Bladder Cancer Chemotherapy, Radiation and Immunotherapy

Chemotherapy is a systemic treatment (i.e., affects the entire body) that uses drugs to destroy cancer cells. It is administered orally or intravenously (through a vein) and in early bladder cancer, may be infused into the bladder through the urethra (called intravesical chemotherapy). Chemotherapy also may be administered before surgery (neoadjuvant therapy) or after surgery (adjuvant therapy). Drugs commonly used to treat bladder cancer include valrubicin (Valstar®), thiotepa (Thioplex®), mitomycin, and doxorubicin (Rubex®). Side effects can be severe and include the following:

• Abdominal pain
• Anemia
• Bladder irritation
• Blurred vision
• Excessive bleeding or bruising
• Fatigue
• Headache
• Infection
• Loss of appetite
• Nausea and vomiting
• Weakness

Radiation

Radiation uses high-energy x-rays to destroy cancer cells. External beam radiation is emitted from a machine outside the body and internal radiation is emitted from radioactive "seeds" implanted into the tumor. Either type of radiation therapy may be used after surgery to destroy cancer cells that may remain. Radiation therapy is also used to relieve symptoms (called palliative treatment) of advanced bladder. Side effects include inflammation of the rectum (proctitis), incontinence, skin irritation, hematuria, fibrosis (buildup of fibrous tissue), and impotence (erectile dysfunction).

Immunotherapy

Immunotherapy, also called biological therapy, may be used in some cases of superficial bladder cancer. This treatment is used to enhance the immune system's ability to fight disease. A vaccine derived from the bacteria that causes tuberculosis (BCG) is infused through the urethra into the bladder, once a week for 6 weeks to stimulate the immune system to destroy cancer cells. Sometimes BCG is used with interferon. Side effects include inflammation of the bladder (cystitis), inflammation of the prostate (prostatitis), and flu-like symptoms. High fever (over 101.5°F) may indicate that the bacteria have entered the bloodstream (called bacteremia). This condition is life threatening and requires antibiotic treatment. Immunotherapy is not used in patients with gross hematuria.

Photodynamic therapy is a new treatment for early bladder cancer. It involves administering drugs to make cancer cells more sensitive to light and then shining a special light onto the bladder. This treatment is being studied in clinical trials.

Follow-Up

Bladder cancer has a high rate of recurrence. Urine cytology and cystoscopy are performed every 3 months for 2 years, every 6 months for the next 2 years, and then yearly.

Prognosis

Superficial bladder cancer has a 5-year survival rate of about 85%. Invasive bladder cancer has a less favorable prognosis. Approximately 5% of patients with metastasized bladder cancer live 2 years after diagnosis. Cases of recurrent bladder cancer indicate an aggressive tumor and a poor prognosis.

Prevention

Bladder cancer cannot be prevented. The best way to lower the risk is not to smoke. Studies have shown that drinking plenty of fluids daily also lowers the risk for bladder cancer.

Meet Our Doctors

The urologists in Uromedix are active participants in medical research. They are devoted to advancing the field of knowledge so new understanding and treatments become available to all of us in the future. Without research, there would be no progress in urology.

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Medical Services

We offer not only state of the art in treatment options, but we also provide a superior patient experience. Our physicians have expertise in the latest urologic surgical procedures including: Robotic Prostatectomy, also known as the Da Vinci Prostatectomy, for the treatment of localized prostate cancer; Green Light PVP laser technology and TUMT procedure for Benign Prostatic Hypertrophy (BHP); no-scalpel vasectomy for male sterilization, as well as laparoscopic and minimally-invasive renal surgery and adrenal surgery.

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Address: 21150 Biscayne Blvd Suite 404
  Aventura, FL 33180
Telephone: (305) 466-9111
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