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Chemotherapy for bladder cancer

Chemotherapy is the use of anti-cancer (cytotoxic) drugs to treat cancer. It is usually a systemic therapy that circulates throughout the body and destroys cancer cells, including those that may have broken away from the primary tumour. Chemotherapy may also be a regional therapy, given to specific areas of the body.

 

Chemotherapy is commonly used to treat bladder cancer.

 

Chemotherapy may be used:

  • before surgery to shrink a tumour (neoadjuvant chemotherapy)
  • after surgery, with or without radiation therapy, to destroy cancer cells left behind and to reduce the risk of the cancer recurring (adjuvant chemotherapy)
  • to treat advanced cancer

 

Drugs, doses and schedules vary from person to person.

Intravesical chemotherapy

Intravesical chemotherapy is placed directly into the bladder through a urinary catheter. It is usually given after transurethral resection (TUR). This type of chemotherapy is most often used for recurrent superficial tumours if biological therapy with bacillus Calmette-Guerin (BCG) is not successful.

  • The chemotherapy drug is placed directly into the bladder through a catheter that is inserted through the urethra and into the bladder.
  • The drug is left in the bladder for 1 or 2 hours to make contact with the cancer cells on the inner lining of the bladder.
  • The treatment is repeated once a week for several weeks.
  • Intravesical chemotherapy may be continued once a month or several times a month, for up to a year.

Chemotherapy drugs

The most common chemotherapy drugs used to treat superficial bladder cancer with intravesical chemotherapy are:

  • thiotepa (ThioTEPA)
  • mitomycin (Mutamycin)
  • doxorubicin (Adriamycin)
  • epirubicin (Pharmorubicin)

Systemic chemotherapy

Systemic chemotherapy is injected through a needle or catheter into a vein. It may be used to treat locally advanced and metastatic bladder cancer.

Chemotherapy drugs

A combination of chemotherapy drugs is more effective than any single drug in treating bladder cancer. The most common chemotherapy combinations used to treat locally advanced or metastatic bladder cancer are:

  • GemCIS, or GC
    • gemcitabine (Gemzar)
    • cisplatin (Platinol AQ)
  • MVAC
    • methotrexate
    • vinblastine (Velbe)
    • doxorubicin
    • cisplatin
  • CMV
    • cisplatin
    • methotrexate
    • vinblastine

 

Other drugs sometimes used in combination to treat bladder cancer include:

  • cyclophosphamide (Cytoxan, Procytox)
  • paclitaxel (Taxol)

 

For more detailed information on specific drugs, go to sources of drug information.

 

See a list of questions to ask your doctor about chemotherapy.

References

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