7

• Nivolumab (Opdivo®)
• Avelumab (Bavencio®)
• Pembrolizumab (Keytruda®)
• Durvalumab (Imfinzi®)
• Atezolizumab (Tecentriq®)

Intravesical immunotherapy is immunotherapy that is delivered directly into the bladder. This is commonly done with Bacillus Calmette-Guerin (BCG). BCG is a type of bacteria that activates the immune system in the bladder to attack cancer cells. Intravesical immunotherapy examples include:^1,3

• Nadofaragene firadenovec (Adstiladrin®) – Uses a virus containing a gene that helps bladder cells make a protein that fights cancer
• Nogapendekin alfa inbakicept (Anktiva®)

Targeted therapy

Targeted therapy acts on specific genes, enzymes, or proteins in cancer cells. This can slow or block the growth and spread of the cancer.^1,8

Targeted therapies, including antibody-drug conjugates, that may be used to treat certain forms of bladder cancer include:^1,3,5,8,9

• Erdafitinib (Balversa®)
• Enfortumab vedotin (Padcev®) – Approved alone and with pembrolizumab, including before and after bladder removal surgery
• Fam-trastuzumab deruxtecan (Enhertu®) – Approved for advanced solid tumors of any type that have high levels of a protein called HER2, after other treatment

Chemotherapy

Chemotherapy drugs kill cancer cells or stop them from dividing. Like immunotherapy, chemotherapy can be systemic or intravesical.^1,10

Systemic chemotherapy is often injected into a vein or muscle and works throughout the entire body. Examples of systemic chemotherapy drugs for bladder cancer include:^1,10

• Cisplatin
• Gemcitabine
• Mitomycin
• Paclitaxel

Intravesical chemotherapy is given directly to the bladder through a catheter. These drugs are sometimes the same as systemic drugs. Examples of intravesical chemotherapy drugs include:^1,11,12

• Gemcitabine
• Mitomycin
• Valrubicin
• Gemcitabine intravesical system (Inlexzo®) – A small, flexible device placed in the bladder that slowly releases gemcitabine. It is approved for some early-stage cancers that BCG has not helped.

Some treatments in these lists may not be approved by the US Food and Drug Administration on their own specifically to treat bladder cancer. They may be approved for other conditions. A doctor may prescribe them “off-label” when evidence suggests they help. Talk to your doctor about what is right for you.¹³

Chemoresection (chemoablation)

Chemoresection (or chemoablation) uses drugs to destroy tumors instead of removing them with surgery. In June 2025, the US Food and Drug Administration (FDA) approved mitomycin for intravesical solution (Zusduri®). It is for adults whose low-grade, intermediate-risk non-muscle invasive bladder cancer (NMIBC) has come back.^14,15,16

Zusduri® goes into the bladder through a catheter as a cold liquid. At body temperature, it turns into a gel. The gel holds mitomycin against the bladder lining for several hours. It then dissolves and leaves the body in the urine.^11,16

Radiation

Radiation therapy uses high-energy X-rays or other types of radiation to kill cancer cells. It is often given along with chemotherapy.^1,17

Possible side effects

Side effects can vary depending on the specific treatment you are taking. These are not all the possible side effects of bladder cancer treatment. Talk to your doctor about what to expect when taking any bladder cancer treatment. You also should call your doctor if you have any changes that concern you when taking bladder cancer treatment.

Complementary and alternative therapies

Complementary and alternative medicine (CAM) includes options that are not part of standard medical care. Examples include meditation, acupuncture, and massage therapy. Some people find that CAM can help ease some side effects of cancer treatment.¹⁸

Complementary therapies are used along with your cancer treatment, not in place of it. Talk with your healthcare providers before starting any type of CAM. Some products, such as herbs and supplements, can be harmful or interact with cancer drugs.¹⁸

Before beginning treatment for bladder cancer, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.