Bladder Cancer Treatment Melbourne
Bladder cancer is one of the most common urological cancers, most often presenting with painless blood in the urine. Dr Brendan Dias provides comprehensive, evidence-based care spanning diagnosis, staging and treatment of all stages of bladder cancer, from low-risk non-muscle invasive tumours managed with endoscopic surgery and intravesical therapy, through to muscle-invasive disease requiring chemotherapy and robotic radical cystectomy. Treatment is individualised to the tumour's stage and grade, and to each patient's overall health and preferences, with close attention to long-term surveillance given the disease's tendency to recur.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Rapid, accurate diagnosis through cystoscopy, imaging and TURBT
- Bladder-preserving options for suitable non-muscle invasive and selected muscle-invasive cancers
- Access to intravesical BCG immunotherapy and chemotherapy to reduce recurrence
- Robotic radical cystectomy with reduced blood loss and faster recovery than open surgery
- Individualised urinary diversion planning (ileal conduit or neobladder)
- Structured, guideline-based surveillance to detect recurrence early
- Coordinated multidisciplinary care with medical and radiation oncology when needed
The Procedure
Management begins with cystoscopy and imaging to identify and characterise any bladder tumour, followed by TURBT to remove visible tumour and obtain tissue for staging. Non-muscle invasive tumours are treated with a course of intravesical chemotherapy or BCG immunotherapy instilled through a catheter, alongside scheduled surveillance cystoscopies. Muscle-invasive tumours generally require neoadjuvant chemotherapy followed by robotic radical cystectomy, during which the bladder (and in men, the prostate) is removed along with pelvic lymph nodes, and a urinary diversion - either an ileal conduit or neobladder - is fashioned from a segment of bowel. Selected patients with muscle-invasive disease may instead be suitable for bladder-preserving trimodal therapy combining maximal TURBT, chemotherapy and radiotherapy.
Who Is a Candidate?
Any patient with visible or persistent microscopic blood in the urine, irritative bladder symptoms without infection, or an abnormal finding on imaging should be assessed for bladder cancer, particularly current or former smokers, those with occupational chemical exposure, and men over 50. Treatment pathway depends on the stage and grade confirmed at TURBT: low and intermediate-risk non-muscle invasive tumours are managed conservatively with intravesical therapy, while high-grade, recurrent or muscle-invasive tumours require more intensive treatment including cystectomy or trimodal therapy.
Recovery
Recovery after TURBT is typically rapid, with overnight or day-case admission and return to normal activity within one to two weeks. Intravesical BCG or chemotherapy courses involve weekly clinic visits over six weeks, with mild bladder irritation as the main side effect. Recovery after robotic radical cystectomy is more involved, with hospital stay of seven to ten days, an enhanced recovery pathway, and eight to twelve weeks for full recovery, including learning to manage a neobladder or ileal conduit with support from stoma therapy nurses.
Risks & Considerations
Risks vary by treatment. TURBT carries a small risk of bleeding, bladder perforation and infection. Intravesical BCG and chemotherapy commonly cause temporary urinary frequency, urgency and mild flu-like symptoms. Robotic cystectomy is major surgery with risks including bleeding, bowel or ureteric complications, infection, blood clots, erectile dysfunction in men, and long-term metabolic or stoma-related issues. Across all treatment types, bladder cancer has a significant tendency to recur, which is why structured, ongoing surveillance is a core part of care rather than a sign of treatment failure.