Non-muscle invasive bladder cancer (NMIBC) is bladder cancer where tumours stay in the inner lining of the bladder and have not grown into the thick muscle wall. It makes up approximately 75% of new bladder cancer cases, making it the most common type of bladder cancer diagnosed. NMIBC usually has a good prognosis, but it can come back or progress after treatment — about 25% of cases originally diagnosed as non-muscle invasive go on to progress to muscle invasive bladder cancer (MIBC). This is why ongoing surveillance after treatment is such an important part of managing NMIBC.
Non-Muscle Invasive Bladder Cancer
What is Non-Muscle Invasive Bladder Cancer (NMIBC)?
Non-muscle invasive bladder cancer (NMIBC) is the most common type of bladder cancer.
Doctors group NMIBC into low, intermediate, or high risk, based on the grade of the cancer cells, the size of the tumour, and how many tumours are present. Your risk category helps determine how closely you’ll be monitored after treatment and whether additional therapy beyond surgery is recommended.
- NMIBC is diagnosed through a combination of tests: cystoscopy (a thin, camera-equipped tube used to look inside the bladder through the urethra), urine tests to check for cancer cells, blood tests, and a CT scan. If a tumour is found during cystoscopy, a TURBT (transurethral resection of the bladder tumour) is typically performed to remove it and confirm the diagnosis.
- NMIBC treatment options include medication inserted directly into the bladder, referred to as a type of immunotherapy called Bacillus Calmette–Guérin.
- Successful bladder cancer treatment depends on early detection and treatment.
Non-Muscle Invasive Bladder Cancer Treatment
The stage of your bladder cancer helps your doctor to decide which treatment you need. For NMIBC, there are several treatment options available.
- Intravesical Treatments — medication delivered directly into the bladder through a catheter, rather than through the bloodstream:
- IV Treatment with Chemotherapy (with Cisplatin, Gemcitabine, Carboplatin or a combination of each)
- Immunotherapy
- Radical Cystectomy (bladder removal surgery) — typically considered for high-risk NMIBC when other treatments haven’t controlled the cancer
Managing Recurrence in Non-Muscle Invasive Bladder Cancer (NMIBC)
The rate of recurrence in non-muscle invasive bladder cancer, NMIBC, can vary greatly based on the rate of progression or recurrence risk.
Typical treatment for NMIBC is the Bacillus Calmette–Guérin, also known as BCG, derived from an antituberculosis vaccine developed by French bacteriologists. Other bladder cancer treatment options include:
- Chemotherapy
- Chemo-radiation
- Immunotherapy
For high-risk NMIBC cases, a radical cystectomy (bladder removal), is recommended.
Resources and Support for Non-Muscle Invasive Bladder Cancer
Bladder Cancer Canada has produced a helpful Guidebook with information about non-muscle invasive bladder cancer, how it’s diagnosed and the NMIBC treatment options available. You can download a free copy of our Guidebook. We also host a moderated public Discussion Forum, where you can ask questions, share your experiences and read about the experiences of others.
The Canadian Urological Association establishes guidelines providing evidence-based guidance for healthcare clinicians based on best practices. To review the guidelines regarding non-muscle invasive bladder cancer, please click here.
We encourage you to contact Bladder Cancer Canada for support if you have non-muscle invasive bladder cancer by email or by calling 1-866-674-8889.