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The drugs and side effects

Men and women discussing bladder cancer

This page tells you about the chemotherapy drugs used to treat invasive bladder cancer. You can find information about


A quick guide to what's on this page

The drugs and side effects

Doctors use combinations of chemotherapy drugs to treat bladder cancer. The drugs most commonly used include gemcitabine, cisplatin, carboplatin, methotrexate, vinblastine and doxorubicin. Your specialist will decide which is most suitable for you based on your individual case. You may hear them talk about your treatment using the initials of the drugs you’ll be having, for example, GC which is gemcitabine and cisplatin, or MVAC which is methotrexate, vinblastine, Adriamycin (doxorubicin) and cisplatin.

Side effects

All chemotherapy has side effects. The effects you get depend on the drugs and dose you have and your body’s individual reaction. Most side effects only last a few days. The most common side effects of bladder cancer chemotherapy are

  • Low resistance to infection due to a drop in the number of white blood cells
  • Feeling sick
  • Hair loss or thinning
  • A sore mouth and mouth ulcers
  • Feeling tired and run down
  • Loss of fertility (ability to have a baby)

The drug doxorubicin (Adriamycin) can make your urine turn red for a couple of days after treatment. This does not mean you have blood back in your urine.


CR PDF Icon You can view and print the quick guides for treating invasive bladder cancer.



Chemotherapy combinations

A chemotherapy combination is when you have more than one chemotherapy drug. There are a few different combinations of chemotherapy drugs for bladder cancer that has spread into the muscle of the bladder wall. These include 

  • GC – gemcitabine and cisplatin
  • MVAC – methotrexate, vinblastine, doxorubicin (Adriamycin) and cisplatin

GC is most often used. It is being used before surgery or radiotherapy to try to improve the chance of curing invasive bladder cancer. Paclitaxel (Taxol) may sometimes be added to GC chemotherapy. 

MVAC is a combination that is widely used to treat bladder cancer. In some people with bladder cancer, their kidneys may not work so well. In this is the case, your doctor may need to change the dose of cisplatin because this drug can put further strain on the kidneys. Or they may use a different drug instead of cisplatin.

If you have chemotherapy at the same time as radiotherapy (chemoradiation) you may have a combination of drugs called mitomycin and fluorouracil (5FU). These drugs are called radiosensitisers which means they make the radiotherapy work better.

For further information, we have drug pages about GC chemotherapy, MVAC chemotherapy, Paclitaxel (Taxol), cisplatin, mitomycin and fluorouracil. You can read bout chemoradiation on our page about radiotherapy for bladder cancer


Possible side effects

We have pages about the side effects of GC and MVAC . There are also pages on the specific side effects of methotrexate, doxorubicin, gemcitabine, vinblastine, and cisplatin.

Below is a general overview of likely side effects with bladder cancer chemotherapy combinations.

All chemotherapy has side effects. The effects you get depend on

  • Which drug or combination of drugs you have
  • How much of each drug you have
  • How you individually react

Some people have more side effects than others. And different drugs have different side effects. So we can't tell you exactly what will happen to you. But here is a list of some common side effects

Some drugs have unusual side effects. Methotrexate can make your eyes sore, you may feel as though they have grit in them. If you are having treatment with doxorubicin (Adriamycin) remember that it can make your urine turn red for a couple of days after you have the drug. Some people worry that it is blood back in the urine, which can be frightening.

Some of the chemotherapy used for bladder cancer is quite intensive. If you are having this type of treatment, you are almost certain to get some side effects. But there is quite a bit that can be done to reduce them. And most side effects only last for the few days that you are actually having the drugs. Tell your doctor or nurse about any side effects you have as soon as they develop, so that they can help treat them.

You can ask your doctor or nurse which of the side effects are most common with the chemotherapy drugs you will be having. You may also find it helpful to look at our section about coping with the side effects of cancer drugs.

Chemotherapy courses can seem to go on for a long time, particularly if you are getting very tired towards the end of your course. But they do finish. And the side effects will go once your treatment has ended.

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Updated: 14 May 2015