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Further tests can determine if the cancer has spread past the bladder or into more distant tissues such as: retrograde or intravenous pyelogram, which uses X-rays and a special dye to visualize the urinary tract further imaging tests, including: additional lab tests such as: complete blood count basic metabolic panel liver and kidney function tests Treatment for MIBC typically involves The National Comprehensive Cancer Networks guidelines for bladder cancer, which are widely used across accredited cancer centers, recommend one of the following options: neoadjuvant cisplatin-based combination chemotherapy followed by radical cystectomy cystectomy alone for those not eligible to receive cisplatin-based chemotherapy bladder preservation with concurrent chemotherapy and radiation (chemoradiotherapy) followed by TURBT radiation therapy or TURBT for people who arent candidates for cystectomy or chemoradiotherapy Cancer recurrence prevention If youve had a radical cystectomy and your cancer is at a high risk of coming back, a doctor may prescribe an immunotherapy drug like nivolumab (Opdivo), for Cancer that has spread to distant areas Cancer that has spread to distant areas of the body (metastasized) may be treated using one or a combination of the following methods: radical cystectomy with urinary diversion If the cancer has spread to distant sites, surgery would be focused on alleviating symptoms and improving quality of life (palliative)

Jama 311 , 183192 (2014)