Stage III cancers have reached the outside of the bladder and highly possibly have grown into nearby tissues or organs.
Stage III cancer treatment has several steps. Ransurethral resection (TURBT) is typically the first step to determine the extent of cancer. Radical cystectomy, meaning removal of the bladder and nearby lymph nodes, is the second standard treatment. Partial cystectomy is not recommended for stage III cancers.
Neoadjuvant chemotherapy (chemo) is often given before surgery in order to shrink the tumor and therefore make surgery easier. The chemo can be especially useful for T4a tumors that have grown outside the bladder. It may also kill any cancer cells that have spread to other areas of the body. This approach helps patients live longer than cystectomy alone in more than half of the cases. In some cases though, the delayed surgery of removing tumor by neoadjuvant chemo can be harmful if the chemo doesn’t kill cancer cells and the tumor continues to grow during chemo. This can happen on some patients.
Chemo after surgery (adjuvant treatment) is also recommended by some doctors in order to kill cancer cells left in other areas of the body that are too small to see. Chemo given after cystectomy may help patients stay cancer-free longer, but so far it’s not clear if it helps them live longer.