Chemotherapy for Bladder Cancer
Chemotherapy (also called chemo) uses drugs to destroy or damage fast-growing cells like cancer cells. In bladder cancer, chemotherapy may be given before surgery to shrink the tumor in the bladder or kill microscopic cells that no scan or blood test shows, but that may be in your bloodstream, lymph nodes or organs. This is called neoadjuvant chemotherapy. It can also be used after surgery to kill any remaining cancer cells, or as the main treatment if surgery or radiation isn’t an option. Chemo drugs are given in different ways. This includes intravenously (IV into a vein), orally by a pill, or by injection. Chemotherapy can be given directly into the bladder (intravesical therapy) for bladder cancer that has not invaded the muscle of the bladder (non-muscle invasive bladder cancer).
These are the chemotherapy drugs that are used most often to treat bladder cancer. New treatments become available all the time, so this may not be a complete list.
Please note: The side effects listed here do not represent a comprehensive list. It's important to discuss all potential side effects of a drug with your healthcare team. Be sure to tell your healthcare team about any side effects you do have.
All Available Treatments
Pill = 
Treatment Type
Platinum-based chemotherapy (MIBC)
Drug Names
Potential Side Effects
Nausea/vomiting
Urinary, kidney, or bladder changes
Low blood counts
Hearing changes
Hair thinning/loss
Taste changes
Weight/appetite changes
Fatigue/weakness
Electrolyte imbalance
Important Things to Know
- Bladder Cancer Type: Muscle-Invasive Bladder Cancer
- Cisplatin is considered the standard for bladder cancer but may not be safe for everyone due to kidney function or other health issues. Carboplatin may be used as an alternative. Kidney function should be monitored closely during treatment.
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
Treatment Type
Antimetabolite
Drug Names
Potential Side Effects
Low blood counts
Nausea/vomiting
Fever
Fatigue/weakness
Liver problems
Flu-like symptoms
Rash
Important Things to Know
- Bladder Cancer Type: Muscle-Invasive and Non-Muscle Invasive
- Often combined with cisplatin for neoadjuvant treatment of bladder cancer or as first or second-linetreatment of advanced or metastatic bladder cancer. May be used on its own in patients who can't tolerate combination therapy.
- Low blood counts are a potential side effect that may put you at risk for anemia, infection, or bleeding.
Treatment Type
Intravenous infusion (IV)
Drug Name
Potential Side Effects
Urinary, kidney, or bladder changes
Important Things to Know
- Placed using a catheter & then removed in 3 weeks
Treatment Type
Combination chemotherapy (MVAC)
Drug Name
Potential Side Effects
Nausea/vomiting
Low blood counts
Mouth sores
Hair thinning/loss
Fatigue/weakness
Kidney problems
Infections
Important Things to Know
- Bladder Cancer Type: Muscle-Invasive
- MVAC is a combination regimen used for neoadjuvant treatment before surgery and for advanced/metastatic bladder cancer.
- Often used in patients who are healthy enough to tolerate aggressive therapy.
- Requires close monitoring due to potential for serious side effects.
Treatment Type
Intravesical therapy
Drug Name
Important Things to Know
- Bladder Cancer Type: Non-Muscle Invasive
- Delivered directly into the bladder via catheter.
- Used for early-stage (non-muscle invasive) bladder cancer after tumor resection.
- Avoid urination too soon after administration to allow the drug to work.
Treatment Type
Direct instillation into the bladder
Drug Name
Important Things to Know
- A drug approved in June for a chemo installation that is a sustained-release gel rather than a liquid.
- It is not a system that needs removal at the end of a cycle.