Chemo for invasive bladder cancer

You may have chemotherapy

• Before or during radiotherapy
• Before or after surgery

If you have chemotherapy before your operation or radiotherapy, it can shrink the tumour and aims to make the treatment more effective. Chemo before other treatment is called ‘neo adjuvant’ chemotherapy. Clinical trials have shown that chemotherapy before surgery or radiotherapy can lower the risk of bladder cancer coming back in the future. Usually a combination of drugs is used. The most common combinations include GemCarbo, MVAC or CMV. There is information about the chemotherapy drugs used for bladder cancer on the next page of this section.

Chemotherapy given after surgery may help to stop the cancer coming back and is called ‘adjuvant’ chemotherapy. This treatment is currently being tested in clinical trials. Our bladder cancer research page has more information about chemotherapy research.

How you have chemotherapy

Chemotherapy for invasive bladder cancer is nearly always a course of treatment, taking several months in total. You have chemotherapy treatment into a vein and then have a break of a week or two. This makes up one cycle of chemotherapy treatment. Then you have the same treatment again. A whole course of chemotherapy can be 6 or more cycles. You are most likely to have treatment over 2 days a week apart for each cycle. Usually you have the treatment in the outpatient department, where there are specialist chemotherapy nurses. The nurses may inject each chemotherapy drug through a small tube put into one of your veins, or you may have the drugs through a drip over a longer time. This depends on the type of chemotherapy you have.

Before each cycle of treatment, you will have blood tests. You will need to wait for the results to come back before you can have your treatment. The blood tests will check to see how well your kidneys are working and also check your blood cell levels. If your blood counts are low you could be likely to get a serious infection, or bruising and bleeding, if you have more treatment. So if you have a low blood cell count, your next treatment may be put off for a week or so, or you may have a lower dose.

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After your chemotherapy

If you have chemotherapy before surgery or radiotherapy, your doctor will need to know how well the chemotherapy has worked. After your course of chemotherapy (or sometimes halfway through) you may be asked to have a cystoscopy or CT scan to see if the cancer has shrunk.

If you are having chemotherapy after surgery, to help stop the cancer coming back, you will have the normal follow up after invasive bladder cancer treatment.

Taking nutritional or herbal supplements with chemotherapy

Doctors are concerned about patients taking dietary supplements and herbal medicines when they have chemotherapy. Doctors often don’t know what their patients are buying over the counter or getting from alternative or complementary therapy practitioners. We don’t yet know much scientifically about how some supplements may interact with chemotherapy Talk to your specialist about any other tablets or medicines you take while you are on cancer treatment.

For instance, it may not be a good idea to take anything that claims to boost your immune system. There is information about the safety of herbal, vitamin and diet supplements in the complementary therapies section of CancerHelp UK.

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