Radiotherapy for bladder cancer

If your bladder cancer has not spread outside of the bladder, radiotherapy may be an option for you. Your treatment will consist of 25 radiation sessions. Depending on the location of the tumor and your overall health, we will either deliver radiation to your entire bladder, or a part of the bladder. Your radiotherapy can be combined with chemotherapy. This is called chemoradiation. The chemotherapy will consist of two types of drugs.

If only a part of your bladder is receiving the treatment, we can use lipiodol as a marker. This liquid will be administered into the bladder a few days before your preparatory CT scans.

If your bladder cancer has advanced or spread throughout the body, your treatment will be adjusted accordingly. If you are experiencing pain, bleeding, or problems with urination as a result of the cancer, the treatment will aim to alleviate these symptoms. The treatment can shrink the tumor, or halt its growth. This is called a palliative treatment, and will consist of 1 to 13 radiation sessions. Your practicing physician can give you more information about your options and the expected results of the treatment.

The latest techniques and advanced technology

Our Radiation Oncology Department is constantly working on the development of new techniques using the most advanced technology currently available - both in diagnostic imaging, preparation, and radiation itself. This allows us to deliver the most effective treatment possible to you, while sparing as much healthy tissue as possible.

Consultation with your radiation oncologist

You will meet with your radiation oncologist to discuss your situation and the treatment that best fits you, its goal, expected outcome preparation, execution, and side effects.

Multidisciplinary team meeting

Your situation, test results and medical history will be discussed in a multidisciplinary team meeting consisting of specialists such as gastroenterologists, surgeons, and radiation oncologist, in order to find the treatment that best fits you. Your radiation oncologist will discuss the results with you.

Research

We are constantly working to improve and develop radiation treatment through research. if your radiation oncologist knows of a trial that you may qualify for, he or she will let you know. You will receive more information to make an informed decision. Your participation is voluntary. if you decide not to participate, you will be treated according to the latest protocols and developments.

Preparation

We will make a CT as a preparation for the treatment. You will be taking the same position you would during radiation treatment: on your back. We may administer an iv for a contrast solution. You will receive instructions on how to fill your bladder. Your radiation therapist will project laser lines on the skin around your pelvic area. You will receive small tattooed dots on these lines in order to deliver the radiation to the same spots during your next session. You will receive special instructions for filling your bladder. The specific will depend on whether we will deliver radiation to the entire bladder, or a part of it.

We will provide information about the treatment during your preparatory consultation. There will be plenty of room to ask questions.

Radiation treatment planning

Your radiation therapist will draw the placement of the radiation field on the CT and MRI scans. He or she will calculate the optimal external beam radiation using special software: the radiation treatment plan. It is important to ensure that the field receives the correct dose and that the surrounding tissue is spared as much as possible.

Radiation delivery

Radiation therapy lab technicians will ensure that you are positioned correctly on the table. The beams on your body will overlap with the tattooed dots on your hips and abdomen.

We will often check whether your position is still correct by using a CT scanner attached to the machine. This allows us to make small adjustments to your position in order to ensure that the radiation matches the tumor shape as closely as possible. The lab technicians will follow the treatment on monitors.

The delivery of the radiation itself will take a few minutes. The total time of the treatment will be approximately 15 minutes. The beams won’t hurt, although you will start to notice the effects of the radiation.

Check-ups with your radiation therapist

During your treatment you will regularly meet with your radiation therapist to discuss the progress and to ask any questions you may have. Your radiation therapist will offer advice on how to deal with the side effects you are experiencing and prescribe medication if needed. You will also hear about the next step after your treatment.

Side-effects

The side-effects you will experience depend on your personal situation, overall shape and health, and the area that is receiving the treatment. Your practicing physician will discuss which side-effects you can expect with you.

You may experience different bladder problems than you had before during the treatment. You may also experience bowel issues and fatigue.

You may notice the acute side-effects after two or three weeks of treatment. These will increase in severity over the course of your treatment and may linger for months after its end. Some side-effects may be permanent. Your practicing physician can tell you which side-effects you can expect.

What you can do

If your symptoms, situation, and overall health allow, we recommend daily exercise to improve your recovery. You could consider walking or biking, or exercise under the supervision of a physical therapist. We also recommend continuing your day to day activities as much as possible.

General nutritional guidelines apply during treatment.

Please consult your practicing physician if you wish to continue taking additional vitamins or supplements during your treatment.

Follow-up care

If you would like extra care during or after your treatment, please ask your radiation therapist or physician assistant to the NKI Survivorship Center. Our physical therapists, occupational therapists, social workers, and psychologists are experienced in care for cancer patients and would love to offer additional support during and after your treatment.