Radiation Therapy for Bladder Cancer

MSK radiation oncologist, Marisa Kollmeier, sits in front of a computer at her desk while speaking to a male patient.

Radiation oncologist Marisa Kollmeier uses advanced techniques to target bladder cancer while reducing radiation to normal tissues.

Radiation therapy uses precisely focused high-energy beams to kill cancer cells. Our doctors deliver radiation therapy in a variety of forms. The form we recommend depends on the type of cancer, the location of the tumor, and whether it has spread.

As part of your treatment for bladder cancer, you may receive radiation therapy before, during, or after surgery. This can shrink the tumors or destroy any remaining cancer cells. For some people, we may use radiation, often combined with a low dose of chemotherapy, in place of surgery altogether.

Our radiation oncologists use advanced techniques to target areas at risk while reducing radiation exposure to normal tissue.

Intraoperative Radiation Therapy during Bladder Cancer Surgery

Intraoperative radiation therapy is a treatment given during bladder cancer surgery to reduce the risk of the cancer returning. This approach delivers powerful radiation through thin tubes called catheters that are placed directly on the tissue. This can kill cancer cells that may remain after the tumor is removed. It is most commonly recommended if the cancer has spread beyond the bladder.

Because this treatment occurs during the surgery and can be delivered to a precisely defined area, it is possible to use a higher-than-usual dose of radiation. Normal tissue, especially the bowel, can be temporarily moved away from the treatment area or covered with shielding devices while radiation is delivered.

Intraoperative radiation treatment usually takes just a few minutes during the surgical procedure. Once the radiation dose is delivered, all radiation-related materials are removed and the operation continues.

External-Beam Radiation Therapy for Bladder Cancer

External-beam radiation therapy is the most common form of radiation treatment. It is delivered by a machine from outside the body. The radiation is most often in the form of X-rays. Sometimes the charged particles called protons or other types of energy are used. Our doctors may recommend external-beam radiation therapy combined with low-dose chemotherapy as an alternative to a cystectomy (removal of the bladder). This means the tumor is destroyed, but it leaves the bladder intact.

Image-Guided Radiation Therapy for Bladder Cancer

To verify the location of the tumor and the position of the bladder before and during the delivery of radiation treatment, we use a form of external-beam radiation therapy called image-guided radiation therapy. One challenge of delivering radiation therapy for bladder cancer is that the bladder moves as it empties and fills with urine. To target tumors precisely over multiple radiation treatments, we implant gold markers to show the exact location of the tumor and track the motion of the bladder from day to day.

We also use CT scanners linked to the machines delivering the radiation. The scanners allow us to visualize the bladder as well as normal surrounding tissue, such as the bowel and rectum. By using these advanced techniques, we can achieve high cure rates and maximize the chances of preserving a healthy bladder.

Intensity-Modulated Radiation Therapy for Bladder Cancer

The precise imaging methods we use when planning treatment allow us to safely and effectively use intensity-modulated radiation therapy. This technique uses computer programs to calculate and deliver varying doses of radiation directly to the tumor from different angles. Our radiation oncologists, in close collaboration with the medical physics team, played a leading role in developing this type of radiation therapy.

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