Chemotherapy is the use of anti-cancer medication to kill cancer cells in the body. Chemotherapy may be combined with surgery for localized bladder cancer and with surgery or radiation for invasive disease. It is also the primary treatment option for disease that cannot be cured with surgery or radiation because it has spread beyond the bladder (metastatic disease or advanced disease).
Two types of chemotherapy are generally used to treat bladder cancer: intravesicular and systemic.
In this type of chemotherapy, a doctor puts chemotherapy drugs into the bladder through a catheter in the urethra. This procedure is often used for patients whose cancer has not invaded the bladder muscle and who have undergone transurethal resection. The goal is to try to kill any remaining cancer cells in the bladder. This therapy does not affect the rest of the body.
In this type of chemotherapy, a doctor (medical oncologist) prescribes chemotherapy drugs that are given by vein or by mouth. This allows the drugs to flow through the bloodstream to nearly every part of the body. Systemic chemotherapy can be used before surgery (neoadjuvant chemotherapy) or after surgery (adjuvant chemotherapy) to improve the chances for cure in patients with cancer that has a high chance of spreading. Systemic chemotherapy can also be combined with radiation therapy (chemoradiation) to make the radiation more effective.
In patients with advanced disease, systemic chemotherapy may be used to control the disease and symptoms and to prolong life. Less often, it may be used in hopes of curing advanced disease (which is rare) or making it easier to remove cancerous tissue surgically.
Your treatment is tailored to your health and goals. A variety of chemotherapy drugs (and drug combinations) are available. Your doctor will talk with you about your options. Most clinical studies for bladder cancer at Seattle Cancer Care Alliance and its parent organizations, Fred Hutchinson Cancer Research Center and UW Medicine, are testing different types of chemotherapy drugs.