Bladder cancer

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Side effects of immunotherapy for bladder cancer

Side effects can happen with any type of treatment for bladder cancer, but everyone’s experience is different. Some people have many side effects. Others have few or none at all.

Immunotherapy is the type of biological therapy used to treat bladder cancer. Side effects can develop any time during, immediately after or a few days or weeks after immunotherapy. Sometimes late side effects develop months or years after immunotherapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or be permanent.

Side effects of immunotherapy will depend mainly on:

  • the type of drug or drug combination given
  • the dose
  • how the drug is given
  • your overall health

The following are the most common side effects of immunotherapy for bladder cancer. Tell your healthcare team if you have these side effects or others you think might be from immunotherapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Side effects of biological therapy for bladder cancer

Flu-like symptoms

Flu-like symptoms are a common side effect of several immunotherapy drugs. These symptoms include:

  • fever
  • chills
  • muscle and joint aches or pain
  • headache
  • nausea and vomiting
  • loss of appetite

These symptoms often occur right after treatment but they improve over time. They usually go away with continued therapy, once the body gets used to the drug.

Taking medicines, such as acetaminophen (Tylenol, Atasol), can help reduce some of these symptoms. Check with your doctor or healthcare team if these symptoms don’t go away or are bothersome.

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Bladder problems

The following bladder problems may develop after intravesical immunotherapy (the drugs are given directly into the bladder):

  • burning or pain during urination
  • blood in the urine (called hematuria)
  • intense need to urinate (called urinary urgency)
  • need to urinate often (called urinary frequency)

It is important to drink plenty of fluids and empty the bladder often on the days that treatment is given. The healthcare team will also want to make sure that you don’t have a bladder infection.

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Skin rash

A rash or skin irritation can occur if the intravesical immunotherapy drug comes in contact with the skin. It is important to avoid getting urine on the skin. For at least 8 hours after treatment is given, wash your hands each time after using the toilet and wash your genital area with soap and water after urinating.

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Fatigue can occur with intravesical immunotherapy. It is often related to the dose of the immunotherapy drug given and often occurs along with flu-like symptoms.

Find out more about fatigue.

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Allergic reactions

An allergic reaction, or hypersensitivity, can occur when any type of drug is given, but it is generally a rare side effect of intravesical immunotherapy. Signs of an allergic reaction include:

  • difficulty breathing
  • wheezing
  • coughing
  • skin rash or hives that may be itchy

The healthcare team closely monitors people receiving immunotherapy for allergic reactions, especially when drugs are first given. In some cases, a serious, life-threatening allergic reaction (called anaphylaxis) can occur. Medicines and other treatments (such as oxygen therapy) are given if a severe allergic reaction occurs.

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In rare cases, the immunotherapy drug bacillus Calmette-Guérin (BCG) can spread throughout the body. When this happens, it can cause a dangerous infection and a high fever. These side effects are treated with drugs used to treat tuberculosis.

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Note: Details on specific drugs change quite regularly. Find out more about sources of drug information and where to get details on specific drugs.


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