Advanced Bladder Cancer Treatments

For many patients with non-muscle invasive bladder cancer (NMIBC), treatment doesn’t end after the initial removal of a bladder tumor. Additional therapies may be recommended to reduce the risk of the cancer returning or progressing. At Urological Associates of Savannah, we offer advanced bladder-directed treatments that deliver medication directly into the bladder, allowing treatment to target cancer cells while limiting effects on the rest of the body.

Depending on your diagnosis, previous treatments, and risk of recurrence, your urologist may recommend immunotherapy, chemotherapy, or newer gene therapy options. Our team develops personalized treatment plans using the latest evidence-based therapies to help achieve the best possible outcomes while preserving bladder function whenever possible.

Internal Link Opportunity: Link to the Intravesical Therapy page for an overview of how bladder-directed treatments are administered.

Understanding Bladder-Directed Therapy

Unlike intravenous chemotherapy, bladder-directed (intravesical) therapy places medication directly inside the bladder using a small catheter. This approach allows high concentrations of medication to come into direct contact with the bladder lining where cancer cells are located, while minimizing exposure to the rest of the body.

These treatments are commonly recommended after a transurethral resection of bladder tumor (TURBT) to destroy any remaining microscopic cancer cells and reduce the likelihood of recurrence. Your physician will recommend the most appropriate therapy based on the stage and grade of your cancer, prior treatment history, and overall health.

BCG (Bacillus Calmette-Guérin)

BCG is considered the standard first-line treatment for many patients with high-risk non-muscle invasive bladder cancer. Rather than attacking cancer cells directly, BCG is a form of immunotherapy that activates your body’s own immune system to recognize and destroy abnormal bladder cells.

During treatment, BCG is placed directly into the bladder through a catheter, where it stimulates an immune response that targets cancer cells while helping reduce the risk of recurrence and disease progression.

Most patients receive an initial series of six weekly treatments, followed by maintenance therapy at scheduled intervals based on their individual treatment plan. Your urologist will monitor your response through regular cystoscopies and follow-up evaluations.

BCG May Be Recommended For Patients Who:

• Have high-grade non-muscle invasive bladder cancer
• Have carcinoma in situ (CIS)
• Are at higher risk for bladder cancer recurrence or progression
• Have recently undergone TURBT for high-risk disease

Common side effects may include temporary urinary frequency, urgency, burning during urination, fatigue, or mild flu-like symptoms that typically resolve within a few days.

Mitomycin

Mitomycin is a chemotherapy medication that works by damaging the DNA of cancer cells, preventing them from growing and dividing. When used as intravesical therapy, the medication remains inside the bladder where it can directly target cancer cells while minimizing systemic side effects.

Mitomycin is often administered shortly after bladder tumor removal to destroy any remaining cancer cells that may not be visible during surgery. Depending on your diagnosis, it may also be recommended as part of a longer treatment schedule consisting of multiple sessions over several weeks.

Your physician may recommend Mitomycin if your bladder cancer has a lower or intermediate risk of recurrence, or in situations where BCG may not be the most appropriate treatment option.

Benefits of Mitomycin Include:

• Direct treatment of the bladder lining
• Reduced risk of bladder cancer recurrence
• Limited absorption into the bloodstream
• Convenient outpatient treatment

Most patients experience only mild temporary bladder irritation or urinary symptoms following treatment.

Adstiladrin® (nadofaragene firadenovec)

Adstiladrin is one of the newest advances in bladder cancer treatment and offers an important option for patients whose cancer has not responded to BCG therapy.

Approved by the FDA for certain patients with BCG-unresponsive non-muscle invasive bladder cancer, Adstiladrin uses gene therapy technology to help the body’s immune system better recognize and fight bladder cancer cells.

Rather than replacing genes or altering DNA permanently, Adstiladrin delivers genetic instructions to cells lining the bladder, allowing them to temporarily produce interferon alfa-2b—a naturally occurring protein that stimulates the immune system to attack cancer cells.

One advantage of Adstiladrin is its convenient dosing schedule. Unlike weekly treatments, it is typically administered once every three months, making it an attractive option for eligible patients while providing durable treatment between visits.

Your urologist will determine whether Adstiladrin is appropriate based on your previous treatments, pathology results, and overall treatment goals.

Choosing the Right Treatment

No two bladder cancer diagnoses are exactly alike. Factors your physician considers when recommending treatment include:

• The stage and grade of your bladder cancer
• Whether the cancer has returned after previous treatment
• Your response to prior therapies
• Your overall health and medical history
• Your personal treatment goals

Our physicians will discuss the benefits, risks, expected outcomes, and follow-up schedule for each treatment option so you can make an informed decision about your care.

Ongoing Monitoring After Treatment

Even after successful treatment, bladder cancer requires ongoing surveillance because recurrence remains possible. Your care plan will typically include regular cystoscopies, urine testing, and imaging studies when appropriate.

These follow-up appointments allow your physician to monitor your response to treatment, identify any recurrence early, and adjust your treatment plan if needed.

Advanced Bladder Cancer Care at Urological Associates of Savannah

At Urological Associates of Savannah, we are committed to providing comprehensive, evidence-based bladder cancer care using today’s most advanced treatment options. From diagnosis through long-term surveillance, our experienced urologists work closely with every patient to develop an individualized treatment plan focused on preserving bladder health, reducing recurrence, and improving quality of life.

If you’ve been diagnosed with non-muscle invasive bladder cancer or have experienced recurrence after previous treatment, our team can help you understand your options and determine the most appropriate next step in your care.