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Chemotherapy for Bladder Cancer
Chemotherapy uses drugs to destroy bladder cancer cells. The drugs enter the bloodstream and travel through the body to the cancer cells. Chemotherapy may be used:
- Before surgery—to shrink the tumor and decrease the amount of tissue that needs to be removed
- After surgery—to kill any remaining cancer cells and decrease risk of return
- In combination with radiation therapy—if surgery is not an option
- To help relieve symptoms of metastatic cancer and extend survival time
Chemotherapy Drugs and Delivery
There are a variety of chemotherapy drugs. The choice and combination of drugs will be based on your particular cancer and reaction to drugs. Chemotherapy drugs for bladder cancer may include:
- Fluorouracil (5-FU)
Chemotherapy for bladder cancer is most often given through an IV. It is delivered in cycles over a set period of time. A medical oncologist will determine how many cycles of chemotherapy are needed and what combination of drugs will work best.
Chemotherapy may also be delivered directly into the bladder. Intravesical chemotherapy places a liquid agent directly into the bladder. The liquid may be a chemotherapy drug or a biologic agent that provokes the immune system into launching an attack on the cancer cells.
Side Effects and Management
Though the drugs are targeted to cancer cells, they can affect healthy cells as well. The death of cancer cells and impact on healthy cells can cause a range of side effects. A medical oncologist will work to find the best drug combination and dosage to have the most impact on the cancer cells and minimal side effects on healthy tissue. Side effects or complications from chemotherapy may include:
- Bloody urine
Bladder irritation causing:
- Frequent need to urinate
- Urgent need to urinate
- Pain and/or burning with urination
- Nausea and vomiting
- Fatigue due to anemia
A variety of treatments are available to help manage side effects including medication, lifestyle changes, and alternative treatments. In some cases, the chemotherapy regimen may be adjusted to reduce severe side effects. The earlier the side effects are addressed, the more likely they will be controlled with a minimum of discomfort.
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Bladder cancer. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/genitourinary-disorders/genitourinary-cancer/bladder-cancer. Updated November 2013. Accessed June 30, 2015.
Treatment option overview. National Cancer Institute website. Available at: http://www.cancer.gov/types/bladder/patient/bladder-treatment-pdq. Updated May 29, 2015. Accessed June 30, 2015.