Radiation Therapy for Bladder Cancer

Radiation therapy uses high-energy radiation to kill cancer cells.

When is radiation therapy used for bladder cancer?

Radiation therapy can be used:

• As part of the treatment for some early-stage bladder cancers, after surgery that doesn’t remove the whole bladder (such as TURBT)
• As part of the treatment for people who can’t have (or don’t want) a cystectomy (surgery to take out the bladder)
• As part of treatment for advanced bladder cancer (cancer that has spread beyond the bladder)
• To help prevent or treat symptoms caused by advanced bladder cancer

Radiation therapy is often given along with chemotherapy (using drugs such as cisplatin, gemcitabine, capecitabine, or 5-FU plus mitomycin) to help the radiation work better. This is called chemoradiation.

How is radiation therapy given?

The type of radiation most often used to treat bladder cancer is called external beam radiation therapy. It focuses radiation from a source outside of the body on the cancer.

Before your treatments start, your radiation team will take careful measurements to find the exact angles for aiming the radiation beams and the proper dose of radiation. This planning session, called simulation, usually includes getting imaging tests such as CT or MRI scans. This helps the doctor map where the tumor is in your body. You'll be asked to empty your bladder before simulation and before each treatment.

Most often, radiation treatments are given 5 days a week for many weeks. The treatment is a lot like getting an x-ray, but the radiation is stronger. Radiation doesn't hurt. Each treatment lasts only a few minutes, but the setup time, which includes getting you into place for treatment, usually takes longer.

Possible side effects of radiation therapy

Side effects of radiation depend on the dose given and the area being treated. They tend to be worse when chemo is given along with radiation. They can include:

• Skin changes in areas getting radiation, ranging from redness to blistering and peeling
• Nausea and vomiting
• Bladder symptoms, like burning or pain when you urinate, feeling the need to go often, or blood in your urine
• Diarrhea
• Blood in stool and/or urine
• Tiredness (fatigue)
• Low blood counts, which can lead to fatigue, easy bruising or bleeding, or increased risk of infection

These effects usually go away over time after treatment, but some people can have longer-term problems. For instance:

• In some people, radiation treatments can lead to incontinence (problems holding urine) later on.
• Radiation can damage the lining of the bladder (radiation cystitis). This might cause long-term problems such as blood in the urine or painful urination.
• Nearby nerves and blood vessels might be damaged, leading to erection problems in men.

Ask your health care team what symptoms you should watch out for. If you have side effects from radiation therapy, be sure to let your health care team know. They can suggest ways to ease many of them.