Patients & Visitors

Urology

D11

Treatment: Chemotherapy

How does it work?

Chemotherapy works by destroying cancer cells. When it’s given into the bladder, the drug comes into direct contact with any cancer cells in the lining of the bladder. Because it’s given into the bladder and not through a vein into the bloodstream, you won’t get side effects like feeling sick or hair loss, which people often associate with chemotherapy.

Hardly any of the drug is absorbed into the bloodstream which means that it rarely affects the rest of the body.  The type of chemotherapy we use is called Mitomycin C.

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When it’s used

Most people with early bladder cancer will have a one-off treatment of chemotherapy into the bladder the morning after surgery.  Some people only have one treatment while others have a course of treatment. People with low-grade early bladder cancer won’t usually need any further treatment.

If you have a moderate risk of your cancer coming back in the bladder you may have a course of chemotherapy into the bladder.  Treatment is usually given once a week, for about six weeks, by one of our nurse specialists.

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How it’s given

If you’re having chemotherapy into your bladder after surgery, you’ll already be in hospital and will have a catheter (small tube into your bladder) in place.

If you then have more chemotherapy after this, you’ll have it in the hospital outpatient department. You can go home as soon as the treatment is finished. It might be a good idea to ask someone to collect you, particularly after the first treatment.

You’re usually asked to limit the amount of fluids you drink before treatment, as if you drink too much your bladder may feel uncomfortably full. Drinking less also helps to increase the concentration of the chemotherapy drug in your bladder. If you normally take water tablets (diuretics), take them later in the day after your treatment. Let your doctor know about any other medicines you are taking. You won’t be given chemotherapy if you’re unwell or have a urine infection. Your nurse or doctor will give you more advice about preparing for your treatment.

The nurse will put a fine tube called a catheter into your bladder. They’ll then put the liquid chemotherapy drug directly into your bladder through the catheter.  The catheter is left in and clamped to keep the chemotherapy in your bladder until your treatment is over. You can walk around during this time. When the treatment is finished your bladder will be drained via the catheter and the catheter then removed.

After treatment you’ll need to take some precautions to protect yourself and others from coming into contact with the chemotherapy drug. To avoid splashing urine on the toilet seat it might be easier for men to pass urine sitting down. You’ll be asked to wash the skin in your genital area carefully with soap and water after you pass urine. This is to make sure any of the chemotherapy drug that may have splashed onto your skin is then wiped off. It’s also important to wash your hands afterwards. Your nurse will advise you about this.

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Side effects

The following side effects are due to cystitis (an inflammation of the bladder lining):

  1. needing to pass urine more often
  2. soreness or pain when you pass urine.

These side effects should settle down within a day or two. Drinking lots of fluids will help ease the irritation. If the side effects don’t improve or if you have a raised temperature and your urine is smelly, get in touch with your doctor straight away as you may have a urine infection.