Bladder cancers often affect only the lining of the bladder and can be treated relatively simply. Sometimes, however, the cancers go more deeply into the muscular wall of the bladder. These are known as 'invasive' bladder cancers and they need treatment with either surgery or radiotherapy.

Surgery usually involves a complete removal of the bladder, with an operation called a total cystectomy, the prostate gland is also removed in men. This is a major operation and involves some permanent 'replumbing' for the flow of the urine, which is usually brought out into a bag on the outside of the abdomen. The operation also often causes some damage to the nerves in the pelvis, which can lead to impotence.

Radiotherapy is the use of high energy rays to destroy cancer cells and involves a course of treatment over some weeks, treatment is every day (Monday to Friday). It consists of lying on a bed, under a machine, for about 15 to 30 minutes each day. The treatment itself is painless but is likely to cause a number of side-effects including tiredness, diarrhoea and cystitis (with stinging and burning when passing urine and passing urine more often than usual). The treatment is normally done as an out-patient.

Statistics suggest that the cure rate for surgery is higher than radiotherapy. But many doctors feel these figures are due to the fact that because surgery involves a major operation it is only used for younger fitter patients, whereas radiotherapy can also be used for older, frailer patients. As a result there is still some uncertainty among specialists as to which is the best treatment.

The side effects people experience from surgery tend to be greater than with radiotherapy. These include: disfigurement - because there is no bladder the person needs to wear a bag to collect the urine and impotency (this can be a problem with radiotherapy as well but it only occurs in half of the men rather than all). Also a small number of those who have had the radiotherapy will need to have their bladders removed later because either the cancer has never gone away or it has recurred. Nowadays in most treatment centres surgery is usually suggested for younger fitter patients and radiotherapy for those who would not cope with the operation as well.

Chemotherapy is also sometimes used before any other treatment. It is thought that those who have a good response to it may benefit more from the radiotherapy and therefore avoid the removal of their bladder.

The final decision on whether to have surgery or radiotherapy should be made on an individual basis after a full discussion with your father's specialists of all the benefits and risks.