The drugs and side effects

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

A quick guide to what's on this page
Chemotherapy combinations
Possible side effects

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’ll probably 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. Which ones you get depends 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

A drop in the number of blood cells
Feeling sick
Hair loss or thinning
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.

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

GC – gemcitabine and cisplatin
MVAC – methotrexate, vinblastine, doxorubicin (Adriamycin) and cisplatin
GemCarbo – gemcitabine and carboplatin
CarboMV – carboplatin, methotrexate and vinblastine
CMV – cisplatin, methotrexate and vinblastine

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. CMV is the same drug combination, but without the doxorubicin (Adriamycin). In some people with bladder cancer, their kidneys may not work so well. In this is the case, you may need to have carboplatin instead of cisplatin, because cisplatin can put further strain on the kidneys. So your doctor might recommend CarboMV or GemCarbo instead of GC, MVAC or CMV.

We have pages about the side effects of GC as well the side effects of GemCarbo, MVAC and CMV. There are also pages on the specific side effects of methotrexate, doxorubicin, gemcitabine, vinblastine, carboplatin and cisplatin. Below is a general overview of likely side effects with bladder cancer chemotherapy combinations.

All chemotherapy has side effects. Those 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.

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.