Does Bladder Cancer Require Chemotherapy for Treatment?

Does bladder cancer require chemotherapy for treatment?

Bladder cancer can be treated through a number of ways and chemotherapy is one of them. Chemotherapy is an important treatment method and it works well in many cases. However, to understand whether it is necessary, it is important to know what it really is.

What is chemotherapy?

It is a medical treatment that involves the use of cytotoxic drugs to kill cancer cells. This treatment method can be carried out in two ways; the drugs can be administered orally through tablets and capsules or also intravenously through an injection into a vein (systemic chemotherapy), which is normally used to treat an invasive bladder cancer. On the other hand, an intravesical chemotherapy is administered directly into the bladder and is usually done when the cancer is in its early stages.

Intravesical Chemotherapy

As said earlier, intravesical chemotherapy is the treatment of early bladder cancer by administering the drugs directly into the bladder. It means that the drug does not get into the bloodstream, and consequently, it will rarely affect the rest of the body. Inside the bladder, the drug directly gets into contact with the cancer cells, thus, destroying them.

Advantages of Intravesical Chemotherapy

This method of treatment has two advantages over the one where the drugs get administered through the vein:

• no hair loss
• patients will not feel sick after the treatment

The above are some of the side effects of getting chemo drugs into your bloodstream. In an intravesical chemotherapy, the drugs will not get into your bloodstream, and therefore, avoiding the side effects.

When is intravesical chemotherapy done?

Intravesical chemotherapy sessions can be done after a surgical removal of the tumor in the bladder. Usually, it is done on patients who have a high risk of cancer coming back again after the surgery. However, for patients who have a minimal risk of the cancer returning, they may not require this type of treatment at all. High-risk patients are those with either grade 1 or 2 of Ta cancer or grade two of T1 cancer.

The chemotherapy is normally done a few hours after surgery. A catheter is put into your bladder and then used to transfer the chemo drugs straight into your bladder. After that, you will be asked not to pass urine for at least an hour long in order to give the drug time to do its work.

In case you happen to pass a lot of blood in your urine after the surgery, the chemo treatment may be delayed and done the next day. You will be given information about how to prepare for the treatment by your doctor or nurses. After the first treatment, the rest of the treatments can be administered in the outpatient department, meaning, you can go home after the chemotherapy is done.

The Dos and Don’ts During Treatment

1. Do not drink a lot of fluids before the treatment. The reason behind it is that it will make your bladder full, thus, giving you an urge to pass urine. Drinking less also makes the concentration of the drug in the bladder to be high, and therefore, will work better.
2. If you take diuretics, ensure that you take them after the treatment. Diuretics are also called as "water pills."
3. Do inform your doctor of any other medications that you may be taking. Moreover, also make sure you report in case you happen to feel unwell before the treatment. Chemotherapy will not be done if you are ill or you have a urine infection.

Guidelines on How to Manage Yourself After Treatment

It is important to ensure that your chemotherapy drugs do not get into contact with the people around you as it may harm them. To avoid such incidence, below are some guidelines on what you can do to ensure that you minimize such chances completely:

1. Drink at least two liters of water daily after each treatment. Drinking water helps to drain out the drugs from your bladder.
2. When passing urine, avoid splashing it on the toilet seat.
3. Always flush the toilet twice after use.
4. Use soap and water to wash your genital area after passing urine in order to rid of any that may have splashed on your skin.
5. Ensure that you wash your hands properly after relieving yourself.

When having sex, a man should always wear a condom. This practice will prevent the partners from exposure to the chemo drugs that may be present in semen or vaginal fluid.

Treatment Side Effects 

During the treatment, you may suffer from inflammation of the bladder lining, and will cause the following:

• pain during urination
• an increased frequency of passing urine
• hematuria (presence of blood in urine)

However, these symptoms do not last long. Ensure that you take in a lot of fluids to reduce the irritation. You can also take painkillers as well. If the symptoms persist, inform your doctor.

Systemic Chemotherapy

This type of chemotherapy involves giving the chemotherapy drugs through pills or an injection into a vein or muscle. The drugs get into the blood and travel throughout the entire body. This method can be used before or after surgery.

When used before surgery, it is done to reduce the size of the tumor if it is large, which makes it easier to remove it and also reduces the chances of it coming back again. The treatment can be administered after surgery to wipe out any traces of the cancer cells that may be left. It can also be done after radiation therapy for the same reason or to make it work better.

Systemic Chemotherapy Side Effects 

Unfortunately, this treatment comes with quite a number of side effects. Chemotherapy drugs work by attacking cells that divide quickly. Aside from the cancer cells, there are also other body cells that divide quickly such as cells in the bone marrow, hair follicles, the mouth, and intestines.

Examples of the side effects include:

• vomiting
• hair loss
• sores in the mouth
• diarrhea
• nausea
• fatigue
• bleeding after minor cuts 
• an increased risk of developing infections

The side effects usually go away after the treatment is done. Always ensure that you inform the doctor of any side effects. Informing your doctor helps in determining the state or progress of your treatment, and thus, making more informed decisions.

Some of the drugs used in chemotherapy include cisplatin, gemcitabine, methotrexate, and vinblastine, among others. Some may be used together while others may be used based on the type of treatment you are getting. However, the use of two or more combinations of the drugs can increase the severity of the side effects, and if you feel that you cannot handle them, be quick to tell your doctor about it.

The Bottom Line

Chemotherapy is one of the most used treatment methods for bladder cancer. It is also used together with other treatment methods such as radiation therapy to reinforce them. In other cases, it is done after a surgical treatment to prevent the tumors from coming back.

However, it is not compulsory. It all depends on the stage of your cancer and how far it has spread. Based on your doctor’s diagnosis, you will be informed if it will be necessary to have it done or not.