When we say that someone has been “cured” of a disease, we mean that the disease has completely disappeared and will not return. When we say that the cancer has been cured, we generally mean that after a certain period of time, there is still no evidence that the cancer has returned.
For most patients, bladder cancer is completely curable. Low grade, superficial bladder cancer is in some sense curable when the tumor has been completely removed. Unfortunately, bladder cancer is prone to recurrence. Although the tumor has been completely removed, it is possible for a new tumor to grow back in the original or new location. Therefore, regular review is needed after surgery. Most recurrent tumors that are detected early are still curable.
Cure is also possible in patients whose tumors have invaded the muscle layer of the bladder. The surgeon removes the tumor by removing part or the whole bladder and if it is complete, you can also say that you are cured. Surgery can cure 80% of bladder cancers that are confined to the bladder. Unfortunately, there is no way to know if the tumor has been completely removed. Surgeons are not sure if any cancer cells have left the bladder under the microscope. In patients where this is suspected, such as when the tumor appears at the edge of resected tissue, further postoperative radiotherapy may improve the chances of curing the tiny tumor lesions that remain in the body. Patients with locally advanced bladder cancer can only achieve a 20-30% cure rate with surgery alone. To be sure that the tumor has not recurred, regular follow-up by the urologist after surgery is important.
Finally, it is possible for patients to be cured even if the tumor has metastasized. The combination of surgery, chemotherapy, and radiation therapy is now able to cure a small percentage of such patients, and the cure rate is increasing. Most patients are more sensitive to chemotherapy in the early stage of treatment. However, for such a patient, it is difficult to say at what point he is cured. It is still important to follow up with X-rays, CT, cystoscopy, and urine exfoliation cytology for several years after treatment.