Bladder cancer

Bladder cancer overview

You are at the center of everything we do at Fred Hutchinson Cancer Center. Here, we surround you with a team of specialists in the Bladder Cancer Multispecialty Clinic. Your team works together closely to provide comprehensive, individualized care and compassionate support, from diagnosis through treatment and beyond.

We guide you every step of the way, combining our deep clinical expertise in bladder or urothelial cancer with a commitment to meet your unique needs.

Following the merger of long-time partners, Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, the organization was renamed to Fred Hutchinson Cancer Center. We are an independent, nonprofit organization that also serves as UW Medicine's cancer program. 

Why choose Fred Hutch?

  • Where you’re treated first matters most
    Studies have shown that the first treatment you receive for cancer is by far the most important and bladder cancer patients have better outcomes if they receive care at centers of excellence with focused expertise, like Fred Hutch, that treat large numbers of people with this disease. We see hundreds of patients with bladder or urothelial cancer each year.
  • True team care
    The Bladder Cancer Multispecialty Clinic has a team of urologic oncologists, medical oncologists, radiation oncologists, pathologists and radiologists from UW Medicine who come together to evaluate you in a single day based on the individual features of your cancer.
  • Experienced bladder cancer specialists
    Fred Hutch patients receive state-of-the-art care from some of the world’s leading doctors. In fact, in the 1980s now-retired Fred Hutch physician Kenneth J. Russell, MD, pioneered the use of radiation therapy for bladder cancer; it’s now an important treatment for the muscle-invasive form of the disease.
  • Comprehensive bladder cancer treatment 
    Our doctors are experts in the full spectrum of treatments bladder cancer may require. Based on the unique characteristics of your tumor, your team may recommend surgery, chemotherapy, radiation therapy or immunotherapy, all available here. 
  • Bladder cancer clinical trials
    To give you access to the most innovative therapies, we unite the leading researchers and cancer specialists of Fred Hutch and UW Medicine so you can take part in bladder cancer clinical studies not available everywhere. 
  • A national leader in cancer care
    Fred Hutch is the leading cancer treatment center in the region and among the top nationally, according to U.S. News & World Report. 
  • NCI comprehensive cancer center
    We are a comprehensive cancer center, a designation from the National Cancer Institute that reflects our scientific leadership and the depth and breadth of our research to prevent, diagnose and treat cancer.
Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiation oncologist A physician who has special training in using radiation to treat cancer. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy.
Bladder Cancer Multispecialty Clinic

Many people with bladder cancer need more than one type of treatment, which means they need more than one type of physician. At Fred Hutch, we bring a team of genitourinary specialists together for you in one place: the Bladder Cancer Multispecialty Clinic (BCMC). It’s our one-stop shop, where we guide you through complex treatment decisions and provide seamless, comprehensive care.

What is the Bladder Cancer Multispecialty Clinic?

The BCMC gives you a “home” where you can see a urologic oncologist, medical oncologist and radiation oncologist all on the same day. Our doctors are UW Medicine physicians who specialize in bladder cancer and other cancers of the urinary tract. They work with you as a team to plan and provide the care you need. 

Our BCMC is the first clinic in the region to provide this type of multidisciplinary care for people with bladder cancer. We treat all types of the disease, from urothelial cancer, the most common type, to rare variations. The clinic is held once a week in the Fred Hutch Prostate Oncology Center in the Surgery Pavilion at UW Medical Center – Montlake. 

As a new patient, you will get a thorough evaluation of your unique case. You will leave your appointment with a complete, personalized treatment plan and a clear set of next steps.

Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Radiation oncologist A physician who has special training in using radiation to treat cancer. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
“At the BCMC, everything revolves around you, the patient. We take a comprehensive, systematic and personalized approach that enables you to be well-informed and empowers you to make the best decisions for you.”
— Petros Grivas, MD, PhD, medical oncologist

Along with your physicians, your BCMC team includes:

  • A pathologist and radiologist, who help with diagnosis and treatment planning
  • Nurses and nurse practitioners, who help provide your care
  • Research coordinators, who can explain clinical trials that are testing leading-edge therapies
  • A program coordinator, who ensures your care runs smoothly

At Fred Hutch, we offer a wide range of supportive care services, like nutrition and physical therapy, to help you thrive. We also have genetics specialists who can help you understand cancer risk in your family and help us find features of your cancer that may affect your treatment plan.

Nurse practitioner A registered nurse who has additional education and training in how to diagnose and treat disease. In cancer care, a nurse practitioner may manage the primary care of patients and their families. A registered nurse who has additional education and training in how to diagnose and treat disease. Nurse practitioners are licensed at the state level and certified by national nursing organizations. In cancer care, a nurse practitioner may manage the primary care of patients and their families, based on a practice agreement with a physician. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
“Having the BCMC clinic and the meeting with my team of doctors was invaluable. The fact that it occurred on one day was appreciated by me and my wife since we were able to ask all our questions while still fresh and receive the most educated answers that would help us confidently determine our course of action.”
— Fred Hutch patient

Who is the BCMC for?

If you have cancer that has invaded the muscle layer of your bladder but hasn’t spread to distant parts of your body, BCMC is designed for you. We also see new Fred Hutch patients with non-muscle-invasive bladder cancer who started treatment somewhere else.

Why? These people are most likely to benefit from having two or more types of treatment: surgery, medicine-based options (like chemotherapy and immunotherapy) and/or radiation therapy.

How does team-based care help?

Research shows that our collaborative approach improves cancer care.1 Having a team of experts in one room at the same time is linked to:

  • More accurate diagnosis
  • Shorter time from your diagnosis to when you start treatment 
  • A treatment plan that closely matches evidence-based national guidelines about the best ways to treat this disease
  • Better communication between members of your care team
  • More satisfied patients

At the BCMC, we often reinterpret the test results and imaging that patients have had elsewhere. Then we refine their diagnosis and disease stage in important ways that influence their treatment choices.

What are the other options?

Not everyone with bladder cancer needs the BCMC.

If you have early-stage bladder cancer (only on the inside surface of your bladder, also called superficial or non-muscle-invasive) and you haven’t had treatment yet, our urologic oncologists have the expertise to plan and provide your care.

If you have metastatic bladder cancer, which has spread to distant parts of your body, our medical oncologists are the right match for your treatment needs. You’ll likely start by seeing one of them first. 

In both of these cases, your physicians work closely with the same UW Medicine pathologists and radiologists who specialize in genitourinary cancers. They will also bring in any other experts you need — not only physicians and nurses, but also supportive care specialists who can help you with your physical and emotional needs.

Your first appointment

Your first appointment at the BCMC will usually take about four hours. You will spend about three hours with your physicians. We invite you to bring a friend or family member with you to help keep track of your questions and the information that your team gives you.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Immunotherapy A type of therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. A therapy that uses substances to stimulate or suppress the immune system to help the body fight cancer, infection and other diseases. Some immunotherapies only target certain cells of the immune system. Others affect the immune system in a general way. Types of immunotherapy include cytokines, vaccines, bacillus Calmette-Guerin (BCG) and some monoclonal antibodies. Metastatic A metastatic cancer is a cancer that has spread to other areas of the body by way of the lymph system or bloodstream. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
“We’re not treating a disease — we’re treating a person, and we figure out which treatments fit best for each individual. ”
— Jonathan L. Wright, MD, MS, FACS, urologist

Here's what you can expect to happen.

Hour 1 – exam 

You will meet with a resident doctor or fellow who will talk with you about your health history and do a physical exam.

Hour 2 – team meeting

Your team of physicians will meet to talk with each other about your cancer and the most effective ways to treat it. During this time, you will be free to visit the Patient Resource Center and other UW Medical Center amenities.

  • Your resident or fellow will present the details they learned from talking with you and examining you. 
  • Your pathologist and radiologist will review and explain the results of any biopsies, other tests and imaging scans you’ve had. 
  • Your urologic oncologist, medical oncologist and radiation oncologist will apply their experience and knowledge about the best treatment approach for people in your situation. 

Together, the team will design a treatment plan specifically for you.

Hours 3 and 4 – recommendations 

You will meet one-on-one with each physician from your team. You will stay in the same room and the physicians will come to you. We will explain the treatment we recommend for you and why. We’re here to answer your questions and talk through your options so you can make decisions you feel good about. 

What happens next?

Before you leave, you will meet the BCMC program coordinator. We will schedule any appointments you need next. Your schedule will depend on your specific situation, but we’re here to handle the details and make the process as worry-free as possible for you.

Once treatment begins, our patients receive care at Fred Hutch South Lake Union, UW Medical Center - Montlake or both.

Everyone on our team is used to partnering one-on-one with patients and their families to put in place the plans that are right for them. We want to help you understand as much as you wish to about your disease, your treatment and how care happens here — so you can focus on living your life.

1. Leonidas N. Diamantopoulos et al, “Bladder Cancer Multispecialty Clinic (BCMC) Model Influences Disease Assessment and Impacts Treatment Recommendations,” Bladder Cancer 5 (2019): 289-298.

Biopsy The removal of a sample of tissue or fluid that is examined to see whether cancer is present. This may be done with a large needle or through surgical removal of tissue or fluids. Imaging In medicine, a process that makes pictures of areas inside the body. Imaging uses methods such as X-rays (high-energy radiation), ultrasound (high-energy sound waves) and radio waves. Medical oncologist A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A physician who has special training in diagnosing and treating cancer in adults using chemotherapy, hormonal therapy, biological therapy and targeted therapy. A medical oncologist is often the main health care provider for someone who has cancer. A medical oncologist also gives supportive care and may coordinate treatment given by other specialists. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiation oncologist A physician who has special training in using radiation to treat cancer. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Bladder Cancer Multispecialty Clinic

Many people with bladder cancer need more than one type of treatment, which means they need more than one type of physician. At Fred Hutch, we bring a team of genitourinary specialists together for you in one place: the Bladder Cancer Multispecialty Clinic (BCMC). It’s our one-stop shop, where we guide you through complex treatment decisions and provide seamless, comprehensive care.
Bladder cancer second opinions

If you’ve been diagnosed with bladder cancer or urothelial cancer, we recommend getting a second opinion before choosing where you’ll be treated. 

Fred Hutch has the region’s only Bladder Cancer Multispecialty Clinic, where urologic oncologists, medical oncologists, radiation oncologists and pathologists come together to discuss and care for people with bladder or urothelial cancer as a team. During a single visit you get the second opinion of not one doctor but an entire group of specialists.

Talk with bladder and urothelial cancer experts who understand your disease in greater depth than the general oncologists in your local community. We will share information back with your local oncologist according to your wishes.

Call us at (855) 557-0555 to request an appointment for a second opinion.

How a second opinion can help

Getting a second opinion from doctors who specialize in urinary tract cancers can help you:

Feel confident that your cancer has been accurately diagnosed and staged

Verifying facts, like the type and stage of your cancer, are important to your decisions about treatment. Pathologists, radiologists and urologists from Fred Hutch are experts in diagnosing urinary tract cancers and have access to the latest technologies to help ensure we know as much about your cancer as possible.

Understand the benefits of specialized, multidisciplinary care

Bladder cancer can be aggressive. If your cancer has invaded the muscle wall of your bladder, you need well-coordinated, comprehensive treatment and should choose a center that has experience in treating bladder cancer with surgery, chemotherapy and especially radiation therapy. 

Even noninvasive cancers require surgery, and they may require further treatment to destroy all signs of cancer now and decrease the risk that cancer will come back.

Consider state-of-the-art treatment options

There are advanced options for urinary tract cancers that not all doctors may know about. These include robot-assisted surgery to speed your recovery and advanced urinary reconstructions that help preserve your quality of life if you need your bladder removed. You may be able to receive bladder-sparing treatment using chemotherapy and radiation therapy. Getting a second opinion may also give you rapid access to new treatments or clinical studies that aren’t available everywhere. 

Start with a course of therapy tailored to you

Changing treatment regimens is not always easy or possible. Once you start a course of treatment, it’s sometimes hard to change to something else. So it’s important to get as much information as you can upfront about the best options. We focus on you, not just your cancer, when developing a treatment plan. We consider your goals, plans, beliefs, values and preferences to design your treatment comprehensively.

Request a second opinion

To request a second opinion with an Fred Hutch doctor, call (855) 557-0555.

And if you received your diagnosis through Fred Hutch, don’t be afraid to ask your doctor about getting a second opinion. They’ll be more than happy to provide you with a list of recommended doctors.

Chemotherapy Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. It may be given alone or with other treatments. Treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping them from dividing. Chemotherapy may be given by mouth, injection, infusion or on the skin, depending on the type and stage of the cancer being treated. It may be given alone or with other treatments, such as surgery, radiation therapy or biologic therapy. Oncologist A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment, such as treating cancer with radiation. A physician who has special training in diagnosing and treating cancer. Some oncologists specialize in a particular type of cancer treatment. For example, a radiation oncologist specializes in treating cancer with radiation. Pathologist A physician who has special training in identifying diseases by studying cells and tissues under a microscope. Radiation oncologist A physician who has special training in using radiation to treat cancer. Radiation therapy The use of high-energy radiation from X-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. The use of high-energy radiation from x-rays, gamma rays, neutrons, protons and other sources to kill cancer cells and shrink tumors. Radiation may come from a machine outside the body (external-beam radiation therapy), or it may come from radioactive material placed in the body near cancer cells (internal radiation therapy or brachytherapy). Systemic radiation therapy uses a radioactive substance, such as a radiolabeled monoclonal antibody, that travels in the blood to tissues throughout the body. Radiologist A physician who has special training in creating and interpreting pictures of areas inside the body. The pictures are made with X-rays, sound waves or other types of energy. Sign In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. In medicine, a sign is something found during a physical exam or from a laboratory test that shows that a person may have a condition or disease. Some examples of signs are fever, swelling, skin rash, high blood pressure and high blood glucose. Stage The extent of a cancer in the body. Staging is usually based on the size of the tumor, whether lymph nodes contain cancer and whether the cancer has spread from the original site to other parts of the body. Treatment plan A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A detailed plan with information about a patient’s disease, the goal of treatment, the treatment options for the disease and the possible side effects and expected length of treatment. A treatment plan may also include information about how much the treatment is likely to cost and about regular follow-up care after treatment ends.
Bladder cancer second opinions

If you’ve been diagnosed with bladder cancer or urothelial cancer, we recommend getting a second opinion before choosing where you’ll be treated. 
In this video, Dr. Petros Grivas and Dr. Jonathan Wright discuss what people diagnosed with bladder cancer should know, including questions to ask their doctor, current treatment options, and the latest research in bladder cancer. · Cancer.Net

Featured stories

Facts

Bladder cancers are highly curable if detected and treated early. Most begin in the cells of the inner lining of the bladder. They can spread to the bladder’s muscle wall and beyond. We offer comprehensive treatment from a team of experts who specialize bladder, urothelial and other genitourinary cancers.

Treatment

Fred Hutch offers comprehensive care for bladder cancer, including advanced treatments and new options available only through clinical studies, at the Bladder Cancer Multispecialty Clinic. 

Clinical trial A type of research study that tests how well new medical approaches work in people. These studies test new methods of screening, prevention, diagnosis or treatment of a disease.

Providers

At Fred Hutch, you receive care from a team of providers with extensive experience in your disease. Your team includes physicians, a patient care coordinator, a registered nurse, an advanced practice provider and others, based on your needs. You also have access to experts like nutritionists, social workers, acupuncturists, psychiatrists and more who specialize in supporting people with cancer or blood disorders.

Clinical trials

To give you access to the most innovative therapies, we unite the leading researchers and cancer specialists of Fred Hutch and UW Medicine so you can take part in bladder cancer clinical trials not available everywhere. 

Resources

There are many resources online for learning about your disease, as well as organizations that provide community and support for your cancer diagnosis. Health educators at the Fred Hutch Patient and Family Resource Center have compiled a list of trusted sources to help you get started.

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