The treatment of muscle-invasive bladder cancer typically involves a combination of surgery, chemotherapy, and sometimes radiation therapy. The specific treatment plan may vary based on factors such as the stage of the cancer, the overall health of the patient, and the preferences of the medical team and the patient. Here are some common treatment approaches:

1. **Transurethral Resection of Bladder Tumor (TURBT):** This is often the initial step in the treatment of muscle-invasive bladder cancer. During this procedure, a surgeon uses a cystoscope to remove the tumor from the bladder lining. TURBT is often followed by additional treatments.

2. **Radical Cystectomy:** This is a major surgery in which the entire bladder is removed. In men, the prostate and seminal vesicles, and in women, the uterus, ovaries, and part of the vagina may also be removed. In some cases, nearby lymph nodes are also removed. After a radical cystectomy, urinary diversion procedures are performed to reroute urine from the body.

3. **Chemotherapy:** Both before and after surgery, chemotherapy may be recommended. Neoadjuvant chemotherapy is given before surgery to shrink the tumor and improve surgical outcomes. Adjuvant chemotherapy is given after surgery to kill any remaining cancer cells. In some cases, chemotherapy may be used as the primary treatment without surgery for patients who are not candidates for surgery.

4. **Radiation Therapy:** This treatment uses high-energy rays to target and kill cancer cells. It may be used in combination with surgery or as the primary treatment for patients who are not candidates for surgery.

5. **Immunotherapy:** Some patients may receive immunotherapy drugs, such as checkpoint inhibitors, which enhance the body's immune system to recognize and attack cancer cells.

6. **Clinical Trials:** Participation in clinical trials may be an option for some patients. These trials investigate new treatments or combinations of treatments to improve outcomes for individuals with bladder cancer.

Treatment decisions are complex and depend on various factors, including the stage of the cancer, the patient's overall health, and individual preferences. It's essential for individuals with muscle-invasive bladder cancer to consult with a multidisciplinary team of healthcare professionals, including urologists, medical oncologists, and radiation oncologists, to determine the most appropriate treatment plan for their specific situation.