There is no definitive method to prevent bladder cancer at this time. However, individuals can lower their risk by quitting smoking and avoiding occupational exposure to chemicals believed to increase bladder cancer risk. In addition, the risk may be reduced by drinking large amounts of liquids and eating a diet rich in fruits and vegetables, especially cruciferous vegetables such as broccoli and cauliflower. In studies reported by the National Cancer Institute (NCI), a high intake of dietary carotenoids (foods rich in beta carotene) and dark green vegetables has been associated with an overall decreased risk for bladder cancer.

Treatment options for bladder cancer vary depending on the patient and the stage of cancer. In general, treatment will involve surgery. There are a number of different surgeries for bladder cancer. Some involve the removal of the entire bladder but others do not. The type of surgery typically depends on the stage of the bladder cancer.

Transurethral surgery is typically used to treat early stage bladder cancer. In this procedure, the surgeon removes the cancer with the aid of a cystoscope (a thin tube with a light and a lens), which is inserted into the bladder through the urethra. A cytoscope may also be used to burn away a portion of the tumor.

The patient will be given medicine to numb the area or has general anesthesia for the surgery. This procedure eliminates the need to cut into the abdomen. Side effects of transurethral surgery are typically mild and may include some bleeding or light pain immediately after surgery. Patients are often discharged the same or following day, and can typically resume normal activities in less than two weeks. After transurethral surgery, other steps may be necessary to eliminate any remaining cancer, such as laser treatment. Some urologists have advocated preservation of the bladder by using a combination of transurethral surgery, radiation therapy and chemotherapy.

When bladder cancer becomes invasive or has begun to spread to nearby tissues, some form of open surgery may be needed, either partial cystectomy, where part of the bladder is removed, or radical cystectomy, which removes the entire bladder as well as neighboring lymph nodes. In men, the prostate is typically removed during a radical cystectomy. In women, the uterus, ovaries, fallopian tubes and a small section of the vagina may be removed. Patients are asleep for both a partial and a radical cystectomy, and both surgeries require 7 to 10 days of hospitalization. Cystectomies have a recuperation period of four to six weeks.

Radical cystectomies can have serious side effects such as excess bleeding, infection, urine leakage and blockage of urine flow. Following a radical cystectomy, the body needs another method of storing and removing urine. Options include:

• Urostomy. A procedure in which tissue is moved from the small intestine and attached to the ureters, and a bag is worn outside the body to catch urine.
  
  
• Continent diversion. A procedure in which the surgeon attaches a sac (created from a small piece of the patient’s intestine) to the ureters. The patient then uses a drainage tube to empty urine. Unlike urostomy, there is no need to wear a urine collection bag outside of the body.  

Other cancer therapies may also be used, either in addition to surgery or instead of surgery. These include:

• Radiation therapy. This treatment uses high-energy x-rays to shrink or eliminate cancer cells. The radiation may come from outside sources or radioactive materials placed directly inside the tumor. After surgery, radiation can often destroy tiny deposits of cancer cells that are too small to detect. Following transurethral surgery, a combination of radiation therapy and chemotherapy can sometimes eliminate cancer cells that would typically require a cystectomy.
  
  
• Intravesical immunotherapy. This type of  immunotherapy is used to treat bladder cancers that are noninvasive or minimally invasive. Intravesical means that the treatment is placed directly inside the bladder instead of being administered orally or injected into the vein. Immunotherapy is the most common form of intravesical treatment for bladder cancer. It causes the body’s immune system to attack the tumor. The Bacillus Calmette Guerin (BCG) bacteria, which is used primarily to make a tuberculosis vaccine, is the immunotherapy most commonly used to treat bladder cancer.
  
  
• Chemotherapy. Often called “chemo,” this treatment uses drugs or combinations of drugs to kill cancer cells. These drugs are typically administered either intravenously or orally, although some forms may be placed intravesically into the patient’s bladder.
  
  

Follow-up care is also an essential part of any treatment plan. Patients typically receive follow-up examinations every three to six months after treatment to monitor whether the cancer has returned or if a new cancer has developed in the urinary system. Follow-up plans typically include a complete physical examination as well as tests such as blood tests and x-rays. Patients and families who have difficulty coping with bladder cancer may benefit from mental health counseling and support groups.