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Medications

What medications are used to treat patients with bladder cancer?

Many patients with bladder cancer receive medication as part of their treatment plan. The types of medicines a patient may receive depends on the patient’s bladder cancer stage and grade, as well as other factors. Medications that are commonly used for treating bladder cancer include:

  • BCG intravesical immunotherapy
  • Intravesical chemotherapy
  • Systemic chemotherapy
  • Immunotherapy medicines
  • Targeted therapy

What is BCG intravesical immunotherapy?

Bacillus Calmette-Guerin (BCG) vaccine treatment is a type of intravesical (delivered directly into the bladder) immunotherapy that can be used to treat patients who have early-stage bladder cancer that is only located in the lining of the bladder, but has not grown into the muscle of the bladder wall.1 It is often used after patients have a transurethral resection of bladder tumor (TURBT) surgical procedure to remove tumors from the bladder lining. BCG immunotherapy is delivered directly into the bladder through the urethra, using a catheter. BCG is a type of bacteria that attracts the body’s immune system cells and causes them to attack cancer cells in the bladder lining.

What is intravesical chemotherapy?

Intravesical chemotherapy is another type of medication that is delivered directly into the patient’s bladder through the urethra using a catheter.2 Chemotherapy includes powerful medicines that attack actively growing cancer cells. Intravesical chemotherapy is generally used to treat patients with early-stage bladder cancer that is only located in the bladder lining, because it does not have an effect on other cancer cells in the bladder muscle or in other parts of the body. This type of chemotherapy is also commonly used in patients after they have TURBT surgery to help destroy any cancer cells remaining in the bladder lining, as well as helping to prevent cancer cells from recurring (growing back after treatment).

What is systemic chemotherapy?

Unlike intravesical chemotherapy, which is delivered directly into the patient’s bladder, systemic chemotherapy is taken by mouth or injected into the patient’s muscle or vein.3 Systemic chemotherapy drugs enter the blood stream and can affect all cancer cells in the body, not just those located in the bladder lining. Systemic chemotherapy is generally used to treat patients with advanced bladder cancer that has spread into the bladder muscle, into organs or tissues near the bladder, or into other parts of the body. Types of chemotherapy that are used to treat patients with advanced bladder cancer include:

  • Neoadjuvant chemotherapy (before surgery)
  • Adjuvant chemotherapy (after surgery)
  • Chemoradiation therapy (systemic chemotherapy combined with radiation therapy)

What are immunotherapy medicines for bladder cancer?

Immunotherapy medicines are a relatively new type of treatment for bladder cancer.4 They are generally used to treat patients with advanced bladder cancer who have already tried treatment with systemic chemotherapy, but the chemotherapy either did not work or no longer works. These drugs work by affecting the way a patient’s own immune system works to help the patient’s body attack cancer cells more effectively. Immunotherapy drugs approved to treat advanced bladder cancer include:

What are targeted therapy medicines for bladder cancer?

Certain changes happen inside cells that cause cancer, and targeted therapies are medications that target these specific changes only. They are different from chemotherapy in this way; they are more specific and can therefore work in a different, more focused way. Some bladder cancers have changes in fibroblast growth factor receptors (FGFRs), which are groups of proteins on bladder cancer cells involved in their growth.5 In people who have bladder cancer that has these changes, targeted therapies focused on FGFR may be effective in treating the cancer. As of April 2019, there is one targeted therapy for bladder cancer, an FGFR inhibitor:

Written by Anna Nicholson | Last review date: July 2019.
  1. Intravesical Therapy for Bladder Cancer. American Cancer Society. https://www.cancer.org/cancer/bladder-cancer/treating/intravesical-therapy.html. Accessed September 2017.
  2. Bladder cancer- Diagnosis and treatment. Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/bladder-cancer/diagnosis-treatment/drc-20356109. Accessed September 2017.
  3. Chemotherapy for Bladder Cancer. American Cancer Society. https://www.cancer.org/cancer/bladder-cancer/treating/chemotherapy.html. Accessed September 2017.
  4. Gupta S, Gill D, Poole A, Agarwal N. Systemic Immunotherapy for Urothelial Cancer: Current Trends and Future Directions. Golubovskaya V, ed. Cancers. 2017;9(2):15. doi:10.3390/cancers9020015.
  5. Targeted Therapy Drugs for Bladder Cancer. American Cancer Society. https://www.cancer.org/cancer/bladder-cancer/treating/targeted-therapy.html Published April 15, 2019. Accessed October 30, 2019.