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. Although chemotherapy drugs are usually given as tablets or injected into a vein, in intravesical chemotherapy the drugs are put directly into the bladder using a catheter, which is a thin, flexible tube inserted through the urethra.
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When is intravesical chemotherapy used?
Intravesical chemotherapy is used mainly for low- to medium-risk non-muscle-invasive bladder cancer. It helps prevent the cancer coming back (recurrence). This method can’t reach cancer cells outside the bladder lining or in other parts of the body, so it’s not suitable for muscle-invasive bladder cancer.
Each treatment is called an instillation. People with a low risk of recurrence usually have one instillation at the time of 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. The chemotherapy solution is left in the bladder for up to two hours and then drained through the catheter. You may be asked 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.
Side effects of intravesical chemotherapy
Because intravesical chemotherapy puts the drugs directly into the bladder, it has fewer side effects than systemic chemotherapy (when the drugs reach the whole body).
The main side effect is bladder inflammation (cystitis). Signs of cystitis include wanting to pass urine more often or a burning feeling when urinating. Drinking plenty of fluids can help. If you develop a bladder infection, your doctor can prescribe antibiotics.
In some people, intravesical chemotherapy may cause a rash on the hands or feet. Tell your doctor if this occurs.
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Prof Dickon Hayne, UWA Medical School, The University of Western Australia, and Head, Urology, South Metropolitan Health Service, WA; BEAT Bladder Cancer Australia; Dr Anne Capp, Senior Staff Specialist, Radiation Oncology, Calvary Mater Newcastle, NSW; Marc Diocera, Genitourinary Nurse Consultant, Peter MacCallum Cancer Centre, VIC; Dr Peter Heathcote, Senior Urologist, Princess Alexandra Hospital, and Adjunct Professor, Australian Prostate Cancer Research Centre, QLD; Melissa Le Mesurier, Consumer; Dr James Lynam, Medical Oncologist Staff Specialist, Calvary Mater Newcastle and The University of Newcastle, NSW; John McDonald, Consumer; Michael Twycross, Consumer; Rosemary Watson, 13 11 20 Consultant, Cancer Council Victoria.
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