Intra-Vesical Chemotherapy

Bladder cancer treatment has been stagnant for the last twenty years. One of the standard forms of bladder cancer therapy is to instil either a drug called BCG or a chemotherapeutic agent called Mitomycin into the bladder after a tumour has been removed surgically from the bladder. 

The treatment is given weekly for six weeks after a wait of about a month to six weeks the bladder is visualised again with a scope to see if all the tumour has destroyed. BCG stimulates an immune response against the remaining cancer cells (stimulates the body to produce killer cells against the tumour) whereas Mitomycin 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. Mitomycin

BCG availability has become a major problem in South Africa and many urologists now rely on Mitomycin only. Mitomycin instilled into a bladder does not cause all the usual awful symptoms patients associate with chemotherapy such as nausea, vomiting and hair falling out.

Recently a new therapy has emerged that improves the effect of intra-vesical chemotherapy by about 80%. By heating the Mitomycin, that has been instilled inside the bladder, it enables the Mitomycin to stimulate 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. It does mean as well that instead of a quick 5 minute visit to the urologist there is now a thirty-minute therapeutic time in the doctor's rooms.

 

For more information please follow these links:

www.nice.org.uk

http://ascopubs.org