The bladder is a part of the urinary system responsible for expelling urine from the body. Bladder cancer occurs when cells in the lining of the bladder start to divide uncontrollably. This cancer is most common in the bladder, but it also appears in other parts of the urinary tract system. It is more common in men, but still affects women, and it can even recur, making it important to receive follow-up appointments after treatment.

The various types of therapies used to treat bladder cancer are as follows:

1. Chemotherapy
Chemotherapy is performed during the early stages of bladder cancer treatments.

There are two types of chemotherapy performed based on the type and stage of bladder cancer:

• Systemic chemotherapy
  The process of administering medications in the form of pills or capsules, or injecting them into a vein (IV) or muscle (IM) is called systemic chemotherapy. In this therapy, the medications go directly into the bloodstream, which will help in attacking cancer cells anywhere in the body.
• Intravesical chemotherapy
  The process of delivering medications into the bladder with the help of a catheter inserted through the urethra is called intravesical chemotherapy. Intravesical chemotherapy only destroys the tumor cells that come in contact with the chemotherapy drugs. Mitomycin-C, thiotepa (Tepadina) and gemcitabine (Gemzar) are the most common medications used for intravesical chemotherapy. Other medications used for bladder cancer treatments include valrubicin (Valstar), cisplatin and doxorubicin.

2. Immunotherapy
Immunotherapy is the process of administering medications to improve one’s immune system to fight against cancer cells and destroy them.

There are two ways in which immunotherapy for bladder cancer can be done:

• Intravesical BCG
  BCG is a type of bacteria that can help in triggering an immune response. Intravesical BCG is a process in which BCG is put right into the bladder as a liquid, which helps in activating immune system cells in the bladder, which further helps in attacking the bladder cancer cells.
• Immune checkpoint inhibitors
  Immune checkpoint inhibitors are most often used for advanced bladder cancers. One of the important functions of our important system is to restrict itself attacking normal cells in the body. To do this function properly, the immune system of our body uses “checkpoints.” The drawback of this function is that the cancer cells sometimes use these checkpoints of the immune system to keep them away from being attacked by them. But in recent days, newer medications used in Immune checkpoint inhibitors target these checkpoints and further helps in bladder cancer treatments.

3. Targeted Therapy
The drugs used in targeted therapy works differently from other therapies. This therapy targets the changes that happen inside the cells which are responsible for causing cancer.

The following is an example of a medication used in targeted therapy, which will explain how this therapy works:

• FGFR inhibitor
  FGFR (Fibroblast growth factor receptors) is a growth factor that helps the bladder cancer to grow. They are a group of proteins on bladder cancer cells which helps cancer to spread further. In some bladder cancers, the cells may change, which controls how much of the FGFR proteins to be made. In such a case, FGFR inhibitors are used to target cells with FGFR gene changes is used for the treatment of bladder cancer.