What Happens During Immunotherapy for Bladder Cancer

Immunotherapy is sometimes used to make the body's own immune system fight cancer.

The most common way to give immunotherapy for bladder cancer is intravesically. That means the drugs are placed directly into your bladder instead of injected into your blood or taken as pills. Early-stage bladder cancer can often be successfully treated with the drug BCG (bacillus Calmette-Guerin). The doctor puts BCG directly into your bladder by inserting it through a catheter in your urethra. Your body’s immune system responds to the presence of BCG, and the bladder cancer cells are destroyed.

You go to your doctor’s office to have intravesical immunotherapy. For the 8 to 12 hours before the treatment, you should drink only a small amount of water. In the last 4 hours before the treatment, you should drink no water. Your bladder needs to be almost completely emptied for BCG to work.

Your doctor inserts a catheter through your urethra into your bladder. This usually isn’t painful, although you will feel some discomfort when the catheter goes through the urethra. Then your doctor injects the drug into the catheter.

You must not urinate for 1 to 2 hours after the drugs are put into your bladder. This allows the drugs to stay in your bladder long enough to kill cancer cells. After you urinate, the drugs will come out of the bladder in your urine.

Your doctor will ask you to drink a lot of water starting about 2 hours after the procedure. This will dilute the drug that remains in your bladder and reduce bladder irritation, fever, and other potential side effects.

You usually have 6 weekly treatments. Some doctors recommend repeat treatment at 3- to 6-month intervals.