Radiation therapy uses high-energy beams to kill bladder cancer cells. Your treatment will depend on the type of bladder cancer, the tumor’s location, and whether cancer has spread.

When is radiation for bladder cancer given?

You may get radiation therapy before, during, or after surgery. Radiation can shrink tumors or kill bladder cancer cells that remain after other treatment. Some people may have radiation instead of surgery, often combined with a low dose of chemotherapy.

Radiation oncologists are experts in treating cancer with radiation. MSK’s radiation oncologists are some of the most experienced in the country. They use advanced methods to deliver exact doses of radiation directly to tumors. Our methods cause less harm to nearby healthy tissues.

Types of radiation for bladder cancer:

Intraoperative Radiation Therapy During Bladder Cancer Surgery

Intraoperative radiation (IN-truh-AH-pruh-tiv RAY-dee-AY-shun) therapy is a bladder cancer treatment aimed at a tumor. Also called IORT, this treatment happens during your surgery. It helps lower the chance the cancer comes back. It’s for cancer has spread beyond the bladder.

How does intraoperative radiation work?

Intraoperative radiation therapy delivers powerful radiation through catheters (thin tubes) placed directly on the tissue. This can kill any cancer cells that remain after the tumor is removed. Treatment is delivered to an exact area, so we can use a higher dose of radiation than usual.

During your surgery, we have ways to reduce side effects and improve your recovery. We move healthy tissue, such as your bowel, away from the treatment area, or shield it during radiation.

Intraoperative radiation treatment usually takes just a few minutes during surgery. After your treatment, we remove everything related to radiation, and continue the surgery.

External Beam Radiation Therapy for Bladder Cancer

External beam radiation therapy is the most common radiation treatment. A treatment machine aims beams of radiation at your tumor. The beams pass through your body and harm cancer cells in their path. You will not see or feel the radiation.

The radiation is most often in the form of X-rays. We also use charged particles called protons, or other types of energy.

Your doctor may recommend external beam radiation therapy along with low-dose chemotherapy. This is a treatment instead of a cystectomy, a surgery to remove the bladder. The tumor is destroyed, but the bladder is kept safe.

Image-Guided Radiation Therapy for Bladder Cancer

Image-guided radiation therapy (IGRT) uses high-energy beams to treat cancer. It works by harming cancer cells and making it hard for them to grow. IGRT can treat tumors with even more accuracy than regular radiation therapy. You will not see or feel the radiation.

Why is IGRT more accurate?

IGRT takes many images of the tumor during treatment. This improves the accuracy of the radiation. During treatment, we can see the tumor’s exact position and account for any movement. Your bladder moves just by filling with urine, for example.

We track the bladder’s motion by implanting (putting in) markers about the size of a grain of rice on your bladder. These markers show the tumor’s exact location and track the bladder’s motion. They can be seen on X-rays and a computed tomography (CT) scan.

During the treatment, we use CT scanners linked to the machines that deliver radiation. The markers helps us target only the tumor, so we keep nearby healthy tissue safe from radiation.

Intensity-Modulated Radiation Therapy for Bladder Cancer

Intensity-modulated radiation therapy (IMRT) is a form of external beam radiation. It uses the latest software to deliver high doses of radiation to the tumor without harming healthy tissue.

How does IMRT work?

IMRT uses advanced computer software and CT scans to mold radiation doses to the shape of the tumor. MSK experts played a leading role in developing this type of radiation therapy.

Before treatment, radiation oncologists and medical physicists will get information about the treatment area. You will have imaging tests, such as:

• Computed tomography (CT) scan. During a CT scan, a special machine uses X-rays to take a fast series of computerized pictures from different angles. These detailed 3D images will map the tumor.
• Magnetic resonance imaging (MRI). An MRI is a test that uses strong magnetic fields to take pictures. These detailed images are used to identify the outline of the tumor.
• Positron Emission Tomography (PET) scan. A PET scan takes detailed, computerized pictures used to map the outline of the tumor.

Your care team will enter the information from your tests into computer software to plan your treatment. It tells us how to position the radiation beams so we can target the tumor with exact doses of radiation.