Radiation Therapy for Bladder Cancer
- External beam radiation therapy is a bladder cancer treatment that aims high doses of radiation at your bladder.
- It may be an option, along with chemotherapy, if you can’t have bladder removal surgery.
- Possible side effects of radiation therapy are skin redness, nausea, diarrhea, and fatigue.
External beam radiation therapy isn’t the main treatment for bladder cancer. But it could be part of your therapy if you don’t want surgery to remove your bladder, or if surgery isn’t an option for you. Bladder removal surgery, called cystectomy, is a major operation that has risks and side effects.Read More
“Half of our patients are above the age of 70. And many of these patients are either not good surgical candidates, or simply do not want to have surgical removal of the bladder, which is very understandable,” Dr. Arjun Balar, director of the Genitourinary Medical Oncology Program at NYU Langone Health’s Perlmutter Cancer Center, tells SurvivorNet.
“For the patients where surgical removal of the bladder is not possible, we often direct them toward radiation treatment to the bladder as an alternative,” he adds.
Other Reasons to Have Radiation
Another reason your doctor might suggest external beam radiation therapy is to shrink your tumor and make it easier to remove before surgery. Typically, radiation is part of a combination treatment strategy.
Another option is to have surgery first, to remove as much of the tumor as possible. Then you have radiation and chemotherapy to get rid of any cancer cells left behind, without removing the bladder. “That approach can actually be similar to outcomes that we have seen with surgical removal of the bladder,” Dr. Balar says.
Radiation is also a treatment for a late-stage bladder cancer. Once bladder cancer spreads, your doctor might prescribe radiation together with other treatments to slow the cancer or relieve your symptoms.
How Does External Beam Radiation Work?
External beam radiation aims high doses of radiation at your body from a machine. But before you have treatment, your doctor will carefully map out the location of your tumor. That usually involves imaging tests such as computed tomography (CT) or magnetic resonance imaging (MRI).
First you’ll have a planning session called a simulation to help your treatment team aim the radiation precisely at your tumor. You lie on a table under a simulator machine that looks just like the real radiation machine. It will help your radiation oncologist see the area being treated. The radiation oncologist will probably use a marker or tiny tattoos to map out the area where you’ll get the radiation.
The treatment itself is much like getting an x-ray, although the radiation dose is stronger. You’ll lie on a table while a machine called a linear accelerator aims radiation at the area around your bladder.
External beam radiation isn’t painful, and it only takes a few minutes per session. Most people get radiation therapy five days a week for a few weeks. Your doctor will let you know how often you’ll need to come in to the treatment center.
Possible Side Effects
Radiation is different from chemotherapy, which treats your entire body. Because radiation is aimed at a specific area, its side effects are more localized.
The most common side effects from bladder cancer radiation treatment are:
- Skin redness, blisters, and peeling
- Nausea and vomiting
- Cramps and diarrhea
- Burning when you urinate
- An urge to urinate more often
- Blood in your urine
- Low blood cell counts, which could increase your risk for infection
These side effects should go away after you finish treatment. Radiation can sometimes cause long-term problems controlling urination or having an erection (in men), but these are less common.
If you’re worried about side effects or you have them, talk to your treatment team. They can suggest treatments to help you manage these problems.
Life After Radiation
What happens next depends on what other treatments you have after radiation. You might have radical cystectomy to remove what’s left of the tumor. Or you could be finished with treatment.
You’ll usually need careful follow-up with your oncologist, especially if you had radiation instead of surgery. “By having the bladder in place, they will have to be followed for recurrence of the bladder cancer,” Dr. Dan Theodorescu, a urologic oncologist at Cedars-Sinai, tells SurvivorNet.
Your oncologist and the other members of your treatment team should talk to you about next steps. Make sure you know what treatment side effects to watch out for, and what signs of returning cancer should make you call the office.