Chemotherapy Bladder Cancer and Other Treatments

Bladder cancer can be treated in several different ways and the treatment selected by your oncologist will depend on various factors. Chemotherapy bladder cancer is one of these options that will be considered.

The factors that need to be considered by the oncologist when deciding on the most appropriate treatment for bladder cancer include the stage of progression of the cancer when it was first diagnosed, the type of cancer cells that were found under microscopic examination, the age and general health condition of the patient.

Having looked at these factors and decided on a course of treatment, your doctor will discuss the prognosis with you and give you all the information. Sometimes treatments are given in conjunction with others. We will look at chemotherapy first, and then touch on other bladder cancer treatments.

What is chemotherapy?

Chemotherapy is called a systemic treatment, which is one that affects the entire body. Drugs are used to kill the cancer cells, but may also affect healthy cells at the same time. Chemotherapy bladder cancer may be administered in several different ways, including:

• Orally in tablet form
• Intravenously – into a vein
• Intravesical – directly into the bladder through the urethra (the tube through which urine passes out of the body)

Sometimes chemotherapy will be given before or after surgery, as a combined treatment. It may also be used in conjunction with radiation therapy.

The drugs that are most commonly used to treat bladder cancer with chemotherapy include thiotepa, mitomycin and doxorubicin. Intravesical chemotherapy, using valrubicin, might be used as a treatment for early stage bladder cancer; this treatment is used as an alternative to surgery.

What are the side effects?
The side effects of chemotherapy for bladder cancer can be severe and include:

• Some abdominal pain
• Anemia or a lowering of iron levels in the body
• Blurred vision
• Irritation of the bladder
• Infection
• General fatigue
• Headaches
• Excessive bruising or bleeding
• Loss of appetite
• Nausea
• Vomiting
• General muscle weakness

Surgery

Surgery, as a treatment for bladder cancer, is considered in certain circumstances. The type of surgery that is considered will be dependant on the stage of progression of the cancer when diagnosed.

Early stage bladder cancer may involve the tumor being removed through the urethra and this surgery is called transurethral resection. Stage 2 and 3 bladder cancer may require partial or even full, or radical, removal of the bladder in a surgery called cystectomy. Newer surgical procedures have made bladder cancer surgery less complicated and more successful, although complications of infection, urinary blockage or stones are still possible.

Radiation Therapy

Radiation therapy involves using x-rays of high energy to destroy the cancer cells in the bladder. Radiation can be either external, using a radiation beam, or internal, using radio-active seeds implanted in the tumor.

Radiation may be used before or after surgery, or in conjunction with chemotherapy. It is a useful palliative treatment to relieve the symptoms of patients with advanced bladder cancer. Side effects of radiation therapy include inflammation, skin irritation, impotence, incontinence and fibrosis.

Immunotherapy

Immunotherapy is also called biological therapy and BCG therapy; it is the best treatment for superficial bladder cancers. This treatment uses a solution containing live bacteria in a weak form to enhance the body's own immune system's ability to destroy cancer cells. The treatment is repeated every week for 6 weeks, after which a maintenance program may be initiated.