Chemotherapy for bladder cancer

When do you have it?

You might have chemotherapy:

• before ​surgery​ or ​radiotherapy​  

• alongside radiotherapy, to make the radiotherapy work better (chemoradiotherapy)

• after surgery - if you didn’t have it before

• as your main treatment, if your cancer has spread (metastatic cancer)

Chemotherapy before surgery or radiotherapy can shrink the ​tumour​. It aims to make the treatment work better. Doctors call this neoadjuvant chemotherapy. It can lower the risk of bladder cancer coming back in the future.

Chemotherapy after surgery may help to stop the cancer coming back. This is called adjuvant chemotherapy. You might have it if you didn't have chemotherapy before your surgery.

This page is about neoadjuvant and adjuvant chemotherapy. We have a separate page about chemoradiotherapy.

Read about chemoradiotherapy

We also have a separate page about chemotherapy for bladder cancer that has spread (metastatic bladder cancer).

Read about chemotherapy for metastatic cancer

Types of chemotherapy

You usually have neoadjuvant chemotherapy before surgery or radiotherapy. You have several drugs together. The most common combinations include:

• gemcitabine and cisplatin (GC)

• methotrexate, vinblastine, doxobrubicin and cisplatin (MVAC)

You might have ​chemoradiotherapy​. The most common drugs for this include:

• a combination of 2 chemotherapy drugs - mitomycin C and fluorouracil (5FU)

• cisplatin

Read about these chemotherapy drugs and their side effects

How you have it

You have chemotherapy into a vein (intravenously). This means you have treatment through a thin short tube called a cannula. It goes into a vein in your arm each time you have treatment. The drugs circulate in your blood, they travel throughout your body. They work by disrupting the growth of cancer cells.

You usually have chemotherapy as cycles of treatment. Each cycle is either weekly or over a 2, 3 or 4 week period. The cycle length varies in time depending on the chemotherapy you are having. 

You usually have 3 cycles of chemotherapy before ​surgery​ or ​radiotherapy. After surgery or radiotherapy, you might have 6 or more cycles.

Your specialist will explain how you have treatment, and how long they expect your treatment course to be.

Find out more about having chemotherapy in your vein

Where you have chemotherapy

You usually have treatment into your bloodstream at the cancer day clinic. You might sit in a chair for a few hours so it’s a good idea to take things in to do. For example, newspapers, books or electronic devices can all help to pass the time. You can usually bring a friend or family member with you.

You have some types of chemotherapy over several days. You might be able to have some drugs through a small portable pump that you take home.

For some types of chemotherapy you have to stay in a hospital ward. This could be overnight or for a couple of days.

Some hospitals may give certain chemotherapy treatments to you at home. Your doctor or nurse can tell you more about this.

Watch the video below about what happens when you have chemotherapy. It is almost 3 minutes long.

Before you start chemotherapy

You need to have blood tests to make sure it’s safe to start treatment. You usually have these a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Your blood cells need to recover from your last treatment before you have more chemotherapy. Sometimes your blood counts are not high enough to have chemotherapy. If this happens, your doctor usually delays your next treatment. They will tell you when to repeat the blood test.

Side effects

Common chemotherapy side effects include:

• feeling sick

• loss of appetite

• losing weight

• feeling very tired

• increased risk of getting an infection

• bleeding and bruising easily

• diarrhoea or constipation

• hair loss

Side effects depend on:

• which drugs you have

• how much of each drug you have

• how you react

Tell your treatment team about any side effects that you have.

Most side effects only last for a few days or so. Your treatment team can help to manage any side effects that you have.

Read more about the chemotherapy drugs and their possible side effects

Dietary or herbal supplements and chemotherapy

Let your doctors know if you:

• take any supplements

• have been prescribed anything by alternative or complementary therapy practitioners

It’s unclear how some nutritional or herbal supplements might interact with chemotherapy. Some could be harmful.

Read about the safety of complementary and alternative therapies

When you go home

Chemotherapy can be difficult to cope with. Tell your doctor or nurse about any problems or side effects that you have. The nurse will give you telephone numbers to call if you have any problems at home.

After your chemotherapy

When you have chemotherapy before surgery or radiotherapy, your doctor needs to know how well it is working. You might have a cystoscopy or CT scan during or after your course of chemotherapy. This can show your doctor whether the cancer has shrunk.

When you have chemotherapy after surgery, you have the normal follow up appointments.

See how you have follow up for muscle invasive bladder cancer