Treating Bladder Cancer: Intravesical Therapy
Some types of bladder tumors are hard to remove using surgical procedures like transurethral resection (TUR). These include tumors considered high grade, that occur in more than one area, lie flat against the bladder wall, or come back after treatment. In these cases, special medications that destroy cancer cells may be placed into the bladder. This is called intravesical therapy. Intravesical therapy may be an option for a hard-to-remove tumor. It may also be done after TUR to help keep the cancer from coming back.
Possible Risks and Complications
- A bladder infection
- Bladder irritation (burning, urge to urinate frequently; pain on urination)
- Changes in your blood cell counts (with some chemotherapy drugs)
- Bladder scarring (rare)
- Infection (with BCG - very rare)
Administering Medication Inside Your Bladder
Intravesical therapy is typically done in the doctor’s office. A catheter (flexible tube) fills the bladder with liquid medication. This medication may be a liquid chemotherapy drug, which kills cancer cells, or BCG (a type of bacterium), which helps boost your body’s immune system.
Treatment
You’re advised to hold the medication in your bladder for up to two hours, then urinate. When BCG is used, your doctor may advise you to pour bleach into your toilet following urination to kill any leftover bacteria. Intravesical therapy is generally given weekly for six to eight weeks. Depending on the medication, you may be prescribed antibiotics to help ward off infection. If you have a fever at any time during treatment with BCG, call your doctor right away.
After Treatment
Following your weekly treatments, you may be given regular follow-up treatments for as much as a year or more. These follow-up treatments help keep the cancer from returning. Once the treatments are over, cystoscopy and urine cytology may be done about every three months to help check for cancer cells.