Medical Oncologist
CION Cancer Clinics
Follow-Up After Radical Cystectomy | CION Cancer Clinics
After a radical cystectomy you are usually seen every three to six months for the first two years, then once a year until about five years. Each visit checks two things: whether the cancer has come back, and whether the new urine route is affecting your kidneys or blood chemistry. This page explains the typical calendar, the scans and blood tests used, and what should not wait for the next appointment. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- How often will I be seen after a radical cystectomy?
- What does a typical follow-up calendar look like?
- What is actually being checked, and why?
- Words you will see on follow-up reports, in plain language
- What decides how closely you are watched, and what this page cannot tell you
- Four things families tell us about follow-up, and what is actually true
- Common questions about follow-up after cystectomy
The short answer
How often will I be seen after a radical cystectomy?
After a radical cystectomy (removal of the bladder) you are usually seen every three to six months for the first two years, then once a year until about five years. Most visits include a blood test. A CT scan of the chest, tummy and pelvis is done at set points, not every time.
Why the visits are closest at the start
If bladder cancer comes back after surgery, it most often does so in the first two to three years. So the calendar is busiest early and then spreads out. Each visit also checks what the operation changed: the new urine route and the kidneys that now drain into a piece of bowel.
Why your calendar may not look like this one
The schedule above is typical, not fixed. Your surgeon sets yours from the pathology report (the report on the removed bladder), the type of urinary diversion you have, and how you are recovering. Cancer in the lymph nodes usually means closer watching. A frail person for whom a scan finding would not change treatment may be seen less often.
Bring your discharge summary and pathology report to the first visit. The schedule is written from them.Year by year
What does a typical follow-up calendar look like?
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The first few weeks
A wound and stoma check, and removal of any stents or the neobladder catheter if still in. The pathology report is explained here, and it decides much of what follows. Ask whether chemotherapy after surgery is being suggested.
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Around three months
Usually the first kidney blood test and the first CT scan. This scan is the baseline every later picture is compared against, so it matters even if you feel well.
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Every three to six months, to two years
Blood tests at most visits. Scans at intervals your team sets, more often if the report showed a higher-risk cancer. A stoma nurse or continence review sits alongside the surgeon's visit.
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Years three to five
Visits spread to about once a year. Scanning continues but less often. Kidney function, salts in the blood and vitamin B12 are checked, because these problems build slowly after a bowel-based diversion.
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Beyond five years
Cancer checks usually stop or become occasional. Kidney and vitamin checks do not stop. They can move to a doctor near home, with results sent to your surgeon if anything changes.
Not sure whether this applies to you?
Ask an oncologistAt each visit
What is actually being checked, and why?
Follow-up watches two separate things: whether the cancer has come back, and whether the new urine route is harming the kidneys or the body's chemistry.
The CT scan
A CT of the chest, tummy and pelvis with contrast dye. It looks at the lungs, liver, lymph nodes, the space where the bladder was, and both kidneys with their draining tubes.
It is looking for
- Recurrence, meaning cancer that has returned
- A blocked or swollen kidney
- A new growth in the ureters
Blood tests
Creatinine and eGFR for kidney function, salts and acid level in the blood, haemoglobin, and vitamin B12. These are about the diversion, not the cancer, and they continue for life.
Urine and urethra checks
If your urethra (the tube you used to pass urine through) was left in place, your team may test a urine wash from it, because cancer can return there. Urine is checked for infection when there are symptoms.
The stoma or neobladder itself
How the skin around the stoma looks, whether the bag is sealing, and for a neobladder, how completely it empties. This is where most day-to-day problems are caught, usually by the stoma nurse.
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Do not wait for the next appointment if this happens
A fever with shivering or pain in the side of the back, very little or no urine coming into the bag for several hours, a swollen and painful calf, or sudden breathlessness. Each of these needs same-day care, because a blocked kidney or a clot cannot wait. Go to the nearest emergency department, say you have had your bladder removed and which diversion you have, and call the helpline so your surgeon knows.
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On your reports
Words you will see on follow-up reports, in plain language
- Surveillance
- The formal word for follow-up. It means watching on a schedule, not that anything has been found.
- Recurrence
- Cancer that has come back. Local means near where the bladder was; distant means somewhere else, such as the lungs.
- Upper tract
- The kidneys and the ureters, the tubes that carry urine down from them. The same cancer can appear here later.
- Hydronephrosis
- A kidney swollen because urine is not draining freely. It can be silent, which is one reason the scan is repeated.
- eGFR
- A number worked out from your creatinine blood test that estimates how well the kidneys are filtering. The trend matters more than one result.
- Metabolic acidosis
- Too much acid in the blood, a known effect of urine sitting in a piece of bowel. It is found on a blood test and treated with tablets.
Being straight with you
What decides how closely you are watched, and what this page cannot tell you
Three things set the intensity of your follow-up: the stage on the pathology report (how deep the cancer went and whether nodes were involved), whether you had chemotherapy around the operation, and which urinary diversion you have. A neobladder is usually reviewed a little more often than an ileal conduit in the first year, because emptying and infection need checking.
Who this schedule does not suit
Someone who had the bladder removed to relieve symptoms rather than to remove all the cancer will usually have a lighter, symptom-led plan. So will someone too frail for further treatment, where a scan result would not change what is done. That is a decision for you and your team together.
What this page cannot tell you
It cannot tell you your own risk of the cancer returning; no calendar can. It cannot tell you what a scan result means; only your surgeon can read that against your pathology and earlier pictures. And it is not a reason to change any medicine or skip a test because you feel well. If you cannot travel to Hyderabad for every visit, say so. Blood tests, and sometimes scans, can be done nearer home and read here.
Unsure whether a visit is due? Call the helpline with your discharge date and someone will check.Commonly believed
Four things families tell us about follow-up, and what is actually true
"He feels fine, so we can skip this visit."
Feeling well is exactly when follow-up does its job. A returning cancer, a silently swollen kidney and a falling B12 level all cause no symptoms at first. The visit exists to find them before they do.
"A scan at every visit would be safer."
More scans do not mean more safety. Each CT carries contrast dye and radiation, and a scan that would not change any decision is a cost and a worry with no benefit. The gaps are set on purpose.
"After five years everything is finished."
The cancer checks usually wind down. The kidney, salt and vitamin checks do not, because the diversion is for life and its effects build slowly. A yearly blood test near home is usually enough.
"The blood tests are only about the cancer."
Most of them are not. Creatinine, salts and B12 are about how the kidneys and bowel segment are coping. A worrying result here is usually treatable with tablets or a change in routine, if caught early.
Questions we are asked
Common questions about follow-up after cystectomy
Which scan is used, and can it be an ultrasound instead?
The usual test is a CT of the chest, tummy and pelvis with contrast dye, because it shows the lungs, liver, lymph nodes and kidneys in one go. Ultrasound is sometimes used between CT scans to check the kidneys for swelling, but it cannot replace the CT.
My kidney function is a little low. Can I still have the contrast dye?
Often yes, with extra fluids before and after, but your team decides case by case. Tell the scan centre your latest creatinine result. If the kidneys are struggling, an MRI or a scan without contrast may be used instead. Ask what the alternative is rather than skipping the scan.
Can I do the blood tests in my district and send the results?
Usually yes. Kidney function, salts, haemoglobin and B12 are standard tests any accredited laboratory can run. Ask your surgeon for a written list, have them done a few days before the visit, and send a photo of the report. Scans usually need a centre your team trusts.
What if the scan finds something?
It does not always mean cancer. Scar tissue, fluid and infection can all look suspicious on a CT. Your surgeon will compare it with earlier scans and may ask for a repeat scan, a PET-CT or a biopsy before anything is decided. Ask what the next step is.
Why is vitamin B12 checked after a bladder operation?
Because the new urine route is made from a piece of small bowel, and that piece absorbed B12 from food. The body's store lasts a long time, so the level falls slowly over years. A low level can be corrected with tablets or injections before it causes tiredness or nerve problems.
Do I still need follow-up if I had chemotherapy as well?
Yes. Chemotherapy before or after the operation lowers the chance of the cancer returning; it does not remove the need to check. Your medical oncologist may share the follow-up with the surgeon, and visits can often be combined.
Who do I contact if a problem starts between visits?
The helpline, on any day. For a stoma leak, sore skin or a supply question, the stoma nurse can usually sort it by phone. For a fever, back pain, no urine, a swollen leg or breathlessness, go to the nearest emergency department first and call afterwards.
Is follow-up covered by Aarogyasri or my insurance?
Consultations, blood tests and scans in a cancer follow-up plan are often covered, but each scheme has its own rules on how many scans and how often. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Call the helpline with your card details and we will check.
Meet the Specialists
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
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Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
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Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
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Radiation Oncologist
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Hematologist
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Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- American Cancer Society — Living as a Bladder Cancer Survivor
- Cancer Research UK — Bladder cancer
- NHS — Bladder cancer: treatment
- National Cancer Institute — Bladder Cancer Treatment (PDQ) - Patient Version
- Macmillan Cancer Support — Bladder cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Kidney Function After Urinary DiversionWhy creatinine and eGFR are watched for lifeVitamin B12 After Urinary DiversionThe slow-falling level that follow-up is designed to catchUrine Infections After Urinary DiversionThe commonest reason to be seen between visitsRecovery Timeline After CystectomyWhat the first weeks and months usually feel likeRadical Cystectomy and Urinary DiversionEvery page in this guide, from the decision to life afterwards
Talk to us
Not sure when your next review is due?
Send us your discharge summary or call the helpline. A surgical oncologist will check what has been done, what is due, and which tests can be done nearer home. One helpline serves every CION centre.