If the cancer has spread outside the bladder, or comes back after the initial treatment, the main treatment is chemotherapy given into a vein. Chemotherapy given in this situation is known as palliative chemotherapy and the aim is to control the tumour and give a good quality of life.
Many people are frightened about having chemotherapy because of the possible side effects. The side effects are discussed in the previous section. Although chemotherapy can cause side effects, these can usually be well controlled with medicines. However, chemotherapy is still a treatment that people would prefer to avoid if they could, and when their doctor suggests chemotherapy, some people ask what would happen if they didn't have it.
Palliative chemotherapy aims to try and slow the growth of the cancer or shrink a tumour, to improve symptoms, keep up a good quality of life and to prolong life if possible. Unfortunately in this situation the chance of a cure is only possible in a small minority of people. Making decisions about treatment in these circumstances is always difficult.
Some people will have good control and shrinkage of the cancer, leading to fewer symptoms, a better quality of life and often a slightly longer life. For other people the chemotherapy may not have any effect on the cancer and the person will therefore have the side effects of the treatment without any benefit. If a person is fairly well, they are more likely to benefit from the chemotherapy and less likely to have side effects.
Despite the limitations of chemotherapy in this situation, some people find that it helps them to feel better and it may slightly increase their length of life. If you have been offered chemotherapy, it is helpful to discuss with your doctor the advantages and disadvantages in your particular situation.
If you decide not to have chemotherapy, there are other medicines and ways of controlling any symptoms of the cancer, and your doctors will discuss these with you.
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