Whole-body treatments

1. Radiotherapy

Radiotherapy can be an alternative treatment option for muscle-invasive bladder cancer and it is seen to be as effective as surgery for most people.

It uses a type of external x-ray treatment that uses carefully measured doses of radiation to destroy cancerous cells and therefore shrink tumours in order to achieve a cure. It is given by a machine that beams the radiation at the tumour cells in the bladder. These abnormal cancer cells are more sensitive to radiotherapy than normal cells and will be destroyed.

Sessions of external radiotherapy for bladder cancer are usually given on a daily basis for five days a week, over the course of four to seven weeks, each session lasting for about 10 to 15 minutes, although the number and frequency of radiotherapy sessions will depend on the extent, size and type of the tumour. Radiotherapy is often preceded by chemotherapy into the veins to improve the overall results of treatment.

The likelihood of success with radiotherapy treatment is the same as cystectomy in terms of the chance to be cancer free. It tends to be preferred over surgery for patients who have other health problems or who are older and therefore the risks associated with surgery are greater. Many younger and fitter patients, especially those with good bladder function, choose radiotherapy because the results are comparable with surgery, and the treatment is carried out as an outpatient and many patients carry on with their normal activities of life during the course of treatment.
 

Always make sure you let the radiographers know exactly how you feel and whether you experience any side-effects.

Palliative radiotherapy

Radiotherapy can also be used to help control the symptoms in cases of incurable bladder cancer, this is known as palliative radiotherapy. This is given in between one and ten schedules and may be given either on a daily basis for one to two weeks or once a week.

For more information on radiotherapy including side effects and tips from patients, download or order a copy of the Muscle-invasive bladder cancer booklet (see link at the bottom of the page).  

Free Care Packages

If you're having radiotherapy, you can request a free cancer kit if you’re under 65 or a free comfort kit if you’re over 65 from Cancer Support UK. 

2. Chemotherapy

This section is about chemotherapy treatment injected into the bloodstream. These treatments, which can also be called systemic chemotherapy, reach all areas in the body that have a blood supply.

The doctor may be able to give you information on the improvements expected from each treatment in your individual case. Remember when you are quoted statistics that they apply to a group of patients, some of whom may do much better than the average, and some who will do not quite as well.

Neoadjuvant chemotherapy

Chemotherapy is often given before radiation therapy for muscle-invasive bladder cancer and also before radical cystectomy. This is called neoadjuvant treatment, meaning before the main treatment. Neoadjuvant chemotherapy in suitable patients has been shown to improve survival.

Concurrent chemotherapy

Concurrent chemotherapy is given alongside radiotherapy to make the cancer cells more sensitive to the radiotherapy.

This can include giving it alongside treatments 1 to 5 and 16 to 20 of radiotherapy, usually using a combination of drugs given through a special drip called a PICC line so the drugs drip into the system 24 hours a day for five days. All this can be done while you are going about life as normal and you do not need to be in hospital.

Doctors can use a treatment called BCON. This involves taking nicotinamide vitamin tablets before radiotherapy and breathing carbogen (high-dose oxygen) throughout the treatment, which makes the cancer cells more sensitive to radiotherapy. Your doctor will give you more information about this if you are suitable.

Adjuvant chemotherapy

This form of chemotherapy is additional to the main treatment, such as an RC, to try to reduce the chance of the cancer returning. This is not usually given if you have had neoadjuvant treatment.

Your oncologist should give you a detailed patient information sheet. Read it carefully and share the information with family members, friends or a Bladder Buddy to make sure you have understood everything correctly. Write down any questions that you have to ask the medical team.

It is also worth buying a thermometer and practising so that you can take your own temperature accurately. You will then be able to monitor your temperature during any chemotherapy treatment if you feel unwell in any way as a raised temperature can indicate an infection.
 

‘My anticipation and worry were worse than the actual treatments. Try not to let your mind run wild with disastrous scenarios. Thinking positively changed my experience.’

Palliative chemotherapy

This means that your medical team cannot cure the cancer but can give you treatment to improve symptoms and extend life — hopefully of good quality. It does not mean that you are terminal. Doctors use the phrase terminal to mean someone for whom there is no treatment available that targets the cancer.

Free Care Packages

If you're having chemo, you can request a free chemo kit from Cancer Support UK.

For more information on chemotherapy including side effects and tips from patients, download or order a copy of the Muscle-invasive bladder cancer booklet (see link at the bottom of the page).