Bladder cancer treatment has been stagnant for the last twenty years. Following the surgical removal of a tumour from the bladder, a standard form of bladder cancer therapy is to instil either a drug called BCG or a chemotherapeutic agent called Mitomycin into the bladder.
The treatment is given weekly for six weeks after a wait of +/- one month to six weeks. The bladder is visualised again with a scope to see if all the tumour has been destroyed. BCG stimulates an immune response against the remaining cancer cells (stimulates the body to produce killer cells against the tumour). Mitomycin, on the other hand, is directly cytotoxic (it kills the cancer cells itself). BCG availability has become a major problem in South Africa and many urologists now rely on Mitomycin only. This treatment is not associated with the common adverse effects associated with chemotherapy such as nausea, vomiting and hair loss.
Recently a new therapy has emerged that improves the effect of intra-vesical chemotherapy by about 80%. Heating the Mitomycin, that’s been instilled inside the bladder, stimulates an immune response as well as inducing its cytotoxic effect. The treatment is more expensive but because the effect is so dramatic, medical funders are coming on board. It does mean as well that instead of a quick
The treatment is more expensive but because the effect is so dramatic, medical funders are coming on board. The administration of this therapy entails a thirty-minute therapeutic time in the doctor’s rooms.
Frequently Asked Questions
Level of pain to expect during and after the procedure?
Usually no pain. If the bladder is small it may be a bit more uncomfortable as the hour of treatment progresses. If there is already an underlying condition that is painful this may cause greater levels of discomfort during the procedure. It is important to discuss this with the physician. Depending on the chemotherapy used there may be pain or bladder irritation or even bleeding after the procedure.
Where is the treatment done?
In the doctors rooms.
Anticipated duration of the treatment?
Usually ten minutes preparation and an hour of treatment.
how soon after the procedure can normal daily activities be resumed?
Normal activities excluding exercise can occur the day after the procedure. Running is prohibited for a month and cycling and rowing for two months
how soon after the procedure can normal daily activities be resumed?
The same day unless there is a reaction to the treatment such as bladder pain etc
how soon after the procedure will i be able to drive?
The same day
how soon after the procedure will i be able to travel?
The same day
Will my sexual function and/or fertility be affected by the procedure?
Usually not unless there is pelvic discomfort.
Would this procedure have any affect on my quality of life going forward?
Usually not unless there is a complication. As an example, with BCG therapy a rare complication is bladder tuberculosis or even systemic (generalised tuberculosis). This is an extreme and fortunately rare complication.
What to expect at my follow-up visit.
Follow up visits usually entail having another cystoscopy to assess the efficacy of the treatment.
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