Treatment for advanced bladder cancer can slow the spread of cancer cells in your body and improve your quality of life. They can also cause side effects. Sometimes, these overlap with the symptoms caused by bladder cancer. Or they could be new and different.
Here are some side effects you may have, and steps you can take to manage them.
Fatigue
Feeling bone-tired is a very common side effect. That's because many treatments that are able to kill cancer cells can also damage healthy cells in your body.
You might feel tired after a good night's rest, or feel rundown when you wake from a nap. If you're like many people, midafternoon may be when your energy drops to its lowest point.
The kind of treatment you have can affect how long your fatigue lasts.
- Chemotherapy causes fatigue that lasts a few days.
- Radiation therapy causes fatigue that gets worse over time. It can last two to three months after you stop treatment.
- Immunotherapy (drugs that use your immune system to attack cancer cells) can lead to fatigue that may last up to a year.
What can help:
Take time to rest. Short naps throughout the day might help more than one long nap.
Get moving. Physical activity, like taking a walk or riding your bike, could help you recharge and build up more stamina.
Try mind-body therapies. Gentle, low-impact workouts like yoga, qi gong, and tai chi can also help reduce fatigue, as well as stress. Ask your doctor if they're safe for you to try.
Weight Loss
Treatments for advanced bladder cancer, such as chemotherapy, radiation, and surgery, can cause you to lose weight. This can happen for a few reasons. Some medications change how foods taste. Others upset your stomach or cause diarrhea. You could also be dehydrated (don't have enough fluids in your body).
Losing weight quickly takes away your lean muscle mass, which you need to stay strong.
Even without weighing yourself on a scale, you could notice:
- Clothes and jewelry that are loose
- Frequent thirst
- Less strength than usual
- Low energy
- Feeling dizzy
- Weakness
What can help:
Eat often. Don't worry about waiting for meal times.
Opt for high-protein, high-calorie foods. For instance, eat trail mix, peanut butter, hard-boiled eggs, and cheese.
Get enough to drink. Smoothies and milkshakes provide needed calories and can keep you hydrated.
Nausea/Vomiting
Feeling sick to your stomach or throwing up can happen before, during, or after treatment. Managing nausea is important. If you don't, you could get dehydrated or the electrolytes (minerals) in your body could get out of balance. These can then cause other health problems.
Before you start treatment for advanced bladder cancer, your doctor will give you medication to settle your stomach and explain when and how to take it. You can take some steps on your own, too.
What can help:
Watch what you eat. Choose cold foods, like yogurt or ice pops, or bland foods that are easy on your stomach like rice, pretzels, or plain pasta. Skip greasy, sugary, spicy, or fried foods.
Eat smaller, more frequent meals. After you eat, try to rest, in an upright position, for at least half an hour.
Use relaxation techniques. These can include deep breathing, listening to calming music, or meditation.
Issues With Sex
Treatments you have for advanced bladder cancer can change parts of your body that help you have and enjoy sex. Based on whether you have radiation, chemotherapy, or surgery to remove your bladder, side effects can include:
- A narrowed or shortened vagina
- Vaginal dryness
- Being unable to get an erect (hard) penis
- Being unable to ejaculate (release semen from your penis)
- Early menopause
- Negative body image
- Low self-esteem
- Reduced desire to have sex
What can help:
Ask your doctor about options. They can prescribe medications, creams, gels, and even implants that can improve your sex life.
Talk to your partner. Being open about what you're going through can help them know how to support you.
Join a support group. Talking about your sex life can feel awkward at first, but you may feel better hearing how others manage the same issues.
Bladder Problems
Radiation can irritate the lining of your bladder. This can cause:
- Peeing more than usual
- Urgency (feeling like you need to pee right away)
- Burning or pain when you pee
- Blood in your pee
- Trouble starting to pee
- Feeling like you aren't able to get all the pee out
- Peeing when you sneeze or cough
- Cramps or pelvic (low belly) pain
After surgery for advanced bladder cancer, you might:
- Have trouble getting out all your pee
- Leak pee
Chemotherapy damages certain cells in your bladder. That can raise your risk of a urinary tract infection (UTI). Symptoms of a UTI include:
- Cloudy or red pee
- A fever of 100.5 F or higher
- Back pain
- Belly pain
- Trouble trying to pee
- Burning when you pee
What can help:
Drink lots of fluids. Your pee should be light yellow or clear.
Avoid alcohol, caffeine, and spicy foods. They can worsen your side effects.
Tell your doctor if you think you have a UTI. It can quickly turn into a serious bacterial infection that needs urgent care.
Infections
Some treatments for advanced bladder cancer make you more likely to get sick. That's because your immune system isn't working as well as usual.
The signs that you have an infection include:
- A fever
- Chills
- Sweating
- Coughing
- Trouble breathing
- Feeling dizzy or light-headed
- Sore throat
- Patches
- Sores in your mouth
- Skin issues, like redness, swelling, or itchy skin
What can help:
Clean your hands often. If you don't have soap and water, use hand sanitizer. Ask people around you to do the same.
Wear a mask when you're around sick people. This can help reduce your chances of catching germs.
Buy a thermometer. Ask your doctor how often to check your temperature and what to do if you run a fever.
Shortness of Breath
Doctors call this dyspnea, and it can have many causes. Sometimes it happens when you don't have enough oxygen in your body, or it can be a side effect of advanced bladder cancer treatment.
Sometimes, it comes on very fast, which can feel scary.
Signs include:
- Finding it hard to breathe when you eat, talk, lie down, or are active
- Fast breathing
- Fast-beating heart
- Cold, clammy (moist) skin
- Wheezing
- Flared nostrils when you take a breath
What can help:
Prop yourself up. If you're lying down, sit up or put an extra pillow behind your head.
Try pursed-lip breathing. Deeply breathe in through your nose. Then breathe out through pursed lips for twice as long.
Know when to call 911. Trouble speaking, feeling dizzy, chest pain, and blueish skin or nails are signs you need help right away.
Pain
Nearly half of people being treated for any type of cancer, including advanced bladder cancer, have some kind of pain. You could have:
- Acute pain, which is mild or severe short-term pain
- Breakthrough pain, which comes on very quickly and can be intense
- Chronic pain, which can last for months or even years
- Phantom pain, where you feel pain in a part of your body where something, like your bladder, was removed
- Referred pain is when one part of your body hurts because of cancer cells somewhere else.
What can help:
Don't "power through." Ongoing pain can affect your quality of life. It can also cause other issues, like anxiety or depression.
Take pain medication exactly as prescribed. That can lower your risk of addiction.
Talk to your doctor about alternative therapies. For instance, acupuncture or hypnosis may give you some relief.
When to Call Your Doctor
Let your team know about all the side effects you have, even if you find them embarrassing.
Your doctor has lots of tips and tools to manage these side effects. In some cases, they may decide to change how they treat your advanced bladder cancer.
Show Sources
Photo Credit: E+/Getty Images
SOURCES:
Joaquim Bellmunt, MD, PhD, director, Bladder Cancer Center, Dana-Farber Cancer Institute, Boston.
Ashish Kamat, MD, MBBS, president, International Bladder Cancer Group (IBCG); professor of urologic oncology (surgery); Wayne B. Duddlesten professor of cancer research; director, Bladder Cancer Research; director, Patient Support Center, University of Texas MD Anderson Cancer Center Department of Urology, Houston.
National Cancer Institute: "Urinary and Bladder Problems," "Nausea and Vomiting and Cancer Treatment."
Mayo Clinic: "Cancer fatigue: Why it occurs and how to cope."
American Cancer Society: "Managing Infections and Sepsis in People With Cancer," "Weight Changes," "Shortness of Breath."
CDC: "Clean Your Hands."
Memorial Sloan Kettering Cancer Center: "8 Tips for Managing Weight During and After Cancer Treatment."
Cleveland Clinic: "Cancer Pain," "Cancer Fatigue."
Cancer Research UK: "Sex and relationships after bladder cancer treatment."
MD Anderson Cancer Center: "Chemotherapy Treatment Side Effects."
