According to the National Institutes of Health, bladder cancer is the sixth most common cancer in the United States. The treatment options for bladder cancer include surgery, radiotherapy and chemotherapy. Chemotherapy, or "chemo," involves using drugs to kill cancer cells or stop their growth and spread in the body. There are different types and applications of chemotherapy in the treatment of bladder cancer.
Intravessical Chemotherapy
This is a form of local chemotherapy, according to the American Cancer Society, in which the drugs are delivered directly into the bladder by means of a catheter via the urethra. According to the American Society of Clinical Oncology, this method is mostly used to deliver the immunotherapy drug called Bacillus Calmette-Guerin, or BCG. Chemotherapy drugs that are delivered by this method include mitomycin C, thiotepa and doxorubicin.
Systemic Chemotherapy
Systemic chemotherapy involves the introduction of drugs to the bloodstream, either by oral pills or intravenous injections. According to the American Cancer Society, this is a better way to deliver drugs where there is a possibility that cancer has spread beyond the bladder.
Combinations of drugs are known to be more effective against cancer than single drugs. One such combination used for bladder cancer is methotrexate; vinblastin; doxorubicin, also known as Adriamycin; and cisplatin. This is known as the M-VAC combination. Another combination is gemcitabine and cisplatin, called GemCis.
Other drugs mentioned in systemic chemotherapy for bladder cancer are ifosfamide, cyclophosphamide, fluorouracil and mitomycin C.
Combinations with Surgery or Radiation
Chemotherapy can be used before surgery in the hope of shrinking the tumor and simplifying the procedure. This type of chemotherapy, according to the American Cancer Society, is called neoadjuvant chemotherapy.
Chemotherapy is also useful in some cases after surgery to clear any leftover cancerous cells, in a process called adjuvant chemotherapy.
Chemotherapy can also be combined with radiation therapy. This increases the effectiveness of radiation but also increases the adverse effects of radiation therapy.
