About chemotherapy for invasive bladder cancer

• A quick guide to what's on this page
• What chemotherapy is
• Chemo for invasive bladder cancer
• How you have chemotherapy

• After your chemotherapy
• Taking nutritional or herbal supplements with chemotherapy
• More information about chemotherapy

Chemotherapy uses anti-cancer or 'cytotoxic' drugs to destroy cancer cells. You have them into a vein (intravenously) or as tablets or capsules. They work by disrupting the growth of cancer cells. As the drugs circulate in the blood, they can reach cancer cells wherever they are in your body.

This page is about chemotherapy into the bloodstream for bladder cancer that has spread into the muscle layer of the bladder (invasive bladder cancer).

For early bladder cancer, you can have chemotherapy drugs put directly into your bladder. There is information about this type of treatment in the section of CancerHelp UK on treatment into the bladder. There is also seperate information about chemotherapy for advanced bladder cancer.

You may have chemotherapy

• Before or during radiotherapy
• Before or after surgery

If you have chemotherapy before your operation or radiotherapy, it can shrink the tumour and aims to make the treatment more effective. Chemo before other treatment is called 'neo adjuvant' chemotherapy. Clinical trials have shown that chemotherapy before surgery or radiotherapy can lower the risk of bladder cancer coming back in the future. Usually a combination of drugs is used. The most common combinations include GemCarbo, MVAC or CMV. There is information about the chemotherapy drugs used for bladder cancer on the next page of this section.

Chemotherapy given after surgery may help to stop the cancer coming back and is called 'adjuvant' chemotherapy. This treatment is currently being tested in clinical trials. Our bladder cancer research page has more information about chemotherapy research.

Chemotherapy for invasive bladder cancer is nearly always a course of treatment, taking several months in total. You have chemotherapy treatment into a vein and then have a break of a week or two. This makes up one cycle of chemotherapy treatment. Then you have the same treatment again. A whole course of chemotherapy can be 6 or more cycles.

You are most likely to have treatment over 2 days a week apart for each cycle. Usually you have the treatment in the outpatient department, where there are specialist chemotherapy nurses. The nurses may inject each chemotherapy drug through a small tube put into one of your veins, or you may have the drugs through a drip over a longer time. This depends on the type of chemotherapy you have.

Before each cycle of treatment, you will have blood tests. You will need to wait for the results to come back before you can have your treatment. The blood tests will check to see how well your kidneys are working and also check your blood cell levels. If your blood counts are low you could be likely to get a serious infection, or bruising and bleeding, if you have more treatment. So if you have a low blood cell count, your next treatment may be put off for a week or so, or you may have a lower dose.

If you have chemotherapy before surgery or radiotherapy, your doctor will need to know how well the chemotherapy has worked. After your course of chemotherapy (or sometimes halfway through) you may be asked to have a cystoscopy or CT scan to see if the cancer has shrunk.

If you are having chemotherapy after surgery, to help stop the cancer coming back, you will have the normal follow up after invasive bladder cancer treatment.

Doctors are concerned about patients taking dietary supplements and herbal medicines when they have chemotherapy. Doctors often don't know what their patients are buying over the counter or getting from alternative or complementary therapy practitioners. We don't yet know much scientifically about how some supplements may interact with chemotherapy

Talk to your specialist about any other tablets or medicines you take while you are on cancer treatment. For instance, it may not be a good idea to take anything that claims to boost your immune system. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section of CancerHelp UK.

For detailed information about having chemotherapy into a vein look at the main chemotherapy section in CancerHelp UK. It explains the treatment, including

• What chemotherapy involves
• How chemo is planned
• How you have the treatment
• General chemo side effects
• Side effects of specific drugs
• Living with chemotherapy

Our bladder cancer organisations page has details of information services you can contact for more information about bladder cancer and its treatment. Our bladder cancer reading list has information about the books and booklets available, some of which are free.