If my bladder cancer has invaded my lymph nodes, will i have to have surgery?

Possibly: If the bladder cancer has spread to few local lymph nodes in the pelvis, then surgery may still be an option to remove the bladder and lymph nodes at the same time. If there is advanced cancer or many lymph nodes present, then chemotherapy and radiation may be first needed to allow shrinkage of the tumor followed by surgery for complete removal.

Possibly: Spread of bladder cancer to lymph nodes is very serious. Extended removal of lymph nodes at the time of bladder cancer removal has been shown to improve survival, but in the case of proven enlargement from cancer before surgery that is less clear. Preoperative chemotherapy can reduce tumor burden and facilitate surgery, but patients with node involvement at surgery have a 25-30% 5 year survival.