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Chemotherapy uses medicines to kill fast-growing cells (like cancer cells) or to keep them from dividing (which is how cancers grow). It is a systemic treatment. This means the medicines will travel throughout your body and destroy cancer cells wherever they may be.
Chemotherapy is given in cycles. You’ll get a dose and then have a rest period, usually two to three weeks, before the next treatment.
Your medical oncologist prescribes your chemotherapy and other medicine-based treatments, like targeted therapies. They also set your treatment schedule.
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How Chemotherapy is Used to Treat Bladder Cancer
Your care team at Fred Hutch Cancer Center may recommend chemotherapy:
- Before surgery to make your tumor smaller so it’s easier to remove
- After surgery to help prevent your cancer from coming back
- As your first treatment, instead of surgery, if your cancer has already spread to another part of your body at the time it is diagnosed
Chemotherapy uses medicines to kill fast-growing cells (like cancer cells) or to keep them from dividing (which is how cancers grow). For localized muscle-invasive bladder cancer, you may have chemotherapy before or after surgery — or, in some cases, to try to save your bladder. If cancer has spread beyond your bladder, chemotherapy is the most common first treatment (and there are more treatment options). Your medical oncologist talks with you about the goals and the pros/cons of systemic therapy, prescribes it and sets your treatment schedule, based on the details of your cancer and your individual needs and wishes.
Types of Chemotherapy
Intravesicular Chemotherapy
After surgeons remove non-muscle invasive cancer, they often put chemotherapy into the patient’s bladder. The goals are to kill any cancer cells that are still there and reduce the risk of cancer coming back. The medicine is put in through a catheter. It is left for one to two hours. It is drained from your bladder before you leave the recovery room.
Systemic Chemotherapy
Systemic chemotherapy is given by infusion and it travels throughout your body.
It can be used:
- Before or after surgery. This may improve the chance of a cure if your cancer has a high risk of spreading. It helps destroy microscopic cancer cells that might still be somewhere in the body after surgery and may not be visible on imaging.
- To make cancer easier to remove with surgery. This may be helpful if you have large, locally advanced disease.
- To control the cancer and related symptoms, improve your quality of life and help you live longer if cancer has spread to distant parts of your body.
For an infusion, liquid medicine is put into a vein through an intravenous (IV) line. This can be a line in your arm (peripheral venous catheter) or a port in your chest (central venous catheter), depending on the therapy. Treatment happens in repeating cycles.
You get infusions in a dedicated area of the clinic. Cancer nurses who are experts in infusions will give you these treatments. They will also check on you during the treatment. They will handle any medical issues that come up and help keep you comfortable.
Why Choose Fred Hutch for Chemotherapy for Bladder Cancer
At Fred Hutch, patients get medical oncology care from leading physicians who specialize in bladder cancers. They are experts in their field and in giving medicines for bladder cancers. We often have clinical trials testing new drugs or new combinations of drugs for bladder cancer. We are able to offer therapies that aren’t offered everywhere.
Your Fred Hutch medical oncologist partners with the rest of your care team. They work closely with your urologic oncologist, radiation oncologist and pathologist. They design a treatment plan for you to target your tumor and have the least impact on healthy tissue. Your medical oncologist also works closely with you to manage any chemotherapy side effects. Your whole team helps you take the best possible care of yourself during treatment.
We routinely use targeted chemotherapy drugs that deliver chemotherapy to cancer cells more selectively compared to conventional chemotherapy, including enfortumab-vedotin and trastuzumab-deruxtecan. Common chemotherapy drugs include, but are not limited to: cisplatin, carboplatin, gemcitabine, docetaxel, among others; we often use combinations of chemotherapy drugs.
Your Fred Hutch team will talk with you about the specific drug combinations we recommend for you, how you’ll receive them and your treatment schedule.
Common chemotherapy side effects include:
- Fatigue
- Mouth sores
- Skin reactions
- Loss of appetite or weight loss
- Nausea or vomiting
- Diarrhea or constipation
- Increased risk of infections
- Easy bruising or bleeding
- Change in sensation in the fingers and toes (neuropathy)
If your Fred Hutch team recommends chemotherapy, we’ll explain what to expect based on the medicine you’re getting and how to manage these side effects.
Your care team at Fred Hutch is here to help you prevent or prepare for side effects and to relieve any side effects you have. The most important step you can take is to speak up and let your team know what you’re feeling. We’ve helped many patients and families through this process and know ways to ease your experience.
Often, there are medicines to help, like anti-nausea drugs. Based on the side effect, there may be a range of other helpful options too, like diet changes, physical therapy and emotional and practical support. We also offer integrative medicine, including acupuncture. Fred Hutch researchers continue to look for the best ways to keep side effects at bay.