Chemotherapy: systemic

Chemotherapy is the treatment of cancer with anti-cancer (cytotoxic) drugs. It aims to kill cancer cells while doing the least possible damage to healthy cells.

For muscle-invasive bladder cancer, drugs are given by injection into a vein (intravenously). As the drugs circulate in the blood, they travel throughout the body. This type of chemotherapy is called systemic chemotherapy. It is different to the intravesical chemotherapy used for non-muscle-invasive bladder cancer, which is delivered directly to the bladder.

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When is systemic chemotherapy used?

You may have systemic chemotherapy:

  • before surgery, to shrink the cancer and make it easier to remove (neoadjuvant chemotherapy)
  • after surgery, if there is a high risk of the cancer coming back (adjuvant chemotherapy)
  • with radiation therapy (sometimes called chemoradiation) if a person is reluctant to have surgery
  • to treat bladder cancer that has spread to other parts of the body.

Systemic chemotherapy is given as a course of drugs every 2–3 weeks for several months. Usually a combination of drugs works better than one drug alone. The drugs you are offered will depend on your age, fitness, kidney function and personal preference. Researchers are studying whether it’s best to have chemotherapy before (neoadjuvant) or after (adjuvant) surgery. Your surgeon will probably discuss the best approach for you at an MDT meeting.


Side effects of systemic chemotherapy

Common side effects may include fatigue, nausea and vomiting, mouth sores, taste changes, itchy skin, hair loss, and tingling or numbness of fingers or toes. Generally, side effects are temporary. However, sometimes the effects are long-term or permanent. Some side effects can be eased with prescription drugs; talk to your doctor about this.

During chemotherapy, you may be more prone to infections. If you develop a temperature over 38°C, contact your doctor or go immediately to the emergency department at your nearest hospital.

Ask your medical team for more information about coping with side effects or call Cancer Council 13 11 20.

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.


This information was last reviewed in February 2018
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