Follow up after non muscle invasive bladder cancer treatment

After treatment, you have regular check ups to look for signs of cancer coming back or spreading.

Follow up gives you a chance to discuss with your specialist how you are. You can talk about any problems and raise any concerns you have about your progress.

You usually have follow up appointments every few months.

What happens?

Your doctor or nurse examines you at each appointment. They ask how you’re feeling, whether you’ve had any symptoms or side effects and if you’re worried about anything.

Your doctor also looks inside your bladder using a flexible tube (cystoscopy). You have a local or general anaesthetic while they do this. 

They might also test your urine. They are looking at the cells in the urine to look for signs of cancer. This is called a urine cytology test. 

How often you have appointments

Your specialist decides how often you should have cystoscopies. This depends on the risk of your cancer coming back or spreading deeper into the bladder wall. 

Low risk

You may only need to have a cystoscopy 3 months after treatment, then after 1 year.

After this you might not need to see your doctor again.

Moderate risk

You may have a cystoscopy at 3, 9 and 18 months after treatment.

After that you may have a cystoscopy once every year for up to 5 years after treatment. Then you might not need to see your doctor again.

High risk

You may have a cystoscopy every 3 months for the first 2 years, and then every 6 months for the next 2 years.

After that you might have one cystoscopy every year.

After removal of your bladder (cystectomy)

You still have regular check ups if you had your bladder removed for early bladder cancer.  You usually have a CT scan at 6, 12 and 24 months to check for any signs of the cancer coming back.

You also have blood tests at least once a year. These are to check how well your kidneys are working, and that you are absorbing enough vitamin B.

Men also have yearly tests for up to 5 years to check their urethra. The urethra is the tube that carries urine from the bladder to the outside of your body.

If you are on a clinical trial

Your follow up may be different if you have been part of a clinical trial. Your doctor or clinical trial team will explain to you when and what you will have after your treatment has finished.

Between appointments

Contact your doctor or specialist nurse if you have any concerns. You should also contact them if you notice any new symptoms between appointments. You don’t have to wait until your next visit.

Many people find their check ups quite worrying. A hospital appointment can bring back any anxiety you had about your cancer.

It can help to tell someone close to you how you’re feeling. Sharing your worries can mean they don’t seem so overwhelming. Many people find it helpful to have counselling after cancer treatment.

Cancer Research UK nurses

If your bladder cancer comes back

The surgeon can remove the growths with cystoscopy again if stage Ta or T1 bladder cancer comes back after treatment.

Your specialist takes more biopsies to check that the cancer is still at an early stage. If it is, you usually have chemotherapy or BCG treatment into the bladder. You then go back to having regular cystoscopies to check your bladder.

Your doctor might suggest you have more intensive treatment such as surgery to remove your bladder (cystectomy). They might recommend this if your cancer is:

• grade 3 (the cancer cells look very abnormal)
• at a more advanced stage than before
• carcinoma in situ (CIS) that has come back after treatment into the bladder