Systemic chemotherapy

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.

Learn more about:

• When is systemic chemotherapy given?
• Side effects of systemic chemotherapy
• Video: What is chemotherapy?

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When is systemic chemotherapy given?

In most cases, systemic chemotherapy is given before surgery to shrink the cancer, make it easier to remove and reduce the risk of the cancer coming back. This is known as neoadjuvant chemotherapy. Occasionally, chemotherapy may be given after surgery (adjuvant chemotherapy) if there is a high risk of the cancer coming back.

You will see a medical oncologist to plan your chemotherapy treatment. In most cases, the chemotherapy will be given as a course of drugs every 2–3 weeks over a few 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.

If a person is reluctant or unable to have surgery to remove the bladder, systemic chemotherapy can sometimes be combined with radiation therapy (chemoradiation) as part of trimodal therapy. Systemic chemotherapy may also be used for bladder cancer that has spread to other parts of the body.  

Side effects of systemic chemotherapy

Common side effects include:

• fatigue
• nausea and vomiting
• constipation
• mouth sores
• taste changes
• itchy skin
• hair loss
• tingling or numbness of fingers or toes.

Side effects are usually temporary, but can be long-term or permanent. Talk to your doctor about whether medicines may ease these side effects.

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.

For more on this, see Chemotherapy.

Video: What is chemotherapy?