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Bladder Cancer Treatment

If you have bladder cancer, you're probably in a lot of pain. Bladder cancer can make it hurt to urinate and cause lower back pain. Needing to urinate but wanting to avoid pain, or not being able to, can feel hard to live with. 

At UVA Health, we work quickly to get your symptoms manageable. You can depend on a care team that offers effective options for pain and treatment. 

Bladder Cancer Treatment at UVA Health

Our urological surgeons and cancer experts work together to develop your customized treatment plan. We aim to remove cancer cells from your bladder while keeping as much healthy tissue as we can.

Options include:

  • Chemotherapy
  • Biologic therapy
  • Gene therapy
  • Immunotherapy
  • Radiation
  • Transurethral resection
  • Removal of all or part of the bladder

First to Deliver Gene Therapy for Bladder Cancer

UVA Health is the first in Virginia — and among select centers nationwide — to bring to patients the first FDA-approved gene therapy for bladder cancer.

The gene therapy helps bladder cells block cancer growth. It's not a cure for bladder cancer. But it can keep bladder cancer from coming back (recurring) for up to a year.

We have a lot of experience with this therapy known as nadofaragene firadenovec (Adstiladrin). In fact, a UVA Health urologic oncologist ran clinical trials at UVA Health that helped lead to its FDA approval.

Who Can Benefit From Gene Therapy for Bladder Cancer?

It’s approved for adults with the most common type of bladder cancer — when the cancer hasn't spread to the muscle of the bladder.

Specifically, we use it for those with non-muscle-invasive bladder cancer (NMIBC) that doesn't respond to a treatment known as Bacillus Calmette-Guérin (BCG).

How Is Gene Therapy Given?

We use a urinary catheter (tube) procedure to inject the therapy into the bladder. We typically do these injections every 3 months over a year.

This offers more convenience compared to several IV immunotherapy treatments done every few weeks.

It also means our patients can avoid the all-over body side effects such as lung problems, diarrhea, and fatigue.

If your bladder cancer is more advanced, you'll have access to the latest treatment options at UVA Health. You'll find the highest level of expertise and support at Virginia's first Comprehensive Cancer Center.

Top Center for Bladder Removal & Reconstruction

At UVA Health, you’ll find one of the top centers for those who need to have their bladder removed and reconstructed. Our experts have vast experience in this highly complex procedure.

And we have a whole team to guide you through this life-changing journey. Learn more about bladder removal surgery (cystectomy).

What to Expect With Bladder Cancer

Michael Devitt, MD, explains the risk factors for bladder cancer. He also covers types of treatment and therapy.

Bladder Cancer Types & Risk

At UVA Health, we have experts in the common and rare types of cancer affecting the bladder:

  • Transitional cell (urothelial) carcinoma — more than 90% of bladder cancers
  • Squamous cell carcinoma — about 4% of bladder cancers
  • Adenocarcinoma — about 1%-2% of bladder cancers

What's Your Risk?

You have a higher risk for bladder cancer with:

  • Smoking
  • Being over 65, white, and male
  • Chronic bladder inflammation or infection
  • Personal or family history of bladder cancer
  • Exposure to arsenic
  • Radiation treatment of the pelvis
  • Bladder birth defects
  • Chemical exposure
  • Urinary stones for many years
  • In-dwelling catheter for many years
  • Bladder diverticuli: an area of weakness in the bladder wall through which some of the lining of the bladder is forced out
  • Growth from another cancer

Exposure to certain chemicals at work can also increase your risk. 

Those at risk include:

  • Rubber, leather, and textile workers
  • Painters
  • Hairdressers
  • Machinists
  • Printers
  • Truck drivers
  • Petroleum industry workers

How We Diagnose Bladder Cancer

Your doctor will feel your abdomen and pelvis. You may need a rectal or vaginal exam.

We'll need to test your urine. Your doctor may also order a biopsy to remove a sample of bladder tissue to test for cancer cells. 

Bladder Cancer Clinical Trials
Research study for adults at risk, diagnosed with, or being evaluated for cancer

The University of Virginia Cancer Center needs your help to find new ways to diagnose, treat and prevent cancer. As a member of ORIEN, the Oncology Research Information Exchange Network, we are part of a network of cancer centers throughout the United States working collaboratively to quickly carry out research on all types of cancer. No two cancers are exactly the same. Currently we treat most cancer patients with standard treatment, however patients that have the same kind of cancer do not always respond to the same type of treatment. The purpose of this study is to help us better understand differences between cancer patients and to find ways to prevent, diagnose and treat cancer patients more on an individual level. If you are eligible for the study and consent to participate, the study involves a donation of leftover tissue that would normally be discarded, collection of blood during a routine blood draw and giving permission for review of your medical information. All of the medical information and samples collected will be coded to protect your privacy There is no cost to be involved in this study. Ages: 18 years of age and older

Testing the role of DNA released from tumor cells into the blood in guiding the use of immunotherapy after surgical removal of the bladder for bladder cancer treatment.

The University of Virginia Comprehensive Cancer Center seeks adults ages 18 and over with bladder cancer who have had their bladder surgically removed for a research study. The purpose of this study is to determine whether a blood test can help us make better decisions about who should get immunotherapy after surgery to remove the bladder for bladder cancer and which immunotherapy treatment is best. New tests have been developed that can detect bladder cancer DNA in the blood which might indicate the presence of bladder cancer cells somewhere in the body. This test, called Signatera, might be able to detect bladder cancer cells in the body even if cancer can’t be seen on a scan of the body. The Signatera blood test is not approved by the FDA in your disease and is investigational. The immunotherapy drug, nivolumab, is already approved by the FDA for use in bladder cancer after surgery to remove the bladder. The immunotherapy drug, relatlimab, is not approved by the FDA for use in bladder cancer after surgery to remove the bladder. The study involves receiving the Signatera test and the investigational drugs (if applicable), as well as coming in for study visits, which include exams, laboratory tests, and procedures such as having your blood drawn, imaging of your tumor, and talking to the study doctor. If your Signatera test is positive, you will be randomized by computer into one if the two groups. One group will get a single immunotherapy drug called nivolumab. The other group will get a combination of two immunotherapy drugs called nivolumab and relatlimab. Each immunotherapy drug is given for 1 day as intravenous infusion every 28 days for up to 12 total doses. If your Signatera test is negative, you will be randomized by a computer into one of two groups. One group will get nivolumab as an intravenous infusion for 1 dose every 28 days for up to 12 doses. The other group will not receive immunotherapy after surgery but will instead be closely monitored with repeated Signatera blood tests. While on monitoring (that is, not receiving immunotherapy), if your Signatera test becomes positive, you will start receiving immunotherapy (nivolumab) as an intravenous infusion for 1 dose every 28 days for up to 12 doses. After you finish your immunotherapy treatments, your study doctor will continue to follow your condition and watch you for side effects. You will be asked to come in for standard scans of the body and other blood tests to monitor you for up to 5 years as well as Signatera tests for up to 2 years. The Signatera tests and immunotherapy drugs nivolumab or relatlimab will be provided by the study at no cost to you. All additional procedures required by the study beyond your standard care, including laboratory tests, are provided to you at no charge. Additional information can be found here: https://clinicaltrials.gov/study/NCT05987241 [email protected]

UT002: A Phase 3, Single-arm, Multicenter Study to Evaluate the Efficacy and Safety of UGN-104, a Novel Formulation of UGN-101, for the Treatment of Patients with Low-grade Upper Tract Urothelial Cancer (LG-UTUC)

The University of Virginia Comprehensive Cancer Center seeks participants ages 18 and over with low-grade upper tract urothelial cancer (LG-UTUC). The purpose of this study is to test a new investigational version of a treatment called UGN-104 for people with LG-UTUC. UGN-104 is a reformulated version of a drug called JELMYTO (UGN-101), which was approved by the FDA in 2020 to treat this type of cancer. The goal of this study is to see if UGN-104 works as well and is as safe as UGN-101. The study will compare how UGN-104 performs to previous studies using UGN-101. In this study, you will undergo a Screening Visit to determine eligibility. Eligible patients will be treated with UGN-104 once weekly for 6 weeks (a total of 6 doses). Every effort will be made to ensure = 50% of patients receive UGN-104 via antegrade administration. You will complete screening visit, treatment visits, primary disease evaluation visit and follow-up visits. You may or may not benefit as a result of your participation in this study. However, this study may also help doctors learn things that can help other people in the future. The total duration of study participation for each patient (from first instillation to last visit) is up to 15 months. Additional information found here: https://www.clinicaltrials.gov/study/NCT06774131 For questions, contact: [email protected]

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