Can bladder cancer be cured?

When we refer to a disease being cured, we usually mean that it is gone and will never come back. But when we refer to a cancer being cured, we usually mean that the cancer is gone for a period of time with no clinical evidence of recurrence.

Bladder cancer can actually be cured for many people. For low-grade, superficial bladder cancer, when the entire tumor is removed, the cancer is, in a sense, cured. Unfortunately, bladder cancer can come back somewhere else in the bladder. Even if the entire tumor is removed, new tumors may grow in the same place or in another place. Therefore, even if the tumor has been completely removed, you still need regular checkups. Most recurrences can still be cured if they are caught early.

For tumors that have invaded the bladder wall muscle layer, cure is still possible with a partial or total cystectomy. If the surgeon can remove the entire tumor with surgery, the patient is also considered cured. Surgery can cure 80% of bladder cancers that are confined to the bladder. However, there is no way to be completely sure whether the tumor has been completely removed.

A very small number of tumor cells may have left the bladder, and the surgeon has no means to detect these cells. If metastasis is suspected, such as tumor cells at the edge of the resected tissue, chemotherapy and radiation therapy can be used to kill these tiny lesions remaining in the body, thereby increasing the possibility of cure. Patients with local tumor progression have only a 20%-30% chance of being cured by surgery alone. Long-term follow-up by a urologist after surgery is important to help determine whether the tumor has recurred.

Patients with metastatic disease may still be cured, and surgery combined with chemotherapy and/or radiation therapy has been able to cure a small and increasing number of patients. Most patients are sensitive to chemotherapy, at least initially. It is difficult to determine a specific point in time when we can conclude that a patient has been cured. Therefore, follow-up with x-rays, CT scans, cystoscopy, and cytology is important for several years after treatment.