Chemotherapy is effective because it targets multiplying cells. Since cancer is characterized by rapid cell growth, this is why chemotherapy works. However, the medications do not distinguish cancer cells from healthy multiplying cells, and side effects occur. Depending on which drugs are used, various organs may be affected, including the bladder. Problems with chemotherapy and the bladder generally fall into two groups: cystitis and hemorrhagic cystitis, according to ChemoCare.com.
Cystitis
Cystitis is diagnosed when the lining of the bladder wall becomes infected. Symptoms of cystitis can include frequent, urgent need to urinate; painful urination; having blood in the urine; low-grade fever; and not being able to fully empty the bladder. A urinalysis or imaging studies may be done to help diagnose cystitis, and once it is diagnosed, antibiotics are used to treat the infection, according to the Mayo Clinic. Other treatments that may be used include intravenous fluids to help flush out the bladder, or a drug called Mesna that protects the lining of the bladder but does not interfere with the effectiveness of chemotherapy.
Hemorrhagic Cystitis
Hemorrhagic cystitis is the sudden occurrence of blood in the urine, accompanied by bladder pain and symptoms of an irritated bladder, such as burning with urination or urinary frequency. With patients receiving chemotherapy, this condition can occur during active treatment, directly after active treatment ends, or months later after treatment has stopped. According to ChemoCare, two commonly used chemotherapeutic drugs that have been known to cause this condition are cyclophosphamide and Ifosphamide. Because hemorrhagic cystitis can be a very serious condition, it is important to get appropriate treatment. There is no standard treatment for it, but possible treatments that may be used include stopping the chemotherapy drugs that are causing it; use of analgesics for pain; antibiotics; and putting medication into the bladder to stop the bleeding.
Prevention
There are several things that can be done to help reduce the risk of side effects on the bladder from chemotherapy. Some of these things, according to ChemoCare, include bladder irrigation with normal saline; a large amount of fluid intake, either orally or intravenously, to help flush medications from the bladder; use of diuretics or a catheter to encourage frequent urination; or the use of the drug Mesna, which helps protect the bladder lining. While doing these things might not completely prevent bladder symptoms, they do help reduce the risk of more serious problems resulting from chemotherapy.
