Treating Bladder Cancer: Intravesical Therapy

Treating Bladder Cancer: Intravesical Therapy

March 21, 2017

Treating Bladder Cancer: Intravesical Therapy

Front view cross section of bladder with catheter inside delivering medication.Some types of bladder tumors are hard to remove completely with surgery. These tumors tend to be high grade. This means they are more likely to grow and spread quickly. They may happen in more than one area and they may be flat against the bladder wall. They may have come back after treatment. In these cases, special medicines that kill cancer cells may be put right inside the bladder. This is called intravesical therapy. It may be a choice if you have a hard-to-remove tumor. Or it may be done after surgery to help keep the cancer from coming back.

Medicine inside your bladder

Intravesical therapy is often done in a healthcare provider’s office or outpatient clinic. A flexible tube (catheter) is passed through the urethra and into the bladder. The catheter is used to fill the bladder with a liquid medicine. This may be a liquid chemotherapy medicine. It kills cancer cells. Or it may be BCG (Bacillus of Calmette and Guerin). This is a type of bacteria that helps boost your body’s immune system so that it kills the cancer cells.

During treatment

You will need to hold the medicine in your bladder for 2 hours. In some cases, the catheter may be left in and the medicine is removed through it when treatment is done. In other cases, the catheter is taken out after the medicine is put in. Then you will urinate after the 2 hours are over. If BCG is used, you may need to pour bleach in the toilet after you urinate. This kills bacteria that may be left over. Intravesical therapy is given weekly for 6 to 8 weeks. During this time, you may be given antibiotics. This is to help prevent infection. It will depend on the medicine that is used for you. 

After treatment

After your initial BCG treatment, you may need to have follow-up treatments for up to a year or more. This is called maintenance BCG. These help keep the cancer from coming back. When all the treatments are done, you may have tests done every few months to help check for cancer cells.

Risks and possible complications

Be aware of the following:

  • Bladder infection

  • Blood in the urine

  • Bladder irritation (burning, need to urinate often, pain on urination)

  • Changes in your blood cell counts (with certain chemotherapy medicines)

  • Scarring of the bladder (rare)

  • General infection (with BCG) (very rare)

Call your healthcare provider right away if you develop a fever of 100.4°F (38°C) or higher. Be sure you know what other problems you should watch for, and know how to get help any time, including after office hours, on weekends, and on holidays. 


March 21, 2017


NCCN Guidelines Bladder Cancer Version 2.2015. National Comprehensive Cancer Network

Reviewed By:  

Image reviewed by StayWell medical illustration team.,Levin, Mark, MD,Stump-Sutliff, Kim, RN, MSN, AOCNS