More than 20 doctors at Memorial Sloan-Kettering — with specialties in urology, medical oncology, urologic surgery, radiation oncology, pathology, and radiology — diagnose and treat nearly 400 patients with bladder cancer each year. Our goal is to provide the highest quality of care for all stages of bladder cancer by providing patients access to innovative techniques, new drugs, and clinical trials of the most advanced treatment approaches.
Memorial Sloan-Kettering's doctors develop an individualized treatment plan for each patient with bladder cancer based on a complete picture of the disease — the location and depth of the cancer and the risks it poses, the patient's other medical conditions, and quality-of-life concerns. Multidisciplinary input is an important aspect of the treatment plan since many patients will receive more than one type of treatment. For bladder cancer, this may include some combination of surgery, chemotherapy, and/or radiation therapy. Having surgeons, medical oncologists, and radiation oncologists collaborating on treatment from the very beginning optimizes patient care.
Our Surgical Technique
Urologic surgeon Bernard Bochner of Memorial Sloan-Kettering discusses minimally invasive surgery and bladder reconstruction options.
Memorial Sloan-Kettering's urologic surgical oncologists annually perform approximately 250 radical cystectomy operations (surgery to remove the bladder as well as nearby tissues and organs). Several of the standards for these surgeries have been established at Memorial Sloan-Kettering.(1)
Our surgeons offer a range of reconstructive options for patients whose treatment requires bladder removal. For example, a new bladder — called a neobladder — can typically be created from a segment of the intestine and connected to the urethra, which allows for normal urination through the urethra. Other options include creating an internal bladder, also made from the intestine, which functions much like the original bladder, as an internal reservoir for urine, eliminating the need for an external appliance or bag following surgery.
Our medical oncology team at Memorial Sloan-Kettering continues to develop and refine chemotherapy regimens to treat bladder cancer more effectively. For patients with cancers that have spread to other areas of the body or that have recurred following surgery, our doctors may offer systemic therapy, which are substances, such as chemotherapy drugs, that travel through the bloodstream, affecting cancer cells throughout the body.
Some patients who are not eligible for surgery may be candidates for a combination of radiation therapy and chemotherapy, which can preserve the bladder and its function. This combination heightens the cancer cells' sensitivity to radiation, increasing the chance that the bladder cancer cells will be killed.
Precision in Radiation Therapy
Visit PubMed for our journal articles from our bladder cancer experts
Memorial Sloan-Kettering's radiation oncologists use intensity-modulated radiation therapy (IMRT) and image-guided radiation therapy (IGRT) to treat bladder cancer. IMRT, which is one of the most advanced and precise radiation treatment techniques, uses radiation beams of varying intensity that are created to match specific tumor shapes and sizes. This helps to reduce the dosage of radiation to healthy tissues and possibly the side effects of treatment. Another type of radiation therapy used to treat bladder cancer is IGRT, a sophisticated technique of radiation delivery that uses radiology imaging (x-ray and/or CT scans) taken immediately before treatment to guide radiation with even greater precision.
Nomogram — Computerized Prediction Tool
Our doctors have developed an online tool called a nomogram to more accurately predict which patients are most likely to have a recurrence of their disease following surgical treatment, and to determine which patients would most likely benefit from chemotherapy before or after surgery. This nomogram is based on detailed information from more than 9,000 bladder cancer patients, treated at 12 centers worldwide, following the surgical removal of the bladder (called a radical cystectomy).(2)