The treatment of bladder cancer depends on how deep the tumor invades into the bladder wall. Superficial tumors (those not entering the muscle layer) can be "shaved off" using an electrocautery device attached to a cystoscope. Immunotherapy in the form of BCG instillation is also used to treat and prevent the recurrence of superficial tumors. BCG immunotherapy is effective in up to 2/3 of the cases at this stage. Instillations of chemotherapy, such as valrubicin (Valstar) into the bladder can also be used to treat BCG-refractory CIS disease when cystectomy is not an option^.
Epidemiology-Bladder Cancer:In the United States, bladder cancer is the fourth most common type of cancer in men and the ninth most common cancer in women. More than 50,000 men and 16,000 women are diagnosed with bladder cancer each year. One reason for its higher incidence in men is that the androgen receptor, which is much more active in men than in women, plays a major part in the development of the cancer.

• You may want to talk to more than one urologist to find the one with whom you feel most comfortable. Clinical experience in treating bladder cancer is of the utmost importance.
  
  
• Talk to family members, friends, and your health-care provider to get referrals. Many communities, medical societies, and cancer centers offer telephone or Internet referral services.

After you have chosen a urologist to treat your cancer, you will have ample opportunity to ask questions and discuss the treatments available to you.

• Your doctor will describe each type of treatment, give you the pros and cons, and make recommendations based on published treatment guidelines and his or her own experience.
  
  
• Treatment for bladder cancer depends on the type of cancer and its stage. Factors such as your age, your overall health, and whether you have already been treated for the cancer before are included in the treatment decision-making process.
  
  
• The decision of which treatment to pursue is made with your doctor (with input from other members of your care team) and your family members, but the decision is ultimately yours.
  
  
• Be certain you understand exactly what will be done and why, and what you can expect from your choices. With bladder cancer, understanding the side effects of treatment is especially important.

Like all cancers, bladder cancer is most likely to be cured if it is diagnosed early and treated promptly.

• A combination of radiation and chemotherapy can also be used to treat invasive disease. It has not yet been determined how the effectiveness of this form of treatment compares to that of radical ablative surgery.
  
  
• Immunotherapy or biological therapy, which takes advantage of the body's innate cancer-fighting ability, is used in some cases, especially for patients with stages Ta, T1, and CIS.
  
  
• The hemocyanin found in Concholepas concholepas blood has immunotherapeutic effects against bladder and prostate cancer. In a research made in 2006 mice were primed with C. concholepas before implantation of bladder tumor (MBT-2) cells. Mice treated with C. concholepas showed a significant antitumor effect as well. The effects included prolonged survival, decreased tumor growth and incidence and lack of toxic effects.

Tests that examine the urine, vagina, or rectum are used to help detect (find) and diagnose bladder cancer.

The following tests and procedures may be used:

• CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
• Urinalysis: A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells.
• Internal exam: An exam of the vagina and/or rectum. The doctor inserts gloved fingers into the vagina and/or rectum to feel for lumps.
• Intravenous pyelogram (IVP): A series of x-rays of the kidneys, ureters, and bladder to find out if cancer is present in these organs. A contrast dye is injected into a vein. As the contrast dye moves through the kidneys, ureters, and bladder, x-rays are taken to see if there are any blockages.
• Cystoscopy: A procedure to look inside the bladder and urethra to check for abnormal areas. A cystoscope is inserted through the urethra into the bladder. A cystoscope is a thin, tube-like instrument with a light and a lens for viewing. It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.
• Biopsy: The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. A biopsy for bladder cancer is usually done during cystoscopy. It may be possible to remove the entire tumor during biopsy.
• Urine cytology: Examination of urine under a microscope to check for abnormal cells.

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