This delivery method for chemotherapy medications puts them into the bladder itself. It is most commonly used when people have superficial cancer (cancer on the surface of the bladder that cannot be removed). This has several advantages – stronger doses of some medications may be given, and many of the systemic effects of chemotherapy are avoided or minimized. A catheter is placed into your bladder. The medication is then instilled through the catheter into your bladder. The catheter is then removed. You will need to hold your urine for 2 hours. Afterwards, you can urinate and the medication will drain out of your bladder.

What chemotherapy medications are given this way?

The 3 chemotherapy drugs most commonly placed directly into the bladder are mitomycin (Mutamycin®), doxorubicin (Adriamycin®), and thiotepa (Thioplex®).

• Thiotepa is known to prevent cells from replicating.
• Mitomycin C is an antibiotic that also prevents cells from replicating.
• Doxorubicin works in several ways to kill the cancer cells but also has a higher rate of side effects.

Studies have shown that those who had surgery (TURBT) and doxorubicin had a 20% lower reoccurrence of their tumor than those who had the surgery without the doxorubicin.

Are there any side effects?

Chemotherapy drugs can affect normal cells as well as cancer cells as they travel throughout your body. Placing the chemotherapy drugs within the bladder reduces the possible side effects.

• Thiotepa can cause you to feel an urgent need to urinate. You may also have painful or difficult urination, moderate to severe nausea/vomiting and cystitis (inflammation of the bladder)
• Mitomycin C can cause painful urination and increased frequency of urination.
• Doxorubicin can cause cystitis (inflammation of the bladder), blood in the urine (hematuria), fever, and allergies.

What else should I know?

You should consider your urine toxic for 6 hours after each treatment.