Radiation therapy for bladder cancer

Radiation therapy uses high-energy rays or particles to destroy cancer cells. It is sometimes used to treat bladder cancer. Your healthcare team will consider your personal needs to plan the type and amount of radiation, and when and how it is given. You may also receive other treatments.

Radiation therapy is often combined with chemotherapy to treat bladder cancer. This is called chemoradiation. The 2 treatments are given during the same time period.

Radiation therapy is given for different reasons. You may have chemoradiation or radiation therapy to:

• destroy cancer cells in the body
• prevent the whole bladder from being removed
• destroy cancer cells left behind after surgery to reduce the risk that the cancer will come back (recur) (called adjuvant therapy)
• relieve pain or control the symptoms of advanced bladder cancer (called palliative therapy)

The following types of radiation therapy are most commonly used to treat bladder cancer.

During external radiation therapy (also called external beam radiation therapy), a machine directs radiation through the skin to the area with the cancer and some of the tissue around it.

External radiation therapy is most often used as a part of chemoradiation to treat bladder cancer that has grown into the muscle layer of the bladder wall (muscle-invasive bladder cancer) so the bladder doesn’t have to be removed. This is called a bladder-preserving approach. The chemoradiation is given after surgery with a transurethral resection of bladder tumour (TURBT). During treatment, the radiation is given to the whole bladder and nearby lymph nodes in the pelvis.

External radiation therapy may be used alone when surgery can’t be done (the cancer is unresectable) or to control bleeding from the bladder. It can also be used to treat other parts of the body where the cancer has spread (metastatic cancer), such as bone. Find out more about metastatic cancer.

External radiation therapy is usually given 5 days a week for 1 to 2 months. It may be given for a shorter amount of time when used as palliative therapy.

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

During radiation therapy, the healthcare team tries to protect healthy cells in the treatment area as much as possible. But damage to healthy cells can happen and may cause side effects. If you develop side effects, they can happen any time during, immediately after or a few days or weeks after radiation therapy. Sometimes late side effects develop months or years after radiation therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.

Side effects of radiation therapy will depend mainly on the size of the area being treated, the specific area or organs being treated, the total dose of radiation and the treatment schedule. Some common side effects of radiation therapy for bladder cancer are:

• an irritated or inflamed bladder, which can cause a need to urinate (pee) more often than usual or blood in the urine
• fatigue
• skin problems
• diarrhea
• bleeding from the rectum
• loss of bladder control (urinary incontinence)

Tell your healthcare team if you have these side effects or others you think might be from radiation therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.

Find out more about radiation therapy and side effects of radiation therapy. To make the decisions that are right for you, ask your healthcare team questions about radiation therapy.