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Chemotherapy for Bladder Cancer

Medical oncologist Dean Bajorin

Chemotherapy is a drug or a combination of drugs that kills cancer cells wherever they are in the body. You may receive chemotherapy before or after surgery to increase the chance for a cure. If you have bladder cancer that has spread, you may receive chemotherapy as the main treatment when surgery is not an option.

At MSK, our medical oncologists specialize in chemotherapy for bladder cancer. We will carefully tailor your treatment to make sure that it’s as effective as possible while helping maintain your quality of life. Your doctor will consider your specific circumstances. We will recommend specific chemotherapy treatments that minimize your side effects.

Before beginning chemotherapy, you’ll undergo a comprehensive evaluation to see how well you may tolerate certain treatments. This includes a careful consideration of your age, general health condition, and kidney, heart, and liver function. We also take into account the characteristics of the tumor.

Our doctors will develop the best chemotherapy plan for you — one that treats the cancer safely while preserving your quality of life.

Here you will find more in-depth information about chemotherapy for bladder cancer.

Intravesical Chemotherapy for Non-Muscle-Invasive Bladder Cancer

Intravesical therapies deliver a drug directly into the bladder through a catheter placed in the urethra (the duct through which urine leaves the body) instead of by mouth or into a vein. The drug stays in the bladder for one to two hours. Then it is drained out through the catheter or in urine. For early-stage (non-muscle-invasive) bladder cancer, we may give intravesical chemotherapy after transurethral resection to reduce the chance that the cancer will return. We typically use the drug mitomycin (Mitosol®) for intravesical chemotherapy.

Chemotherapy before Surgery for Muscle-Invasive Bladder Cancer

For muscle-invasive bladder cancer, our doctors may recommend chemotherapy before surgery. This treatment approach is called neoadjuvant chemotherapy. Large clinical studies have shown that this method improves cure rates and long-term survival for people with muscle-invasive bladder cancer. We typically use the drugs gemcitabine (Gemzar®) and cisplatin for neoadjuvant chemotherapy.

Chemotherapy after Surgery for Muscle-Invasive Bladder Cancer

Some people may have surgery without neoadjuvant chemotherapy. In this case, chemotherapy after surgery (adjuvant chemotherapy) can kill any remaining cancer cells and reduce the chances that these cancer cells will form new tumors. For adjuvant chemotherapy, we use the same drugs, gemcitabine and cisplatin, that are used for neoadjuvant chemotherapy.

Chemotherapy for Bladder Cancer That Has Spread

Our standard treatments for bladder cancer that has spread include conventional chemotherapy regimens and immunotherapy treatments as well as approaches that are being tested in clinical trials. These approaches are designed to shrink tumors and relieve symptoms while maintaining quality of life. At MSK, our doctors are continuously seeking out new chemotherapy combinations to provide better outcomes for the people we care for.