Bladder cancer surveillance refers to the period of time that you are monitored for a recurrence of bladder cancer after the bladder cancer has been removed or treated. It is a term that is used for patients who have been treated for superficial bladder cancer. Even after successful treatment of a tumor, it is important to remember that you are at risk of developing cancer in other areas of the bladder and thus must be followed for the long term.
The stage and grade of a tumor help to predict the risk of getting a recurrence, but in general, half of all patients will experience a recurrence. The term “surveillance” is usually applied only to patients who have superficial (not invasive) cancer treated with a TURBT and/or BCG (or other intravesical therapy).
We know that many patients will eventually have a recurrence of superficial tumors; thus, we must follow these patients closely. The need is similar to patients who have small skin cancers that have been removed; the cancerous growth has been removed, but the rest of the skin has had a lifetime of exposure to the sun and thus is at risk of developing a new cancer in a different area.
The exact timing of procedures for bladder cancer surveillance varies according to the type of tumor, age of the patient, and overall health of the patient. Most patients will have a cystoscopy in the office every 3 months for the first year and will then decrease to twice a year or annually thereafter, as long as no new tumors are found. Also, urine cytology or other urine tests will be sent.
Finally, remember that the ureters and kidneys possess the same types of cells as the bladder, and thus they too are at risk of a recurrence. Periodic X-rays of the kidneys should be obtained to monitor for recurrences. While there is no clear time frame for how often these should be done, most physicians will check the kidneys every few years. Surveillance allows us to catch and treat any recurrence early on, with the goal of preventing progression to muscle invasion.