Intravenous treatments involve instilling the active drug directly into the bladder using a vesical catheter. The drug is therefore active directly on the bladder wall that it bathes, compared to oral or intravenous administration.
The treatment is mainly active on the bladder lining with which it comes into contact, in an attempt to limit the major and undesirable effects that may occur in other parts of the body.
When is the use of intravenous therapy indicated?
Intravenous instillation treatments are used after trans-urethral resection of a bladder tumour for superficial tumours that have not reached the bladder muscle (Ta or T1 stage).
The purpose of these instillations is to prevent the recurrence of bladder tumours.
These instillations are only useful for superficial tumours because the solution of the active drug acts only on the layers in contact with it and bathes it.
These treatments are active on tumours developed at the expense of urothelium or having eventually crossed the basal membrane and invaded the chorion but in any case, they cannot treat deeper tumours, in particular invading the muscle.
What type of intravenous therapy?
There are 2 types of intravenous therapy:
Immunotherapy stimulates the body’s immune system to fight cancer cells.
Treatments with the Bacillus of Calmette-Guérin
Calmette-Guerin Bacillus (BCG) is the primary intravenical immunotherapy treatment for early-stage bladder cancer.
BCG is a bacterium of the TB bacillus family. However, it does not usually cause significant illness.
BCG is introduced directly into the bladder using a bladder catheter.
The body’s immune system is therefore stimulated locally by BCG in the bladder, and immune cells attack bladder cancer cells.
Treatment is usually started at least 3 weeks after a trans-urethral bladder tumor resection.
The treatment schedule includes intravenous instillation every week for 6 weeks.
There is no longer any reactivation treatment after the initial phase.
Treatment with BCG can lead to undesirable symptoms such as a feeling of flu with fever, tremors, chills, fatigue.
It can also cause burns during urination.
Rarely, BCG can spread into the general circulation by causing a severe infectious problem: BCG-ite.
A warning sign is a fever that does not respond to the administration of ASPIRINE or PARACETAMOL.
In intravenous chemotherapy, chemotherapy drugs are injected directly into the bladder cavity using a bladder probe.
These chemotherapy drugs eliminate cancer cells.
These are the same drugs that are administered systemically, intravenously, to treat later stages of bladder cancer.
MITOMYCINE is the molecule usually used for intravenous chemotherapy.
Other molecules have been used: VALRUBICINE, DOCETAXEL, THIOTEPA and GEMCITABINE.
The advantage of administering this chemotherapy directly into the bladder rather than through the intravenous systemic route is that these treatments do not affect other parts of the body. The effect is only local intravenous. This saves the patient from the adverse effects of chemotherapy.