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Introduction
This page will give you an overview of intravesical chemotherapy, how it is given and side effects it may cause. Please read it carefully as it contains information that will help you as you undergo your treatment. If you have any concerns or would like further information please do not hesitate to contact one of the urology team on the contact details listed below.
This involves putting medicine directly into the bladder to treat a condition. This medicine is a chemotherapy drug called Mitomycin C. It is used to kill cancer cells, and slow down or stop cancerous bladder tumours from growing inside the bladder.
The bladder is a hollow, muscular, balloon-like organ. It is in your lower pelvis and connected to your kidneys by two tubes called ureters. Urine passes down these tubes and is collected and stored in the bladder. Urine is passed out of the bladder through a tube like structure called the urethra. See diagram.
In women this is a short tube which opens up in front of the vagina while in men it is much longer and passes through the prostate and penis.
A tumour is an abnormal growth of the body’s tissue cells and can be classified as benign (not cancer) or malignant (cancer). Benign tumours do not invade healthy tissue or spread around the body, they are not cancers. Malignant tumours have the ability to invade healthy tissue and to spread to other areas of the body.
Bladder tumours are removed during the TURBT procedure, and then sent for analysis in a laboratory to see if they are malignant or benign.
The bladder is lined with a urine proof membrane called the urothelium, which is made up of cells called transitional cells.
Most cancers in the bladder start in this membrane layer and are called transitional cell bladder cancers. Other, rarer, types of bladder cancer are squamous cell cancer and adenocarcinoma. Squamous cell cancer starts from one of the types of cell in the bladder lining. Adenocarcinoma starts from glandular cells which produce mucus.
Some bladder cancers form warty outgrowths or mushroom-like growths on the inside lining of the bladder. These are called papillary cancers. They have a short stem attached to the lining of the bladder. Sometimes they go on to spread into the wall of the bladder.
If a bladder cancer only affects the inner lining of the bladder, it is known as a superficial (non-muscle invasive) cancer. If it has spread into the muscle layer of the bladder, it is called a muscle-invasive cancer.
Bladder cancer occurs most commonly in people between 50 and 70 years of age. It is the fourth most common cancer in men and eighth most common in women in the UK.
After your TURBT procedure, your urology consultant has recommended an additional single treatment with intravesical chemotherapy using Mitomycin C.
Mitomycin-C is a chemotherapy drug which works by killing cancer cells inside the bladder and therefore helps to prevent tumours from coming back. The treatment is liquid solution, administered directly into the bladder and not into a vein, and so does not pass around the body.
Research has shown that Mitomycin C given shortly after the TURBT procedure can decrease the chance of cancer cells growing back.
Immediately following your TURBT, we will be waiting for the laboratory to confirm whether your tumour was malignant or benign. However, the intravesical chemotherapy has been recommended as there is a strong suspicion that your tumour was a bladder cancer.
Like all treatments, it comes with some possible side- effects (see below) and the risk of these should be considered against the risk of the bladder cancer for which the treatment is being given.
Side effects usually start within three to four hours after treatment and last up to 24 hours. If you experience severe pain during or immediately after your treatment then please tell your clinical nurse specialist or doctor.
Common side effects:
- Your bladder may feel uncomfortable after your TURBT procedure but some patients also experience cystitis like symptoms, such as pain or burning when passing urine. You may also notice some blood in your urine; this may be related to the chemotherapy immediately after receiving treatment.
- Seeing blood in the urine off and on is also a common side effect after TURBT, and may last for up to several weeks. Drinking plenty of fluids will help with these symptoms.
- If you have cystitis symptoms, and they persist for longer than three days, then you should contact your GP in case you have a urine infection.
- Very occasionally, some patients may experience rashes on their hands, feet or genital area. Washing thoroughly with soap and water after passing urine will help to prevent this from happening, but you should tell your clinical team if you develop these symptoms. On very rare occasions, some patients may develop a body rash, please tell your clinical team if you notice any type of rash on your body.
If you develop any of the following symptoms, you should attend an Accident and Emergency department immediately:
- Shortness of breath or difficulty breathing
- Facial swelling
- Severe abdominal (tummy) pain
- Cannot pass urine at all
- If you are a smoker, you should be aware that smoking seems to encourage the recurrence of bladder cancer.
- Sexually active patients should either refrain from sexual intercourse or use a condom for 48 hours after receiving intravesical chemotherapy.
- Pregnant women should not receive chemotherapy. If you or your partner is planning to become pregnant then please consult your doctor.
Your urology consultant has recommended a single treatment with intravesical chemotherapy following your TURBT. As your bladder tumour was suspicious for a bladder cancer, intravesical chemotherapy may offer an additional protective benefit. If you choose not to have this treatment your urology team will discuss the alternative. However, it is important to note that not having treatment may increase the chance of a bladder tumour returning.
The alternative option would be not to receive intravesical chemotherapy on this occasion. However, if bladder cancers continue to recur or progress, other intravesical treatments, radiotherapy or surgical removal of the bladder may need to be considered.
Your treatment will be carried out during your inpatient stay, following your TURBT. It will be administered by the ward nurse via your existing catheter (which was placed during your procedure). They will ensure that your urine is clear enough, and you are well enough, to receive the treatment.
We would recommend that you reduce your fluid intake for an hour before your treatment, if this is possible, and while the chemotherapy remains inside your bladder.
This will help you to retain the treatment in your bladder comfortably. You can continue to eat normally.
If you are ready, you may be able to go home once your treatment is completed.
Your ward nurse will discuss with you what will happen before, during and after your treatment, and you will be given the opportunity to ask any questions that you may have. This is part of the process of obtaining your informed consent to proceed.
Your ward nurse will administer the chemotherapy solution via the catheter and then clamp the catheter (stop it from draining) to keep the solution inside your bladder. We would recommend that you regularly change position (either moving from side to side in bed or by walking around) while the solution is in your bladder. This will help the solution to reach all the areas in your bladder.
The chemotherapy solution should remain inside you bladder for up to 1 hour, but it is not harmful for the solution to stay in your bladder for slightly longer than an hour.
Some people can find it difficult to keep the solution in their bladder for the whole hour. This is usually because their bladder is still too uncomfortable after their TURBT procedure. Don’t worry if the solution needs to be removed early, this will not significantly affect the overall benefit from your TURBT and intravesical chemotherapy.
Please drink plenty of fluids (1-2 litres per day) in the first couple of days following your treatment, and also avoid caffeinated drinks such as tea, coffee and cola which can irritate your bladder. This helps to keep your urine diluted and makes recovery more comfortable. It also reduces the chances of developing a urinary tract infection.
Your urine may contain traces of chemotherapy for up to six hours following treatment, so it’s important to take some precautions during this time.
It is recommended that both men and women sit down to use the toilet as this reduces the risk of spillage or splashing onto the skin. It is also recommended that you thoroughly wash your hands and genital area with soap and water after going to the toilet, as this reduces the risk of skin irritation.
Taking medications such as paracetamol or ibuprofen can help you cope with any bladder side-effects. Please always read the instructions for use.
Macmillan Cancer Support
Tel: 0808 808 0000 (Mon-Fri, 9am-8pm)
Action on Bladder Cancer (ABC-UK)
ABC is a UK based charity made up of healthcare professionals and patients who are dedicated purely to improving the lives of people with bladder cancer and raising awareness of the disease.
Fight Bladder Cancer
Fight Bladder Cancer is a UK based bladder cancer charity founded and run by bladder cancer survivors and their families.
The British Association of Urological Nurses (BAUN)
BAUN is a registered charity which aims to promote and maintain the highest standards in the practice and development of urological nursing and urological patient care.
The British Association of Urological Surgeons (BAUS)
BAUS is a registered charity which promotes the highest standards of practice in urology for the benefit of patients.
University College Hospital at Westmoreland Street
Switchboard: 0845 155 5000 or 020 3456 7890
Richard Weston, clinical nurse specialist
Tel: 0203 447 5134
Email: richard.
Kay Boyer, clinical nurse specialist
Tel: 07977 079333
Email: kay.
Hilary Baker, lead clinical nurse specialist
Email: hilary.
Superficial bladder cancer and renal service
Tel: 0203 447 9485
Email: uclh.
University College Hospital at Westmoreland Street 16 - 18 Westmoreland St, London, W1G 8PH
Intravesical treatment clinic
2nd floor outpatient’s department.
On arrival, please check in at the ground floor outpatient reception.
Page last updated: 07 August 2024
Review due: 31 August 2025