Questions when starting a new treatment for bladder cancer

Bladder cancer refers to cancer that begins in the bladder. It is one of the more common forms of cancer. In a given year, there are an estimated 80,000 new cases, and bladder cancer accounts for 4.5 percent of all new cancer cases.

Treatment for bladder cancer will depend on a number of different factors, including the type of cancer, the stage, the tumor grade, biomarkers and immune checkpoint inhibitors, and how likely it is that the cancer will progress. It will also depend on a number of factors about the affected person, including age, medical history, and overall health.

Treatment for bladder cancer can include localized therapies that target specific tumors. These may include surgery, radiation therapy, and intravesical chemotherapy and immunotherapy, which use liquid drugs that are placed directly into the bladder. Treatment can also include systemic therapies that target cancer throughout the body, which are usually given as an infusion or taken orally. Examples include chemotherapy, immunotherapy and targeted therapy.

A treatment plan can include several different therapies: systemic medications may be used in combination with one another; an initial therapy may be followed by a maintenance therapy to prevent the cancer from progressing or coming back; a certain therapy may be discontinued due to side effects; a therapy may not work or may stop working, and you and your healthcare team may decide to continue treatment with a different therapy.

Whatever the reason for beginning a new therapy when treating bladder cancer, the questions below can help when talking with your healthcare team and making treatment decisions.

Questions about the treatment

Treating cancer is about making informed decisions and understanding both the potential risks and the potential benefits. In order to do this, you should learn about how a therapy works and what the treatment process will entail. Questions you may want to ask your healthcare team include:

• Why is this therapy recommended for the type of cancer I have?
• How does this therapy compare to other treatment options?
• How does this therapy work?
• What is the goal of this therapy?
• How is the therapy administered?
• Where will the therapy be administered?
• How often is this therapy administered?
• How long will I be on this therapy?
• Will I need additional tests or appointments?

Remember that each case of bladder cancer is somewhat unique and treatment plans are decided on a case-by-case basis. A treatment that is recommended for one person may not be recommended for you, and a treatment that is recommended for you may not be recommended for someone else.

Questions about quality of life

Understanding the potential impact a particular cancer therapy can have on your quality of life is very important when making treatment decisions. Quality of life refers to your overall physical and mental wellbeing—things like your mood, energy levels, if you are able to do the things you want to do, and many other determining factors.

In addition to the questions above, these questions can also help you understand the impact of a particular cancer therapy:

• What are the common side effects I should expect?
• Will these side effects be short term or long term?
• What can I do to ease or limit side effects?
• Is there a risk of serious side effects?
• What is the recovery time after therapy?
• How much does this therapy cost?
• Will this therapy cause any sexual side effects?
• Will this therapy affect my fertility?
• Are there foods I should avoid?
• Will I be able to work while on this therapy?

Remember that cancer is a different experience for everyone and that your healthcare team is there to help you. In addition to talking to your oncologists, it can be helpful to speak with an oncology social worker who can help you find answers to your questions, as well as work through the mental and emotional burdens of living with and treating bladder cancer.