Bladder and kidney cancer treatment
The treatments used for bladder and kidney cancers — including treatments placed into the bladder, surgery, chemotherapy, immunotherapy and targeted drugs — planned by a specialist team according to the type and stage.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- Bladder and kidney cancer treatment depends heavily on type and stage — from removing an early bladder tumour through a telescope, to major surgery, to drug treatments for advanced disease.
- Early bladder cancer is often treated by removing the tumour and then putting treatments such as BCG into the bladder; it can come back, so regular bladder checks (cystoscopy) are important.
- No one can guarantee a cure; ask your team honestly whether treatment is aiming to cure the cancer or to control it.
- Almost all of this care is delivered and funded by the NHS through a urological cancer team; private input is usually about speed, choice or a second opinion, not a better cure.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your specialist will give you advice for your situation.
Removing an early bladder tumour, with treatments placed in the bladder, can cure it and lower the chance of return.
BCG into the bladder may not be advisable if your immune system is suppressed, you have certain bladder problems, or there is active infection.
Blood in the urine and stinging for a few days, with advice to drink plenty of fluids. Most people get back to normal quickly between treatments.
A named clinical nurse specialist or key worker as your point of contact
Blood in the urine and stinging for a few days, with advice to drink plenty of fluids. Most people get back to...
Treatments are given weekly for a few weeks, with flu-like or bladder symptoms that usually settle between...
Hospital recovery, then a gradual return of strength over weeks. After bladder removal, support from a stoma or...
Regular reviews with blood tests and scans. Side effects such as high blood pressure or immune-related effects are...
What is bladder and kidney cancer treatment?
Bladder and kidney cancers are common urological cancers. Most bladder cancers start in the lining of the bladder; many are 'non-muscle-invasive', meaning they have not grown into the muscle wall, while others are 'muscle-invasive' and more serious. Kidney cancer (most often renal cell carcinoma) starts in the kidney itself.
Treatment depends a lot on the type and stage. For early bladder cancer, the tumour is removed through a telescope (a procedure called TURBT), often followed by treatments placed directly into the bladder — such as BCG (a type of immunotherapy) or chemotherapy — to lower the chance of it coming back or progressing. For muscle-invasive bladder cancer, treatment may involve removing the bladder (cystectomy) or radiotherapy, often with chemotherapy. For kidney cancer, surgery to remove part or all of the kidney is the main treatment for disease that can be removed, while advanced kidney cancer is treated with targeted drugs and immunotherapy.
Every plan is made by a urological cancer multidisciplinary team (MDT) after the cancer has been examined under a microscope and staged. The aim is described honestly as either curative intent or, for advanced disease, control of the cancer and easing symptoms.
This guide is an overview of the whole pathway. It cannot promise a cure, it cannot give you a number for your own outlook, and it does not replace the discussion you should have with your own urology and oncology team.
Types, options & approaches
There may be different ways to do this. The right approach depends on the clinical question and your circumstances.
Non-muscle-invasive versus muscle-invasive bladder cancer
| Question | Non-muscle-invasive | Muscle-invasive |
|---|---|---|
| How deep | In the lining, not the muscle wall | Grown into the muscle wall |
| Usual treatment | Remove tumour (TURBT) then treatments in the bladder | Remove the bladder, or radiotherapy with chemo |
| Usual aim | Cure and prevent return; close monitoring | Cure where possible; more intensive treatment |
| Key follow-up | Regular bladder telescope checks (cystoscopy) | Scans and specialist review |
Knowing whether bladder cancer is muscle-invasive is central to the plan. Ask your team which type you have.
Preparing for your treatment
- Make sure the diagnosis and type are confirmed under a microscope, and the cancer is staged with scans before the plan is finalised.
- Ask whether your case has been discussed by the urological cancer multidisciplinary team (MDT) and what they recommended.
- For bladder cancer, ask whether it is muscle-invasive, as this changes the treatment a lot.
- Bring a full list of your medicines and conditions, including any that affect your immune system or bleeding.
- If bladder removal is planned, ask about the different ways of passing urine afterwards and arrange to meet a stoma nurse if relevant.
- Plan practical support and transport, especially for major surgery or repeated bladder treatments.
- Write down your questions and consider bringing someone with you to appointments.
What happens
After tests confirm the type and stage, the MDT recommends a plan and you meet the relevant specialists — a urologist (surgeon), a medical oncologist and/or a clinical oncologist.
For bladder cancer, the first step is often removing the tumour through a telescope (TURBT) under anaesthetic as a day case or short stay. Depending on the findings, you may then have a course of treatment placed into the bladder (such as BCG or chemotherapy), usually weekly for a few weeks, followed by regular bladder telescope checks.
If the bladder needs removing, this is major surgery with a hospital stay and a new way to pass urine. Kidney cancer surgery removes part or all of a kidney, also under general anaesthetic.
For advanced disease, immunotherapy is given as a drip in clinic over many months, and targeted drugs for kidney cancer are often tablets taken at home with regular reviews. A specialist nurse usually supports you throughout, and your response is monitored with scans, examinations and bladder checks.
Is this treatment right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- BCG into the bladder may not be advisable if your immune system is suppressed, you have certain bladder problems, or there is active infection.
- Major surgery may not be advisable if you are not fit enough to recover safely, in which case bladder-sparing or non-surgical options may be considered.
- Some targeted drugs and immunotherapy only help particular situations and will not work for everyone.
- Aggressive treatment of a small, slow-growing kidney cancer may not be in your best interests if monitoring is safer.
Delay or rearrange if…
- There is an active urine or other infection that should be treated first (BCG is not given with a urine infection or visible blood).
- Essential staging scans or pathology results are still awaited.
- You are not fit enough for major surgery or intensive treatment and need optimising first.
- You have not yet had a proper discussion of the aim, risks and alternatives.
Alternatives to discuss
- Bladder-sparing treatment (radiotherapy with chemotherapy) instead of removing the bladder, where suitable
- Partial rather than complete kidney removal for some kidney cancers
- Active monitoring for some small, slow-growing kidney cancers
- Different drug treatments for advanced disease, or a clinical trial if suitable
- A second opinion from another specialist urological cancer centre
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Comfort, sedation or contrast choices
If local anaesthetic, sedation, contrast or pain relief is used, ask what is planned, why, and what it means afterwards.
Benefits
- Removing an early bladder tumour, with treatments placed in the bladder, can cure it and lower the chance of return.
- Surgery to remove the bladder or kidney can cure cancer that can be fully removed.
- Radiotherapy with chemotherapy can be an effective bladder-sparing treatment for some muscle-invasive bladder cancers.
- Targeted drugs and immunotherapy can shrink or control advanced kidney or bladder cancer for some people.
- Some small kidney cancers can be safely monitored, avoiding unnecessary treatment.
- A team-based plan means decisions are shared across specialists and tailored to you.
Risks & complications
- After removing a bladder tumour or bladder treatments: blood in the urine, stinging, and needing to pass urine often for a few days
- BCG treatment: flu-like symptoms, bladder irritation and tiredness
- Major surgery recovery: pain, tiredness and a longer recovery; a stoma or new urine system to adjust to after bladder removal
- Targeted therapy for kidney cancer: tiredness, high blood pressure, diarrhoea, sore hands and feet
- Emotional impact, including anxiety about recurrence
- Infection during treatment, including urine infections after bladder procedures
- BCG causing a more troublesome bladder reaction or, occasionally, a wider infection needing treatment
- Immunotherapy causing immune-related inflammation of the bowel, liver, lungs or hormone glands
- Surgical complications such as bleeding, leaks, or problems with a new urine system
- Reduced kidney function after kidney surgery
- Serious, occasionally life-threatening infection (including from BCG) or immune reaction
- Major bleeding or damage to nearby organs during surgery
- A hole in the bladder (perforation) during a telescope procedure
- Severe reactions to chemotherapy or targeted drugs
The biggest uncertainties are whether early bladder cancer will come back or progress, and whether treatment will control advanced disease and for how long. BCG and immunotherapy work through the immune system and can occasionally cause serious reactions, so report new symptoms early. Ask your team: is treatment trying to cure or control the cancer, how often will I need bladder checks, and what side effects should I watch for.
Published figures to discuss
Survival varies a great deal by cancer type and stage, and the figures below are population averages from Cancer Research UK, not predictions for any individual. They describe net survival. They cannot tell you what will happen to you and do not capture quality of life or newer treatments. Use them only to understand that stage matters, and discuss your own situation with your team.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Bladder cancer surviving 5 years or more — stage 1 | More than 75 in 100 (more than 75%) | Cancer Research UK, England 2016–2020. Early bladder cancer often does well but can come back, needing ongoing checks. | Cancer Research UK — Bladder cancer survival by stagecancerresearchuk.orgPublished figure |
| Bladder cancer surviving 5 years or more — stage 4 | More than 10 in 100 (more than 10%) | Cancer Research UK, England 2016–2020. An average for advanced disease; not a prediction for any individual. | Cancer Research UK — Bladder cancer survival by stagecancerresearchuk.orgPublished figure |
| Kidney cancer surviving 5 years or more — stage 1 | Almost 90 in 100 (almost 90%) | Cancer Research UK, England 2016–2020. Early kidney cancer that can be removed often does well. | Cancer Research UK — Bladder cancer survival by stagecancerresearchuk.orgPublished figure |
| Kidney cancer surviving 5 years or more — stage 4 | Around 15 in 100 (about 15%) | Cancer Research UK, England 2016–2020. An average for advanced disease; newer drugs are not fully reflected in older figures. | Cancer Research UK — Bladder cancer survival by stagecancerresearchuk.orgPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
What happens afterwards
Recovery differs by treatment. After removing a bladder tumour or a bladder treatment, irritation usually settles within days. Major surgery to remove a bladder or kidney has a significant recovery, and bladder removal means adjusting to a new way of passing urine. Drug treatments have no wound but side effects to manage over months.
- Blood in the urine and stinging for a few days after bladder procedures or treatments
- Flu-like symptoms and bladder irritation during a BCG course
- Tiredness during months of drug treatment for advanced disease
- Adjusting to a stoma or new urine system after bladder removal
- Ups and downs in mood while waiting for results or bladder checks
Aftercare
- Drink plenty of fluids after bladder procedures and treatments, as advised.
- Keep a written record of your treatment, drug names and your team's contact numbers.
- Attend all bladder telescope checks (cystoscopy) — early bladder cancer can come back and these checks catch it.
- Report any new symptom during immunotherapy promptly, such as diarrhoea, breathlessness or feeling very unwell.
- Take targeted-therapy tablets exactly as prescribed and attend blood-pressure and other monitoring.
- Get support from a stoma or specialist nurse if you have a new urine system after bladder removal.
- Attend all follow-up scans and appointments and report new or returning symptoms promptly.
- A written treatment plan stating the type, stage and aim of treatment
- The name and number of your clinical nurse specialist or key worker
- Clear written instructions on which symptoms to report urgently
- A schedule of bladder checks (cystoscopy) for bladder cancer
- Stoma or specialist nurse support arranged if the bladder is removed
- Transport and time off work arranged for treatment days
- Someone to support you at appointments and at home
⚠ Get urgent help if…
- A high temperature, shaking chills or feeling very unwell after BCG or during treatment — this can mean a serious infection and needs urgent assessment
- Heavy or persistent blood in the urine, or being unable to pass urine
- New or worsening diarrhoea, breathlessness or severe tiredness during immunotherapy (possible immune-related side effects)
- Severe abdominal or flank pain, or signs of a wound or urine-system problem after surgery
- A swollen, painful calf, or sudden breathlessness or chest pain (possible blood clot)
- Fever with burning on passing urine (possible urine infection)
- Any symptom your team has told you to report urgently
Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your specialist gives you.
Results & realistic expectations
A good result for early bladder cancer means the tumour is removed and stays away, which is checked with regular bladder telescope examinations. For cancers that can be removed by surgery, the aim is that the cancer has been fully taken out. For advanced disease, a good response means the cancer shrinks or is controlled on scans while side effects stay manageable.
Early bladder cancer in particular has a real chance of coming back, which is why ongoing monitoring matters even after successful treatment. A reassuring result does not remove all risk, and your team can explain what your results mean for you without being able to give a guarantee.
How long the benefit lasts depends on the type, the stage and the biology of the cancer. Many early bladder cancers are controlled long-term but need continued monitoring because they can recur. Kidney and bladder cancers fully removed by surgery can be cured, especially when found early. Advanced disease is more uncertain — drug treatments can give worthwhile control for some people, while in others the cancer progresses and treatment is changed. Your team will explain the realistic picture for your situation.
Related tests, treatments or support
Bladder and kidney cancer treatment often combines approaches — for example removing a bladder tumour followed by treatments placed in the bladder, chemotherapy before bladder removal, or surgery followed (or replaced) by drug treatment for advanced disease. Supportive care, stoma support and management of side effects run alongside the main treatment.
Follow-up & long-term care
After treatment you are followed up with appointments, scans and, for bladder cancer, regular bladder telescope checks, on a schedule that depends on the type and stage. The aim is to find any recurrence early and to manage side effects and your urine system. You should be told who to contact, and how quickly, if new symptoms appear between appointments.
- Regular bladder telescope checks (cystoscopy) for bladder cancer, sometimes for years
- Ongoing care of a stoma or new urine system after bladder removal
- Monitoring of kidney function after kidney surgery
- Blood-pressure and other monitoring during targeted therapy
- Regular follow-up scans and appointments on a schedule set by your team
Repeat, follow-on and what comes next
- Early bladder cancer commonly comes back and is treated again; this is why regular bladder checks continue, sometimes for years.
- If BCG does not control the cancer, the team may change to a different treatment or recommend removing the bladder.
- Drug treatment for advanced disease is often given in lines: if one stops working, another may be tried.
- Doses are commonly adjusted or paused to manage side effects, which is normal and not a failure.
Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.
What good aftercare looks like
- A named clinical nurse specialist or key worker as your point of contact
- A clear, written schedule of bladder checks for bladder cancer
- Clear instructions on immunotherapy and BCG side effects and what to report urgently
- Stoma or specialist nurse support and kidney-function monitoring where relevant
- Coordination with your NHS team and GP, and access to psychological support
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- Whether treatment is a bladder telescope procedure, bladder treatments (BCG or chemotherapy), surgery, radiotherapy or drug treatment
- The number of bladder treatments or chemotherapy cycles and the specific drugs used
- Hospital or facility fees and any inpatient stay for major surgery
- Scans, bladder telescope checks (cystoscopy) and pathology
- Stoma or specialist nurse support after bladder removal
- Monitoring such as blood pressure during targeted therapy
- Follow-up scans, bladder checks and appointments over time
- Exactly which treatments are included, and the aim (curative or palliative)
- Consultant (surgeon and oncologist) fees and facility/theatre fees
- Anaesthetic and inpatient stay for surgery
- Drug costs and how many bladder treatments or chemotherapy cycles are planned
- Scans, bladder checks (cystoscopy) and pathology
- Follow-up appointments, bladder checks and scans, and stoma support if relevant
- What happens, and who pays, if a complication or side effect occurs
On the NHS? Almost all bladder and kidney cancer treatment is provided and funded by the NHS through a specialist multidisciplinary team; private care is generally used for speed, choice or a second opinion rather than for a different chance of cure.
You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Not being told clearly whether bladder cancer is muscle-invasive, which changes the whole plan.
- No clear explanation of life with a stoma or new urine system before agreeing to bladder removal.
- Starting BCG or immunotherapy without explaining the side effects and what to report urgently.
- Being offered an expensive private treatment as if it improves the chance of cure when the NHS would offer the same.
- No clear schedule for the bladder checks that are central to follow-up.
Marketing red flags
- Any clinic promising a cure or a guaranteed response for bladder or kidney cancer
- Unproven 'miracle cure', detox or alternative therapies promoted instead of standard treatment
- Pressure to pay quickly for surgery or drugs without MDT review or proper staging
- Downplaying the chance that bladder cancer can come back or the side effects of treatment
- Discouraging you from continuing NHS care or seeking a second opinion
Choosing a specialist safely
- Check the specialist is on the GMC Specialist Register for this area.
- Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
- You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
- Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including any follow-up — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good specialist will welcome every one of these.
- What type and stage of cancer do I have, and was my case discussed by the MDT?
- For bladder cancer, is it muscle-invasive, and how does that change my options?
- Is the aim of my treatment to cure the cancer or to control it?
- If I need BCG or bladder treatments, what are the side effects and how often will I have bladder checks?
- If surgery is needed, will the whole organ be removed, and what will that mean for me day to day?
- If I have advanced disease, what drug treatments are options, and what side effects should I watch for?
- Who is my main point of contact, and when should I ring urgently?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the specialist who carries out my treatment, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this treatment not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Can paying privately get me a better chance of a cure?
What is BCG, and why is it put into my bladder?
Why do I need so many bladder checks?
Will I lose my whole bladder or kidney?
What happens to my urine if my bladder is removed?
Can a small kidney cancer just be watched?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NICE — Bladder cancer: diagnosis and management (NG2) Cancer Research UK — Bladder cancer survival by stage Cancer Research UK — Kidney cancer survival by stage Macmillan — Treatment for bladder cancer BAUS — BCG treatment for bladder cancer (patient leaflet) NHS — Kidney cancer
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Bladder cancer surgery (cystectomy) · Bladder tumour removal (TURBT) · Kidney removal (nephrectomy) · Cancer of unknown primary assessment · Bowel (colorectal) cancer treatment