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About chemotherapy for invasive bladder cancer

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This page tells you about chemotherapy for invasive bladder cancer. There is information about


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About chemotherapy for invasive bladder cancer

Chemotherapy uses anti cancer (cytotoxic) drugs to destroy cancer cells. You have chemotherapy into a vein (intravenously), or as tablets that you swallow. You may have chemotherapy during radiotherapy (chemoradiotherapy) or before the radiotherapy. Or you may have chemotherapy before or after surgery.

If you have chemotherapy before surgery or radiotherapy, it can shrink the tumour and aims to make the treatment work better. Chemotherapy after surgery may help to stop the cancer coming back.

We have information about the particular chemotherapy drugs used in bladder cancer.

You can find out more about chemotherapy in the main chemotherapy section. It has detailed information about what chemotherapy involves, it's side effects, and tips on coping with chemotherapy.


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What chemotherapy is

Chemotherapy uses anti cancer or cytotoxic drugs to destroy cancer cells. You have the drugs into a vein (intravenously) or as tablets or capsules. They work by disrupting the growth of cancer cells. As the drugs circulate in the blood, they travel throughout the body. 

This page is about chemotherapy into the bloodstream for bladder cancer that has spread into the muscle layer of the bladder (invasive bladder cancer).

For early bladder cancer, you can have chemotherapy drugs put directly into your bladder. There is information about this type of treatment in the section about treatment into the bladder. There is also separate information about chemotherapy for advanced bladder cancer.


Chemotherapy for invasive bladder cancer

You may have chemotherapy in one of the following ways

  • During radiotherapy treatment (concommitant chemoradiation)
  • Before radiotherapy
  • Before or after surgery

If you have chemotherapy before your operation or radiotherapy, it can shrink the tumour and aims to make the treatment work better. Chemotherapy before other treatment is called neo adjuvant chemotherapy. Clinical trials have shown that chemotherapy before surgery, or before or during radiotherapy, can lower the risk of bladder cancer coming back in the future. 

Chemotherapy given after surgery may help to stop the cancer coming back and is called adjuvant chemotherapy. You may have adjuvant chemotherapy if you didn't have chemotherapy before your surgery. Usually a combination of drugs is used. The most common combinations include GemCis, and MVAC.

There is information about the chemotherapy drugs used for bladder cancer on the next page of this section. Our bladder cancer research page has information about chemotherapy research.


How you have chemotherapy

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.

Usually you have the treatment in the outpatient department, where there are specialist chemotherapy nurses. The nurses may inject each chemotherapy drug through 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 are able to go home after your treatment. We have information about the drugs used on the invasive bladder cancer drugs and side effects page.

Before each cycle of treatment, you will have blood tests. You will need to wait for the results to come back before you can have your treatment. The blood tests will check to see how well your kidneys are working and also check your blood cell levels. If your blood counts are low you could be likely to get a serious infection, or bruising and bleeding, if you have more treatment. So if you have a low blood cell count, your next treatment may be put off for a week or so, or you may have a lower dose.

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After your chemotherapy

If you have chemotherapy before surgery or radiotherapy, your doctor will need to know how well the chemotherapy has worked. After your course of chemotherapy (or sometimes halfway through) you may be asked to have a cystoscopy or CT scan to see if the cancer has shrunk.

If you are having chemotherapy after surgery, to help stop the cancer coming back, you will have the normal follow up after invasive bladder cancer treatment.


Nutritional or herbal supplements and chemotherapy

We don't yet know much about how some nutritional or herbal supplements may interact with chemotherapy. 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 active treatment. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section.

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.


More information about chemotherapy

For detailed information about having chemotherapy into a vein look at the main chemotherapy section. It explains the treatment in detail, including

Our bladder cancer organisations page has details of information services you can contact for information about bladder cancer and its treatment. Our bladder cancer reading list has information about the books and booklets available, some of which are free.

If you want to find people to share experiences with online, you could use CancerChat, our online forum.

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Updated: 14 May 2015