These cancers are present in the abdominal or pelvic or abdominal wall (represented as T4b). They may have spread to nearby lymph nodes (any N), and have spread to distant parts of the body (M1). Stage IV cancers are not curable.
Usually, chemotherapy (with or without radiation) is the first treatment if the cancer has not spread to distant parts of the body (M0). Re-examination of the tumor is the next step. If there are no traces of the tumor, chemotherapy with or without radiation or cystectomy are options. If there are still signs of cancer in the bladder, oncologists recommend cystectomy.
Chemotherapy with or without radiation is the first treatment when bladder cancer has spread to distant parts of the body (M1). After this treatment the cancer is reexamined. If it looks like it is gone, a boost of radiation to the bladder may be given or cystectomy might be done. If there are still signs of cancer, chemotherapy, radiation, both at the same time, and immunotherapy might be options.
Challenges to treatment
In most cases surgery or radical cystectomy cannot remove all of the cancer. Treatment aims at slowing the tumor growth and spread. This helps people live longer and feel better. If surgery is a treatment option, it is important to understand the goal of the operation. Surgery may be either curative or palliative.
People who cannot take chemotherapy because of other health problems might need radiation therapy or an immunotherapy drug. Urinary diversion without cystectomy helps prevent or relieve a blockage of urine that could cause severe kidney damage. clinical trials are gaining popularity as treatment is unlikely to cure these cancers. Furthermore, read about other treatment options for bladder cancer.