Types of Chemotherapy for Bladder Cancer

The National Cancer Institute estimates that in 2009 over 70,000 individuals will be diagnosed with bladder cancer (cancer.gov). The bladder is the organ that stores urine, and bladder cancer forms in the lining of the bladder and grows into the bladder walls (cancer.org). The primary forms of treatment for this kind of cancer are surgery, radiation, immunotherapy and chemotherapy.

Background

• Chemotherapy is one type of treatment for bladder cancer, and depending on the stage and extent of the cancer, the medication may be given in different ways. Chemotherapeutic drugs interfere with and stop the cancer cells from replicating and growing.

Modes of Administration

• Bladder cancer may be treated with intravesical chemotherapy, which is done by delivering the medication into the bladder through a tube inserted through the urethra. This type of administration allows the chemotherapy to work directly on the cancer cells in the lining of the bladder. If there is any cancer outside the lining of the bladder, it will not be affected by this chemotherapy. This is used primarily for early-stage bladder cancers.

  Other ways of administering chemotherapy include giving pills to be taken by mouth or administering the medication intravenously.

Medications

• Combination chemotherapy, or using more than one chemotherapeutic drug at a time, has been shown to be more effective than using one drug at a time for bladder cancer (cancer.org). Combinations that are often used in treating bladder cancer, according to the American Cancer Society, include methotrexate, vinblastine, doxorubicin (brand name Adriamycin) and cisplatin (this combination is called M-VAC); gemcitabine and cisplatin (GemCIS); and carboplatin and a taxane drug (usually paclitaxel or docetaxel). Other drugs that can be used in treating bladder cancer include cyclophosphamide (brand name Cytoxan), 5-fluorouracil (5-FU) and mytomycin C.

Side Effects

• Because chemotherapy is a systemic treatment, meaning it affects cells throughout the body, there are a wide variety of side effects that may occur. Common side effects include nausea and vomiting, hair loss, loss of appetit, and mouth sores. These side effects vary, depending on the specific drugs that are given, the dosage and the individual. Low blood-cell counts are also a common side effect of chemotherapy. A low white-blood-cell count increases the risk of infection, a low platelet count may cause bruising, and a low count of red blood cells may cause fatigue. Sometimes physicians will give other medications to help boost blood-cell counts to combat these side effects. Antinausea medications also help alleviate any nausea and vomiting that may occur.

Clinical Trials

• Clinical trials are research studies that investigate new ways of treating a medical problem. Many cancer clinical trials work on developing new chemotherapy drugs to better treat cancer. Talk to your doctor about whether a clinical trial would be beneficial to you, and whether you are able to participate. She will be able to explain what trials are being done, and what each one is exploring.