Chemotherapy for invasive and advanced bladder cancer

Chemotherapy uses anti-cancer drugs to destroy cancer cells. What you have depends on your type or bladder cancer, its size and whether it has spread. You may have chemotherapy before surgery or radiotherapy, after surgery, or at the same as radiotherapy treatment (chemoradiation). You will usually have a combination of chemotherapy drugs to treat bladder cancer.

If the bladder cancer has spread outside the bladder, chemotherapy can help to shrink or slow the growth of the cancer. It can also help to improve any symptoms. It can be difficult to decide whether or not to have chemotherapy in this situation. It might help to talk to your healthcare team, family and friends before making a decision.

Chemotherapy is usually given as several sessions (cycles) over a few months. Each cycle lasts a few weeks and includes a break with no treatment. The drugs are usually given into a vein through a line or a drip. Your doctor or nurse will explain how you will have treatment.

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. Cytotoxic means toxic to cells. These drugs disrupt the way cancer cells grow and divide but they also affect normal cells.

Chemotherapy may be given:

  • before surgery or radiotherapy, to shrink the cancer and reduce the risk of it coming back (neo-adjuvant chemotherapy)
  • at the same time as treatment with radiotherapy (chemoradiation), to make treatment more effective
  • sometimes after surgery (adjuvant chemotherapy), if there’s a high risk of the cancer coming back. It’s not known how effective this is, so it’s usually given as part of a clinical trial
  • on its own for bladder cancer that has spread to other parts of the body (palliative chemotherapy).

Drugs are often given in combination to treat bladder cancer. Some commonly used combinations are:

Other drug combinations or a single drug may also be given.

We have more information about individual chemotherapy drugs and different combinations.


Chemotherapy for advanced or metastatic bladder cancer

Chemotherapy may be given when the cancer has spread outside the bladder to other parts of the body. It can help shrink or slow down the growth of the cancer and reduce your symptoms.

The type of chemotherapy you have will depend on how advanced your cancer is and how physically well you are. You may be given a combination of chemotherapy drugs or one drug on its own.

Many people worry about having chemotherapy because of the possible side effects, but these side effects can usually be well controlled with medicines.

Deciding whether to have treatment when you have metastatic cancer can be difficult. You can talk to your doctor and specialist nurse about the advantages and disadvantages of treatment in your situation. Talking to your family and close friends may also help.

If you decide not to have chemotherapy, there are other medicines available and ways of controlling cancer symptoms such as pain. Your doctor will discuss these with you.

We have more information about making treatment decisions that you may find helpful.


How chemotherapy is given

You have your treatment in the chemotherapy day unit or during a short stay in hospital. Chemotherapy is usually given as a course of several sessions (or cycles) over a few months. One cycle often takes a few weeks. A cycle includes having the treatment and having a break with no treatment. Your doctor or nurse will explain more about this.

If you have chemotherapy at the same time as radiotherapy (chemoradiation), your doctor or nurse will tell you how the chemotherapy will be given.

Usually, the chemotherapy drugs are given into a vein (intravenously). This can be by injection or as a drip (infusion). The drugs are given through a small tube (cannula) in your arm or a soft plastic tube, called a central line or PICC line. A central line goes into a vein in your chest. A PICC line is put into a vein above the bend in your arm.

Back to Chemotherapy explained

What is chemotherapy?

Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells. It can be given alone or with other treatments.

When is chemotherapy used?

Chemotherapy is used to kill cancer cells in the body. Your doctor will explain if chemotherapy is advised for you.

How do chemotherapy drugs work?

Chemotherapy drugs work by stopping cancer cells reproducing. The drugs can also affect healthy cells, causing side effects.