Muscle Invasive Bladder Cancer (includes T2 tumors) , Locally Advanced (includes T3 tumors) , Metastatic Bladder Cancer (includes T4 tumors)

Chemotherapy

Systemic chemotherapy

• Suitable for most people to treat muscle-invasive bladder cancer, including when the cancer has spread to other parts of the body
• Can be given before surgery (neoadjuvant chemotherapy) to shrink the tumor so it’s easier to remove or after surgery (adjuvant chemotherapy) to kill any remaining cancer cells
• Also suitable as an alternative treatment if surgery cannot be done because of serious health problems

Kills cancer cells anywhere in the body, to stop these growing and dividing

• Used before surgery to help to shrink the tumor so it’s easier to remove, and help lower the chances of the cancer coming back after surgery
• Used after surgery, or radiation therapy, to kill any remaining cancer cells and lower the risk of the cancer coming back
• Given as a treatment for bladder cancer that has spread to other parts of the body

• Given as a pill
• Injected into a vein
• Injected into a muscle

• Nausea and vomiting
• Loss of appetite
• Hair loss
• Mouth sores
• Diarrhea
• Constipation
• Increased risk of infection
• Easy bleeding or bruising
• Fatigue

• Combined-modality therapy (CMT): Chemotherapy is often given with radiation therapy to make the radiation therapy more effective
• Chemotherapy –> immune checkpoint inhibitor maintenance treatment: For advanced bladder cancer, a treatment regimen of chemotherapy followed by an immune checkpoint inhibitor may be used as maintenance therapy, to maintain the benefits of chemotherapy and slow the progression of the cancer
• Chemotherapy + monoclonal antibody: In some cases, chemotherapy can also be given with a monoclonal antibody to help the chemotherapy to find and kill the bladder cancer cells