A radical cystectomy — surgery to remove the bladder and nearby lymph nodes — is often the best treatment option for muscle-invasive bladder cancer, as well as non-muscle-invasive bladder cancer that is high-risk or hasn’t responded to other treatment. But even after bladder removal, cancer can still come back.
After a cystectomy, bladder cancer recurs in 30% to 40% of patients, usually in the first two to three years following bladder removal. Here’s why it can return, and what to watch for.
Reasons why bladder cancer can return after bladder removal
Recurrence can be due to a number of factors that may be related to tumor characteristics, lifestyle and health or as a result of residual cancer cells following surgery.
- The type of cancer: High-risk cases of non-muscle-invasive bladder cancer and muscle-invasive bladder cancer both have a greater risk of recurring. Tumors that are larger in size also pose a greater risk of returning.
- Residual cancer cells: Microscopic cancer cells can remain in surrounding tissue after bladder cancer surgery and develop over time.
- Diet and lifestyle factors: Smoking and being overweight both increase the risk of recurrence.
- Other health conditions: Chronic urinary tract infections and interstitial cystitis can cause inflammation, increasing the risk of bladder cancer recurrence. Uncontrolled diabetes also increases risk.
Where does bladder cancer come back if the bladder was removed?
Bladder cancer may recur in tissue close to where the bladder was, in the pelvis, in the lymph nodes and in the urinary tract, namely the ureters and the kidneys.
In men, the prostate may be affected; in women, the uterus and vagina are at risk. It may also spread to other parts of the body, including other lymph nodes, the bones, the liver and lungs.
Read more about bladder cancer recurrence
Ways to help prevent the recurrence of bladder cancer
Unfortunately, there is no guarantee that removal of the bladder will completely eradicate your bladder cancer. However, there are some steps you can take to help prevent its return.
Close monitoring: After cancer treatment, you will have regular follow-up appointments with your doctor. Your blood will be analyzed, your urine will be tested for cancer cells and CT scans or ultrasounds will be used to look for any signs of recurrence. Signs of infection in your kidneys will also be carefully monitored. Early detection allows for urgent treatment. Make sure to follow your care team’s recommendations and attend all follow-up appointments.
Lifestyle modifications: Stopping smoking, adopting a healthy diet, incorporating low impact exercise, staying at a healthy weight and having a good sleep schedule are all essential for maintaining overall good health.
Staying vigilant about any new or unexplained symptoms: Report any of the following symptoms to your doctor: chronic fatigue, unexplained weight loss, persistent pain in the lower back or abdomen or swelling in your legs.
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