Drug treatments and radiotherapy for muscle-invasive bladder cancer

Radiotherapy 

Radiotherapy is a treatment that uses high-energy X-rays to kill cancer cells. 

Radiotherapy for muscle-invasive bladder cancer may be given:

• Instead of surgery.
• Before surgery to shrink a tumour.
• After surgery to destroy any remaining tumour.
• With chemotherapy to make the treatment work better (chemoradiation).
• To relieve symptoms if the cancer is advanced or has come back. For example, pain, discomfort, bleeding or blockage.
• To treat a single spread of cancer, such as in your brain or bone.

How much radiotherapy will I need?

The course can be several treatments over a number of days or weeks (6 to 8 weeks) or between 1 and 10 doses for palliative treatment.

After radiotherapy

After radiotherapy for bladder cancer, you will need close follow-up to make sure the cancer does not come back. You will need to have regular cystoscopies. If the cancer does come back, your bladder might need to be removed.  With bladder cancer the type of radiotherapy used is called external beam radiotherapy. Read more about radiotherapy.

Side-effects of bladder radiotherapy

Short-term possible side-effects

• Bladder and back passage irritation.
• Changes to your bowel habits (constipation or diarrhoea).
• Skin irritation and rashes.
• Tiredness (fatigue).
• Loss of hair in genital area.

Longer-term possible side-effects

• Blood in your urine or bowel motions.
• Narrowing of the vagina.
• Effects on ability to have erections (erectile dysfunction).
• Infertility.

Read more about radiotherapy side-effects.
 

Chemotherapy

Chemotherapy is a treatment using drugs to kill cancer cells. Chemotherapy for muscle-invasive bladder cancer may be given:

• Before surgery or radiotherapy to shrink the cancer and reduce the risk of it coming back. This is called neo-adjuvant treatment.
• At the same time as radiotherapy to make the treatment work better (chemoradiation).
• After surgery to reduce the risk of the cancer coming back. This is called adjuvant treatment.

• As a treatment on its own for advanced (metastatic) bladder cancer.

This type of chemotherapy is different to intravesical chemotherapy, which is used to treat non-muscle-invasive bladder cancer

A combination of different chemotherapy drugs is often used for muscle-invasive bladder cancer. Your doctor or nurse will discuss your treatment with you. Read more about chemotherapy and its side-effects.

Treating metastatic bladder cancer

Metastatic or secondary bladder cancer means the cancer has spread beyond the bladder, usually to your bones, lungs or liver.

Remember that not all bladder cancers spread.

If your cancer has spread it can still be treated. Treatment is usually to try to control the cancer rather than to cure it.

Often metastatic cancer is treated with chemotherapy or other cancer drugs. Or you may be suitable for a clinical trial.

Read more about metastatic cancer.