Systemic chemotherapy

Chemotherapy uses drugs to kill or slow the growth of cancer cells. The aim is to destroy cancer cells while causing the least possible damage to healthy cells. For muscle-invasive bladder cancer, drugs are injected into a vein (intravenously). As the drugs circulate in the blood, they travel around the body. Systemic chemotherapy is different to the intravesical chemotherapy used for non-muscle-invasive bladder cancer, which is delivered directly into the bladder.

Learn more about:

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

When is systemic chemotherapy used?

Systemic chemotherapy for non-muscle-invasive bladder cancer is used:

• before surgery (neoadjuvant chemotherapy) – to shrink the cancer and make it easier to remove; it can also reduce the risk of the cancer coming back
• after surgery (adjuvant chemotherapy) – if there is a high risk of the cancer coming back.

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.  

Having systemic chemotherapy

You will see a medical oncologist to plan your chemotherapy treatment. Chemotherapy is commonly given as a period of treatment followed by a break. This is called a cycle. In most cases, you will have several cycles of treatment 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. Your medical oncologist can answer any questions you have.

Side effects of systemic chemotherapy

The side effects of chemotherapy vary. They may include:

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

In most cases, side effects last for only a few weeks or months, although sometimes they are permanent. Talk to your doctor about ways to reduce or manage any side effects you have.

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 our general section on Chemotherapy.

Video: What is chemotherapy?

Watch this short video to learn more about chemotherapy.