• Other Treatments for Bladder Cancer: Biologic Therapy and Photodynamic Therapy

    Biologic Therapy

    Biologic therapy (also called immunotherapy) is a treatment that uses drugs to improve the way your body’s immune system fights disease. Your immune system is your body’s natural defense against disease. A healthy and strong immune system can detect the difference between healthy cells and cancer cells. Biologic therapy attempts to repair, stimulate, or enhance the immune system so that it can fight the cancer more effectively. These therapies can be used to fight cancer or to lessen the side effects that may be caused by some cancer treatments.
    Biologic therapy for bladder cancer involves instilling a liquid containing Bacille Callmette-Guérin (a live, weakened form of the bacteria that causes tuberculosis ) into the bladder. The bacteria seem to provoke the body’s immune system, increasing its ability to kill the cancer cells that are in the bladder.
    The bacteria solution is placed into the bladder through a catheter tube inserted through the urethra and into the bladder. Once the solution is in the bladder, you’ll be asked to hold it in the bladder for about two hours. These treatments usually occur once a week for six weeks. Some people require a second six-week cycle of treatments to achieve full benefit.

    Effectiveness

    Biologic therapy for bladder cancer is very effective against superficial bladder cancer.

    Side Effects

    This form of biologic therapy used to treat bladder cancer may cause the following symptoms:
    • Flu-like symptoms (achiness, fatigue)
    • Fever, chills
    • Nausea
    • Urinary symptoms:
      • Frequent need to urinate
      • Urgent need to urinate
      • Pain/burning with urination
      • Bloody urine
    • Rare tuberculosis-like severe infection

    When to Contact Your Healthcare Provider

    Call your doctor if you experience the following symptoms:
    • Cough
    • Rash
    • Severe or persistent fever and chills
    • Severe pain

    Photodynamic Therapy (Phototherapy)

    Photodynamic therapy is a relatively new weapon in the fight against bladder cancer. In photodynamic therapy (PDT), photosensitizers, or light-sensitive molecules, are injected into the bloodstream and absorbed by cells throughout the body. These agents remain in cancer cells longer than in normal cells. A cystoscope is then inserted through the urethra into your bladder, where it shines a red laser light onto the tumor. When the cancer cells are exposed to laser light, the photosensitizers are activated and cause cell damage and death.
    Effectiveness
    Photodynamic therapy is only effective against very superficial forms of bladder cancer. Its effects do not penetrate to deeper areas of the bladder.
    Side Effects
    Phototherapy may cause the following side effects:
    • Severe photosensitivity (greatly increased tendency to sunburn)
    • Flu-like symptoms (achiness, fatigue)
    • Fever, chills
    • Nausea
    • Urinary symptoms:
      • Frequent need to urinate
      • Urgent need to urinate
      • Pain/burning with urination
      • Blood urine
    Special Considerations
    Because photodynamic therapy makes you more sensitive to sunlight, check with your doctor regarding appropriate sun precautions. You should avoid being outside during the sunniest times of day (about 10 in the morning until late afternoon). If you do have to go outside, always use a sun block with SPF of at least 30, and wear protective clothing and a wide-brimmed hat.
    When to Contact Your Healthcare Provider
    Call your doctor if you experience the following symptoms:
    • High fever
    • Severe pain
    • Serious sunburn

    References

    Campell’s Urology. 8th ed. New York, NY: Elsevier Science; 2002: 2732-2765.

    Cecil Textbook of Medicine. Philadelphia, PA: WB Saunders Company; 2002: 633-634.

    Conn’s Current Therapy. 54th ed. Philadelphia, PA: WB Saunders Company; 2002: 720-721.

    What you need to know about bladder cancer. National Cancer Institute website. Available at http://www.cancer.gov/cancerinfo/wyntk/bladder . Accessed December 2002.

    Revision Information


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