Preparing for and coping with bladder cancer treatment can be challenging. But, keep in mind that an experienced cancer care team is there to help you every step of the way. They gain their expertise from caring for many other people who have gone through bladder cancer treatment.
Surgery is the main treatment for most cases of bladder cancer. Other treatment options include intravesical therapy, chemotherapy, and radiation therapy. There are benefits to each of these options, but there are also side effects. Knowing ahead of time what you may experience with different treatments will help you and your care team prepare for and manage potential side effects. Side effects vary by the specific treatment and also your individual health and wellness level.
The type of surgery you need for bladder cancer will depend on the extent of cancer. It can range from simple tumor removal to removal of the bladder and some of the urethra. Doctors may also need to remove nearby reproductive organs. For men, this can include the prostate and seminal vesicles. In women, it can include the ovaries, fallopian tubes, uterus, cervix, and part of the vaginal canal. Side effects of surgery will depend on how extensive it is.
Partial Cystectomy
Partial cystectomy removes only part of the bladder wall. After the doctor closes the resulting hole, the bladder will be smaller than before surgery. The main side effect of partial cystectomy is a more frequent need to urinate due to reduced bladder size.
Radical Cystectomy
In a radical cystectomy, doctors remove the entire bladder and some of the urethra. This means you will need reconstructive surgery. Your doctor will make a new way for your body to store urine and eliminate it. One method is to create a new bladder out of intestinal tissue. The new bladder (neobladder) allows you to urinate normally during the day. Other methods divert urine through an opening in the abdomen to collect in a pouch.
As part of a radical cystectomy, doctors may remove nearby reproductive organs. This usually means prostate removal, or prostatectomy, for men. The main side effect of this procedure is erectile dysfunction (ED). If ED becomes a problem for you, talk with your doctor about available treatments. Learning the pros and cons of each ED treatment option will help you choose the best one for you.
For women, side effects of radical cystectomy will depend on which organs the doctor removes. Removing the ovaries can cause menopausal symptoms in women who have not gone through menopause. Removing the uterus will stop menstruation and end the ability to have children. Some women may also experience sexual changes. Your cancer care team can answer any questions or concerns you may have about surgical side effects and refer you to a specialist to help manage them if needed.
Intravesical therapy involves instilling a drug—chemotherapy or immunotherapy—directly into the bladder. This tends to limit side effects in the entire body. However, side effects can still occur locally in the bladder. Chemotherapy can cause burning and irritation in the bladder.
Burning in the bladder can also happen with BCG immunotherapy, the main type of intravesical immunotherapy for bladder cancer. BCG is actually a vaccine to guard against tuberculosis, but administering it directly in the bladder triggers an immune response against bladder cancer cells. The main BCG side effect is flu-like symptoms, such as fever, chills and fatigue. If your fever does not respond to medicine, contact your doctor. This may be a sign of infection. Also, tell your doctor if BCG treatment side effects become a challenge as you continue bladder cancer treatment.
Systemic chemotherapy, or chemo, affects the whole body. Chemo affects everyone differently. It depends on the stage of cancer, your general health beforehand, and the specific chemo drug and dose. While there are many drugs and combinations of drugs, there are a few common chemo side effects. This includes appetite changes, diarrhea, fatigue, fever, infection, hair loss, memory problems, mouth and throat sores, and nausea and vomiting.
Always call your doctor if you experience side effects. There may be causes other than chemo drugs or your doctor may be able to adjust your regimen.
Radiation therapy uses high-energy X-rays or particles to destroy cancer cells. Like chemo, side effects depend on the dose of radiation. Short-term side effects can include fatigue, nausea, vomiting, diarrhea, and skin changes. Skin problems, such as redness, blistering and peeling, occur over the target area. Other side effects include blood in the urine, needing to urinate often, painful urination, or burning with urination. Side effects from radiation therapy for bladder cancer often end after you finish treatment.
Long-term problems can include urinary incontinence and damage to the bladder lining. This damage is called radiation cystitis. Symptoms include blood in the urine and painful urination. More advanced and targeted radiation therapies can help minimize bladder damage. Doctors can treat radiation cystitis with medications to control bleeding.
There are often solutions to bladder cancer treatment side effects. Ask your doctor beforehand what you can expect from your specific treatment. Find out how you can avoid side effects and how your doctor plans to deal with them if they occur. Many side effects have specific solutions to relieve your symptoms. With surgery, the doctor’s experience with the procedure often plays a role in its success.
