Chemotherapy into the bladder

Chemotherapy into the ​bladder​ is a treatment for non muscle invasive bladder cancer. Chemotherapy is an anti cancer (cytotoxic) drug which destroys cancer ​cells​ . You have it through a flexible tube called a ​catheter​ , which goes into your bladder.

Your doctor might call this treatment intravesical chemotherapy. Intravesical chemotherapy reduces the chance of the cancer coming back or spreading.

Intravesical chemotherapy is different to chemotherapy treatment for muscle invasive bladder cancer. Muscle invasive means the cancer has spread into or through the muscle layer of the bladder.

Read about chemotherapy for muscle invasive bladder cancer

When do you have it

Your treatment plan depends on your risk of the bladder cancer spreading or coming back after treatment. Your doctor will tell you whether you have:

• low risk non muscle invasive bladder cancer

• intermediate risk non muscle invasive bladder cancer

• high risk non muscle invasive bladder cancer

Find out more about risk groups for non muscle invasive bladder cancer

Single dose

You can have chemotherapy into your bladder as a one off treatment (single dose). You have it after a trans urethral resection of your bladder tumour (TURBT). For low risk non muscle invasive bladder cancer, this is often all the treatment you need.

Course of chemotherapy

If you have a moderate (intermediate) risk of your cancer coming back, you have chemotherapy into your bladder regularly, for up to a year.

You might also have this treatment if your cancer comes back after the initial ​surgery​ and chemotherapy treatment.

Find out about having a TURBT

Types of chemotherapy

There are different types of chemotherapy drugs. For intravesical chemotherapy, the most common drug is mitomycin C.

Sometimes, doctors might use other chemotherapy drugs such as epirubicin or doxorubicin. 

Find out more about these cancer drugs

Side effects

You get fewer side effects having chemotherapy into your bladder than you would having chemotherapy into a vein. This is because the drug tends to stay in your bladder. So very little of it gets into your bloodstream.

Some of the side effects might include:

Irritation of the bladder 

Chemotherapy can irritate your bladder. You may feel as if you have a bad urine infection (​cystitis​ ). This can make you:

• pass urine very often

• pass urine with urgency 

• feel uncomfortable

• feel some pain

Blood in your urine

You may have a small amount of bleeding. Contact the hospital immediately if:

• the bleeding is getting worse

• there are ​blood clots​ in your urine

• you have severe pain when passing urine

• you can't pass urine and have severe pain

Skin rash and itching

You may get a rash on your hands or feet for a short time after having this treatment. Some skin rashes may get red, sore and swollen. Some people get severe itching. Contact your doctor if you get any of these symptoms.

Infection

Some chemotherapies can increase your risk of getting an ​infection​ . You're also at increased risk of infection from having a catheter put in. If you generally feel unwell, severe pain, bad smelling urine or discharge or have a ​temperature​ contact your doctor.   

Allergic reaction

There is a risk of having an ​allergic reaction​ to the chemotherapy. But this is rare. If it does happen the nurse gives you medicines to control the reaction. Tell the doctor or nurse if you feel unwell at any time.

Find out more about coping with side effects