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About Chemotherapy for Bladder Cancer

This group of medications stops the growth of rapidly dividing cells in the body, both cancerous and noncancerous. While powerful, chemotherapy can cause more side effects than other medication types, because it cannot distinguish between cancerous and healthy cells. Chemotherapy is a treatment option for many patients with bladder cancer.

Conditions treated with chemotherapy

Chemotherapy may be offered to select patients with bladder cancers that have progressed into the deeper layers of the bladder wall or with cancers that have certain aggressive features. Chemotherapy also may be used to manage symptoms and improve quality of life when cancers are considered incurable.

Approaches to chemotherapy for bladder cancer

Many people who have stages 1, 2, or 3 bladder cancers have local therapy in the form of surgery to remove the tumor. Our cancer teams pair drug therapy with surgery in different ways:

• Before surgery (鈥渘eoadjuvant chemotherapy鈥�):听Drug therapy is often given for several months before surgery to kill any invisible cancer cells that may have escaped from the bladder. It may also shrink the cancer within the bladder to make cure more likely with surgery. If the pathologist (doctor who specializes in testing) cannot find any remaining cancer cells in the bladder after it is removed, this result is called a pathologic complete response and it is highly associated with long-term cure.
• After surgery (鈥渁djuvant chemotherapy鈥�):听Drug therapy can also be used after surgery to destroy any remaining cancer cells. Studies have shown that drug therapy can help you live longer and prevent or delay cancer from returning.

Intravesical therapy

This is a unique means to deliver chemotherapy directly inside your bladder. It does not get absorbed into the bloodstream.

You will be asked to drink any fluids for a few hours before treatment. During your treatment appointment, your doctor will slip a tiny tube called a catheter into your bladder to deliver the medication. It is best to avoid urinating for an hour after the treatment.

Chemoradiation

For many types of cancer, chemotherapy is offered before or after radiation therapy. In the case of some cancers, like bladder cancer, your doctor may recommend a lower dose of chemotherapy treatment while you receive radiation therapy.

Possible side effects of chemotherapy

The side effects of chemotherapy depend on the specific drugs you receive, the dose, and whether it is limited to the inside of your bladder through intravesical therapy or if it is given to you as a medication that travels through your bloodstream. Your doctor will discuss the specific medications you will be taking, their side effects, and ways to manage them.

Most side effects go away after treatment ends. The most common side effects seen with chemotherapy delivered to the bloodstream are:

• Fatigue
• Nausea and vomiting
• Hair loss
• Changes to fingernails and toenails
• Hot flashes
• Loss of appetite
• Mood disturbances
• Mouth sores

Other, rare side effects include:

• Blood clots
• Bone thinning (loss of bone mass), which can lead to osteoporosis
• Heart attack or damage that can lead to congestive heart failure
• Joint stiffness
• Muscle pain
• Shortness of breath
• Stroke

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Current as of: 2/2020