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Treating locally advanced or metastatic bladder cancer

Treating locally advanced or metastatic bladder cancer

If you have bladder cancer that has spread to other parts of your body, your oncologist should talk to you about what is likely to happen in the future. They should discuss the advantages and disadvantages of having treatment, including what might happen if you decide not to have treatment for your cancer. They should also offer you treatment to relieve symptoms caused by your cancer (for more information see relieving cancer symptoms).

Chemotherapy

You should be offered a course of chemotherapy with a combination of drugs.

Your oncologist should check your health regularly while you are having chemotherapy. They should offer you treatments to help relieve side effects of chemotherapy. They should stop the chemotherapy if the side effects are too strong or the chemotherapy isn't helping.

If your first course of chemotherapy doesn't help, your oncologist should discuss another course of chemotherapy with you. They should talk to you about the advantages and disadvantages of having a second course of chemotherapy, including what might happen if you decide not to have it.

Relieving cancer symptoms

Problems urinating

If urinating is painful, there is blood in your urine, or you need to urinate very often or during the night, you should be offered radiotherapy, which may help to relieve your symptoms.

Pain in your lower back or kidneys

Pain in your lower back or kidneys may be caused by a blockage in your ureter (the tube that carries urine from the kidneys to the bladder). You may be offered a procedure to drain the kidneys to help ease the pain. This could be an external drainage tube into the kidney (called a nephrostomy) or a splint (called a stent) placed between the kidney and the bladder.

Your urologist should discuss the treatment options with you. They should talk to you about what is likely to happen in the future and the advantages and disadvantages of treatment, including not having treatment.

Severe and painful bleeding from your bladder

You may be offered radiotherapy or a treatment called embolisation, in which the blood vessels that supply the bladder are blocked, to stop the bleeding.

Pain in your pelvic area

You may be offered radiotherapy, chemotherapy or treatment with a drug to block the pain.

Questions to ask your care team

  • What is meant by locally advanced cancer? What does it mean for me?

  • What is meant by metastatic cancer? What does it mean for me?

  • What are the advantages and disadvantages of having chemotherapy?

  • How likely is it to work? What happens if it doesn't work?

  • What might happen if I decide not to have any treatment?

  • What will you be able to do for me if I get painful symptoms from the cancer?

  • Is there support available for people with this type of bladder cancer?

  • Information Standard