This should probably be it's own thread.
At this point, it could be that he changes his mind and gets his bladder out. I had mine out almost four years ago and I'm doing fine and have been cancer free ever since having it removed. Others here have had their bladders out for 8 years or more.
Not sure why he felt it wasn't worth it but I also don't know what was diagnosed or if it had already metastasized.
There will be considerable pain before he dies so if he isn't really having pain now then he's likely not even close.
It spreads differently but it typically will spread to the bones, lungs, and/or brain.
Maybe you should ask him. He probably asked a few questions of the doctor and has some answers. Of course, you know him better than anyone else so maybe he wouldn't have asked the doctor or done any research. Still, seems like it would be worth you asking him.
Having blood in the urine doesn't necessarily mean it is spreading. Just means that it is there in the bladder and the cells have been damaged enough by cancer that it causes bleeding. Often, that is the first sign any of us had that gave us a clue we had bladder cancer. First time for that for me was in 2006. However, I had the tumor removed and was treated. It came back so I got my bladder removed.
If he was told to get his out back in February, they likely removed whatever cancer was there and determined that it was at least T2 (muscle invasive). T3 is deep muscle invasive and t4 is that it has invaded all the way through the bladder into the abdomen. Since they didn't tell him chemo and just said to remove it, he was likely T2 or T3.
Chances are that the cancer has now come back. That would be indicated by the return of the blood. When mine was first treated, they got it all and it didn't come back for two years.
The reason they wanted to remove it is because, if it hasn't spread at all, then removing the bladder removes the chance of spread. Sometimes it has already spread (once it gets muscle invasive) but it is too microscopic to even find. That is called micro mets.
The thing is, he may be in a position today to change his mind about having it removed and be able to be cancer free for years and years to come. The only one that would know that would be a bladder cancer specialist. Of your your dad may know more but until you know what he does, not much to do.
Sure seems like "Gee dad, I'd kind of like to know what the deal is and what to expect if this darn cancer is going kill you" would be a reasonable question to ask him.
Good luck!
Mike