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Having chemotherapy

You can have chemotherapy for invasive, locally advanced and advanced bladder cancer. See how and where you have chemotherapy.

What it is

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells.

For invasive, locally advanced and advanced bladder cancer you have the drugs into a vein (intravenously). As the drugs circulate in your blood, they travel throughout your body. They work by disrupting the growth of cancer cells.

When you have it

Invasive bladder cancer

You may have chemotherapy:

  • during radiotherapy treatment (chemoradiotherapy)
  • before radiotherapy
  • before or after surgery

Chemotherapy given before surgery or radiotherapy can shrink the tumour. It aims to make the treatment work better. This is called neoadjuvant chemotherapy. It can lower the risk of bladder cancer coming back in the future.

Chemotherapy given 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. Usually a combination of drugs is used. The most common combinations include GemCis and MVAC.

Locally advanced bladder cancer

You might have chemotherapy after you have had treatment to your bladder and nearby lymph nodes with radiotherapy or surgery.

Advanced bladder cancer

Chemotherapy can help to control or get rid of advanced bladder cancer for some time.

How you have it

Chemotherapy for invasive bladder cancer is nearly always a course of treatment, taking several months in total. You have chemotherapy treatment into a vein and then have a break of a week or two. This makes up one cycle of chemotherapy treatment. Then you have the same treatment again.

Treatment before surgery or radiotherapy is usually 3 cycles. Chemotherapy after surgery or radiotherapy, or alongside radiotherapy, can be 6 or more cycles.

Where you have it

Usually you have the treatment in the outpatient department of a hospital.

Specialist chemotherapy nurses inject your chemotherapy drugs. They might use a small tube called a cannula put into one of your veins, or you may have the drugs through a drip over a longer time. This depends on the type of chemotherapy you have. Usually you can go home after your treatment.

Before you start chemotherapy

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

The blood tests check how well your kidneys are working, and also check your blood cell levels. If your blood cell count is low, you could be likely to get a serious infection or bruising and bleeding if you have more treatment. Your next treatment may be put off for a week or so, or you may have a lower dose.

Nutritional supplements and other remedies or medicines

We don't yet know much about how some nutritional or herbal supplements may interact with chemotherapy. But some could be harmful.

It is very important to let your doctors know if you take any supplements. And tell them if you are prescribed any remedies by alternative or complementary therapy practitioners.

Talk to your specialist about any other tablets or medicines you take while you are having treatment.

Some studies seem to suggest that fish oil preparations may reduce the effectiveness of chemotherapy drugs. If you are taking, or thinking of taking, these supplements talk to your doctor to find out whether they could affect your treatment.

Side effects

Common chemotherapy side effects include:

  • feeling sick
  • loss of appetite
  • losing weight
  • feeling very tired
  • a lower resistance to infections
  • bleeding and bruising easily
Contact the doctor or nurse immediately if you have any signs of infection such as a temperature higher than 38C or generally feeling unwell. Infections can make you very unwell very quickly.

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 the few days that you’re having the drugs. The team caring for you can help reduce your side effects.

When you go home

Chemotherapy for invasive bladder cancer 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

After you have chemotherapy before surgery or radiotherapy, your doctor needs to know how well the chemotherapy has worked. You may be asked to have a cystoscopy or CT scan after your course of chemotherapy (or sometimes halfway through). This can show your doctor whether the cancer has shrunk.

When you have had chemotherapy after surgery, you then have the normal follow up appointments to help stop the cancer coming back.

Information and help

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