Intravesical chemotherapy

What is this?

Instillations of Mitomycin C into the bladder for aggressive, multiple or recurrent superficial cancer of the bladder

What alternatives are there?

Repeated cystoscopy, radiotherapy, surgical removal of the bladder with urinary diversion or bladder reconstruction, systemic chemotherapy

What to expect before procedure

Your Consultant Urologist has referred you for treatment of your superficial bladder cancer. Superficial bladder cancer affects a few layers of cells on the inner surface of the bladder only but has the ability to progress to more aggressive disease If not treated effectively. The aim of the treatment, therefore, is to stop or slow down re-growth by instilling a drug into the bladder; this is called intravesical chemotherapy. You will be asked to come to the Hospital once a week for 6 weeks. You should limit your fluid input for 6 hours before each treatment. Your first treatment will take up to 90 minutes. On arrival in the clinic, you will be asked to pass urine which will be tested to ensure that you do not have an infection in the urine. If you do, your treatment will need to be postponed for one week while you are treated with antibiotics.

What happens during the procedure?

A fine plastic tube (called a catheter) will be passed into the bladder and the medication (approximately half a cup of fluid) will be given through it. The catheter will then be removed. You will be asked not to pass urine for an hour to allow the medication to treat the bladder lining. On your first visit, If you have not had Mitomycin before, you will be asked to stay in the clinic for the duration of the treatment and you will be asked to pass urine before you go home. For the remaining treatments, If you live within 20 minutes of the hospital and have your own transport, you may be allowed to go home with the medication in your bladder and pass urine after one hour.

After the procedure

Once the treatment has been completed, you will be able to go home. There is no risk of contamination with Mitomycin when you get home. You should drink plenty of fluids (2-3 litres) for the few days after the treatment. Some patients find that, for a few days after BCG treatment, a glass of cranberry juice daily eases any bladder symptoms; cranberry juice, however, should not be used If you are taking Warfarin

Potential side effects