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 the drugs are usually given as tablets or injected into a vein (systemic chemotherapy), in intravesical chemotherapy the drugs are put directly into the bladder using a flexible tube called a catheter, which has been inserted through the urethra.
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When is intravesical chemotherapy used?
Intravesical chemotherapy is used only for non-muscle-invasive bladder cancer. It helps keep the cancer from coming back (recurrence). This form of chemotherapy can’t reach cancer cells outside of the bladder lining or 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 solution is left in the bladder for 60 minutes and then drained out through a catheter. People with a moderate risk of recurrence usually have weekly instillations for six weeks. Once the bladder is filled with the chemotherapy, it 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 chemotherapy washes over the entire bladder.
During the period you are having 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 include wanting to pass urine more often or a burning feeling when urinating. Drinking plenty of fluids after treatment 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.