What Happens During Treatment
A urinary catheter is inserted through your urethra and into your bladder. Then the BCG solution is injected into the catheter. The catheter is clamped off so the solution stays in your bladder. Some doctors may remove the catheter at this time.
You have to hold the medicine in your bladder. Youll be instructed to lie on your back and to roll from side to side to make sure the solution reaches your entire bladder.
After about two hours, the catheter is unclamped so the fluid can be drained. If the catheter was already removed, youll be asked to empty your bladder at this time.
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What Bladder Problems May Occur As Side Effects Of Cancer Treatment
Irritation of the lining of the bladder is called cystitis. This condition is commonly caused by a urinary tract infection, where bacteria have infected your bladder. However, it is also a side effect of some cancer treatments. Cancer patients in particular are at increased risk of developing a more severe form of cystitis called hemorrhagic cystitis. This condition may occur during treatment, immediately following treatment or months after treatment. Hemorrhagic cystitis can be a very serious condition leading to significant bleeding and/or life-threatening infection.
Before You Start Chemotherapy
You need to have blood tests to make sure its safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.
Before each treatment you need to stop drinking fluids. This stops the urine from diluting the drug in your bladder and will help you hold the urine more easily. Your hospital will tell you when to stop drinking.
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Side Effects Of Chemotherapy
Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow , the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemo, which can lead to side effects.
The side effects of chemo depend on the type and dose of drugs given and how long they are taken. When chemo and radiation are given at the same time, side effects tend to be worse. Common side effects of chemo include:
- Nausea and vomiting
- Constipation
- Increased risk of infections
- Easy bleeding or bruising, even after minor cuts or injuries
- Fatigue
These side effects usually go away over time after treatment ends. There are often ways to lessen these side effects, some can even be prevented. For instance, drugs can be used to help prevent or reduce nausea and vomiting. Ask your health care team about the side effects your chemo drugs may cause and what can be done to prevent and/or treat them.
Some chemo drugs can cause other, less common side effects. For example, drugs like cisplatin, docetaxel, and paclitaxel can damage nerves. This can sometimes lead to symptoms such as pain, burning or tingling, sensitivity to cold or heat, or weakness. This is called peripheral neuropathy.
How Long Does Advanced Bladder Cancer Treatment Last
Treatment options for advanced bladder cancer vary from person to person. The length of treatment depends on the overall treatment goals.
In general, most people with advanced bladder cancer receive chemotherapy for 6 to 12 months, depending on how long it takes to reduce cancer cells.
The length of time for immunotherapy also varies depending on the stage of cancer and how your body reacts to treatment.
For example, you may receive treatment every day for 2 or 3 weeks and then take a rest period before restarting treatment.
Treatment can prolong life for people living with advanced bladder cancer. However, in many cases, the disease tends to progress.
Your doctor may recommend that you continue to receive treatment to improve your quality of life.
As the cancer progresses, your doctor may suggest palliative care. You can continue treatment for the cancer while also receiving palliative care, notes the Bladder Care Advocacy Network .
Palliative care is aimed at addressing the physical, emotional, and social aspects of the condition.
It can treat specific physical symptoms, such as nausea and fatigue. It can also help improve your overall quality of life and help you manage stress related to the condition.
The goals of treatment at this stage are usually to:
- slow the spread of the cancer
- shrink the size of the affected areas
- extend your life as long as possible
- make you comfortable
For example, your health insurance policy will likely cover the cost of:
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Remission And The Chance Of Recurrence
A remission is when cancer cannot be detected in the body and there are no symptoms. This may also be called having no evidence of disease or NED.
A remission may be temporary or permanent. This uncertainty causes many people to worry that the cancer will come back. While many remissions are permanent, it is important to talk with your doctor about the possibility of the cancer returning. Understanding your risk of recurrence and the treatment options may help you feel more prepared if the cancer does return. Learn more about coping with the fear of recurrence.
If the cancer returns after the original treatment, it is called recurrent cancer. It may come back in the same place , nearby , or in another place .
When this occurs, a new cycle of testing will begin again to learn as much as possible about the recurrence. After this testing is done, you and your doctor will talk about the treatment options.
People with recurrent cancer often experience emotions such as disbelief or fear. You are encouraged to talk with the health care team about these feelings and ask about support services to help you cope. Learn more about dealing with cancer recurrence.
How Does Bladder Cancer Spread
Bladder cancer usually begins in the cells of the bladder lining. In some cases, it may spread into surrounding bladder muscle. If the cancer penetrates this muscle, it can spread to other parts of the body, usually through the lymphatic system.
If bladder cancer spreads to other parts of the body, such as other organs, it’s known as metastatic bladder cancer.
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What Are Common Side Effects Of Chemo
Side effects are common with chemo, but it’s important to know that they can often be prevented or controlled. The side effects from chemo often go away over time after the treatment ends.
Side effects depend on the type and amount of medicines youre taking. They also depend on the way you receive the medicines . They vary from person to person.
The side effects from intravesical chemo may include:
-
Burning feeling and irritation in your bladder
-
Having to urinate more often
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An urgent need to urinate
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Blood in your urine
Symptoms Of Bladder Cancer
Blood in your urine is the most common symptom of bladder cancer.
The medical name for this is haematuria and it’s usually painless. You may notice streaks of blood in your urine or the blood may turn your urine brown. The blood isn’t always noticeable and it may come and go.
Less common symptoms of bladder cancer include:
- a need to urinate on a more frequent basis
- sudden urges to urinate
- a burning sensation when passing urine
If bladder cancer reaches an advanced stage and begins to spread, symptoms can include:
- pelvic pain
- swelling of the legs
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What Is Intravesical Chemotherapy
Chemotherapy uses anti-cancer drugs to destroy cancer cells. Cytotoxic means toxic to cells. These drugs disrupt the way cancer cells grow and divide.
Chemotherapy can be given directly into the bladder. This is called intravesical chemotherapy. You may have this as part of your treatment for non-muscle-invasive bladder cancer.
Bladder Cancer Clinical Trials
Major drug companies continually research and develop new medications and treatments for bladder cancer that must be shown to be safe and effective before doctors can prescribe them to patients. Through clinical trials, researchers test the effects of new drugs on a group of volunteers who have bladder cancer. Following a strict protocol and using carefully controlled conditions, researchers evaluate the investigational drugs under development and measure the ability of the new drug to treat bladder cancer, its safety, and any possible side effects.
Some patients are reluctant to take part in clinical trials for fear of getting no treatment at all. But patients who participate in clinical trials receive the most effective therapy currently available for the condition, or they may receive treatments that are being evaluated for future use. These bladder cancer drugs may be even more effective than current treatment. Comparing them in a clinical trial is the only way to find out.
Hereâs where to find information about whether a bladder cancer clinical trial is right for you.
This website lists industry-sponsored clinical trials that are actively recruiting patients.
Show Sources
American Cancer Society: âBladder Cancer Treatment,â âBladder Cancer Surgery,â âRadiation Therapy for Bladder Cancer,â âChemotherapy for bladder cancer,â âFDA Approves New Immunotherapy Drug for Bladder Cancer,â âImmunotherapy for bladder cancer.â
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Why Does Bladder Cancer Happen
Most cases of bladder cancer appear to be caused by exposure to harmful substances, which lead to abnormal changes in the bladder’s cells over many years.
Tobacco smoke is a common cause and it’s estimated that half of all cases of bladder cancer are caused by smoking.
Contact with certain chemicals previously used in manufacturing is also known to cause bladder cancer. However, these substances have since been banned.
Read more about the causes of bladder cancer and preventing bladder cancer
When To Call Your Cancer Care Team About Chemo Side Effects
Because your cancer care team will give you lots of information about side effects, you might be more aware of physical changes. Do not take any physical symptoms you have lightly. Some side effects are short-lived and minor, but others may be a sign of serious problems. Make sure you know how to reach someone on your team any time, including after hours, weekends, and holidays.
Contact your cancer care team right away if you have any of the following symptoms during chemo treatment:
- A fever higher than what your cancer care team has instructed
- Bleeding or unexplained bruising
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How Is Intravesical Chemotherapy Given
Each treatment is called an instillation. People with a low risk of recurrence usually have one instillation straight after TURBT surgery. The chemotherapy solution is left in the bladder for 60 minutes and then drained out through a catheter.
People with a medium risk of recurrence may have instillations once a week for six weeks. This is usually done as a day procedure in hospital. The chemotherapy solution is left in the bladder for up to two hours and then drained through a catheter. You may have to change position every 15 minutes so the solution washes over the entire bladder.
While you are having a course of intravesical chemotherapy, your doctor may advise you to use contraception.
Can Bladder Cancer Cause Sleep Interference And Fatigue
It is not unusual for patients with bladder cancer to experience the symptoms of fatigue and sleep interference.2 Fatigue is a feeling of tiredness and very low energy that generally does not go away after sleeping or resting. Sleep interference includes problems falling asleep, staying asleep, and waking during the night several times and/or for long periods of time. Radiation therapy and chemotherapy, both common treatments for bladder cancer, can cause the symptoms of fatigue and sleep interference. These symptoms can have a significant impact on a patients quality of life, and there are strategies that can be used to help address them.
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Stages And Grades Of Bladder Cancer
There are five stages of bladder cancer, stages 0 to IV:footnote 3
- Stage 0: Cancer cells are only on the surface of the inner layer of the bladder. This may be called carcinoma in situ.
- Stage I: Cancer has grown deeper into the inner layer but not into the muscle layer.
- Stage II: Cancer has grown into the muscle layer of the bladder.
- Stage III: Cancer has grown through the muscle layer and into nearby organs, such as the prostate, uterus, or vagina.
- Stage IV: Cancer has grown into the wall of the pelvis or the belly but not into any lymph nodes. Or the cancer has spread into at least one lymph node or to another part of the body, such as the liver, lungs, or bones.
The grade of bladder cancer is usually either low-grade or high-grade . High-grade tumours tend to grow faster. They are also more likely to spread than low-grade tumours. When your doctor knows the grade of your cancer, this information will help him or her choose the best treatment plan for you.
More information about bladder cancer is provided by the National Cancer Institute at www.cancer.gov/cancertopics/types/bladder.
If Treatment Does Not Work
Full recovery from bladder cancer is not always possible. If the cancer cannot be cured or controlled, the disease may be called advanced or metastatic.
This diagnosis is stressful, and for many people, advanced cancer is difficult to discuss. However, it is important to have open and honest conversations with your health care team to express your feelings, preferences, and concerns. The health care team has special skills, experience, expertise, and knowledge to support patients and their families, and is there to help. Making sure a person is physically comfortable, free from pain, and emotionally supported is extremely important.
Patients who have advanced cancer and who are expected to live less than 6 months may want to consider hospice care. Hospice care is a specific type of palliative care designed to provide the best possible quality of life for people who are near the end of life. You and your family are encouraged to talk with the health care team about hospice care options, which include hospice care at home, a special hospice center, or other health care locations. Nursing care and special equipment can make staying at home a workable option for many families. Learn more about advanced cancer care planning.
After the death of a loved one, many people need support to help them cope with the loss. Learn more about grief and loss.
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What Else Can I Do
Drinking plenty of fluids may also help toâflushâ the bladder and prevent cystitis.
References
Side Effects Of Chemotherapy In Gallbladder Cancer Treatment:
During this procedure, these drugs kill the healthy cells also, which can lead to a lot of side effects. These side effects vary from individual to individual. Following are the side effects a person could experience post chemotherapy for gallbladder cancer:
Change in taste:
During and after taking chemotherapeutic drugs, patients experience a change in taste of food. Food might taste bland or metallic.
Constipation:
The drugs can cause constipation and pain. Diet changes during and after chemotherapy for gallbladder cancer can be a cause for the condition.
Diarrhea:
There is a direct affect on the intestinal cells when chemotherapeutic drugs are prescribed for treating gallbladder cancer. This leads to a disturbance in the stomach.
Nausea and Vomiting:
Chemotherapy for gallbladder cancer cause dizziness and drowsiness during and after the treatment. In a few cases, this weakness can lead to vomiting.
Fatigue:
Chemotherapeutic drugs can cause a lot of weakness and feeling of tiredness during and after treatment.
Skin problems:
These drugs damage the skin extensively. Patients who are given chemotherapeutic drugs often experience skin peeling, dryness and itching during and after the treatment.
Hair loss:
The dosage of the chemotherapy and the drugs will determine the damage of the hair follicles. Hair loss generally begins in the first two weeks if the first cycle, and continues until the patient is completely recovered.
Lowered white blood cell count:
Effect on kidneys:
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Which Chemo Drugs Are Used To Treat Bladder Cancer
Chemo drugs may be used alone or in combination, depending on what theyre being used for, a persons overall health, and other factors.
When chemo is given with radiation, the most common drugs used include:
- Cisplatin
When chemo is used without radiation, the most common combinations include:
- Gemcitabine and cisplatin
- Dose-dense methotrexate, vinblastine, doxorubicin , and cisplatin
- Cisplatin, methotrexate, and vinblastine
- Gemcitabine and paclitaxel
For some people, the side effects of getting more than one chemo drug might be too much to handle. For those people, treatment with a single drug, such as gemcitabine or cisplatin, may be an option. Other drugs sometimes used alone for bladder cancer include, docetaxel, paclitaxel, doxorubicin, methotrexate, ifosfamide, and pemetrexed.
Doctors give chemo in cycles, with each period of treatment followed by a rest period to allow the body time to recover. Each cycle typically lasts for a few weeks.
Most bladder cancers are transitional cell cancers, but there are other types as well, including squamous cell carcinoma, adenocarcinoma, and small cell carcinoma. These rare types of bladder cancer may be treated with drugs different from those listed above.