Intravesical treatment using Mitomycin C chemotherapy

This treatment involves putting chemotherapy through a catheter into your bladder. The chemotherapy is called Mitomycin C.

If you choose not to have this treatment your urology doctor will discuss alternatives for you. Going without treatment could pose a serious risk to your life.

The most likely alternative treatment would be to continue with bladder surveillance. This means that you will have regular cystoscopies so we can monitor your bladder cancer. A cystoscopy is a tube which has a light and a tiny camera on the end. We use it to look inside your bladder.  

If your cancer grows or spreads, we may offer you the following treatments: 

• Other intravesical treatments 
• Radiotherapy 
• Surgery to remove your bladder.  

Please ask your CNS or doctor if you would like more information about these treatments.

We want to involve you in all the decisions about your care and treatment. If you choose to have intravesical chemotherapy, by law we must ask you to sign a consent form before you have it. This confirms that you agree to have the treatment and understand what it involves. Staff will explain the risks, benefits and alternatives before you sign a consent form. If you are unsure about having the treatment, please tell your hospital doctor or CNS.

Side effects usually start within three to four hours after treatment and last up to 24 hours. Tell your CNS or doctor if you have severe pain during or immediately after your treatment. Common side effects include:

• Cystitis. You might feel pain or a burning feeling when you pee, need to pee more often than usual, or see blood in your urine. Don’t worry if this happens as it is normal. It helps to drink plenty of fluids. Contact your GP if you have these symptoms for more than three days.
• Rashes on your hands, feet or genitals. To stop this happening, wash your hands and genitals thoroughly with soap and water after peeing.
• Body rash. This happens very rarely.
• Fatigue. How long it lasts varies from person to person.

If you develop any of the following symptoms, immediately go to your local Emergency department (A&E):

• Shortness of breath
• Difficulty breathing
• Face swelling
• Severe tummy pain
• Unable to pass any urine.

• Drink 1 to 2 litres of fluid, each day for the first couple of days after your treatment. This keeps your urine diluted which will make your recovery more comfortable. It also reduces the chances of developing a urinary tract infection.  
• Avoid caffeinated drinks such as tea, coffee, fizzy drinks and alcohol as these can irritate your bladder. 
• For up to six hours after your treatment, your urine may contain small traces of chemotherapy. So, it’s important to take some simple precautions during this time: 
  • We recommend that both men and women sit down when using the toilet as this reduces the risk of spills or splashes.  
  • For the first six hours after each treatment, flush the toilet twice with the lid down each time you use it. 
  • Wash your hands and genitals thoroughly with soap and water after you pee. 
• Take paracetamol or ibuprofen to cope with bladder pain or discomfort. Please always read the instructions for use.
• Avoid sex or use a condom for 48 hours following each treatment.

Research shows that smoking can cause bladder cancer recurrence. Speak to your CNS if you need support to stop smoking. Or visit nhs.uk/live-well/quit-smoking

You’ll have the treatment, once a week for six weeks. Treatment plans may vary between hospitals, but all follow expert guidelines and the best research evidence.

You will have a cystoscopy every three to six months after the course of treatment. We use it to see the inside your bladder and urethra. You will usually have a flexible cystoscopy under local anaesthetic. You have regular cystoscopies to monitor your bladder and check that there is no cancer recurrence. Contact your team if you don’t get your cystoscopy appointment.

Action on Bladder Cancer (ABC-UK)
0300 302 0085
ABC is a UK charity made up of healthcare professionals and patients. They are dedicated to improving the lives of people with bladder cancer and raising awareness of it. 

British Association of Urological Surgeons (BAUS)
BAUS is a charity which promotes high standards in urology for patients. They have a range of information for patients about tests and treatments.

Fight Bladder Cancer
01844 351 621
Fight Bladder Cancer is a UK charity founded and run by bladder cancer patients and their families.

Macmillan Cancer Support
0808 808 0000 (7 days a week, 8am to 8pm)
Provides clear information, emotional support, and practical advice.

The Urology Foundation (TUF)
TUF is a UK charity that helps improve urological health and care. They offer clear information about bladder cancer symptoms, tests, and treatments. They also offer advice on life after cancer treatment.