Chemotherapy is a drug or a combination of drugs that kills cancer cells wherever they are in the body. Our medical oncologists specialize in chemotherapy for bladder cancer and will carefully tailor your treatment to make sure that it’s as effective as possible while helping maintain your quality of life. For example, if you’re an older patient, our medical oncologists can recommend specific chemotherapy treatments that will minimize your side effects.

Before beginning chemotherapy, you’ll undergo a comprehensive evaluation to assess how well you may tolerate certain treatments. This includes a careful consideration of clinical aspects — such as age, general health condition, and kidney, heart, and liver function — but also takes into account the characteristics of your tumor.

In these ways, our oncologists are able to develop the best chemotherapy plan for you — one that treats the cancer safely while preserving your quality of life.

Chemotherapy before surgery

If you have muscle-invasive bladder cancer that requires the removal of the bladder, you will likely receive chemotherapy before surgery to eliminate cancer cells that may have spread to other organs, a treatment known as neoadjuvant chemotherapy. Large clinical studies have shown that this method improves cure rates and long-term survival, so we typically use this approach with our patients.

We place a very high priority on making sure that you complete your neoadjuvant chemotherapy efficiently (in about 12 weeks) and are ready for surgery four to six weeks after that.

This shortened time frame has been shown to produce better results. (Most treatment centers take much longer — often twice as long — to get their patients through chemotherapy and surgery.)

We’re able to ensure this timeliness through the close coordination of our medical oncologists, bladder surgeons, and highly specialized nurses. In addition, all the members of your team have immediate access to your clinical information — including pathology and lab tests, scan results, medications, and more — at all times.

Chemotherapy after surgery

If you don’t receive chemotherapy before surgery, you might benefit from receiving it afterward (called adjuvant therapy) if your cancer has spread beyond the bladder wall or to surrounding lymph nodes or organs.

Chemotherapy for metastatic bladder cancer

In some people, bladder cancer has already spread (metastasized) so extensively to other organs that surgery to remove the primary tumor would provide no benefit. In these situations, we typically recommend treatment with chemotherapy designed to shrink the tumors.

Our standard treatment for metastatic bladder cancer includes both conventional chemotherapy regimens as well as new approaches that are being tested in clinical trials. Our physicians are continuously investigating and refining new chemotherapy combinations and regimens to provide better outcomes for our patients.