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Treating Bladder Cancer:

Adriamycin Intravesical Therapy

Risks and Possible Complications

  • Bladder infection

  • Bladder irritation (burning, need to urinate frequently, pain on urination)

  • Changes in your blood cell counts (with certain chemotherapy drugs)

  • Scarring of the bladder (rare)

Certain types of bladder tumors are hard to remove using surgical procedures like transurethral resection (TUR). These include tumors that are high grade, occur in more than one area, are flat against the bladder wall, or come back after treatment. In these cases, special medications that destroy cancer cells may be placed into the bladder. This treatment is called intravesical therapy. Intravesical therapy may be an option if you have a hard-to-remove tumor. It may also be done after TUR to help keep the cancer from coming back.

Images of patient undergoing procedure and cutaway view of bladder

Prior to Treatment

For best effect of the medication, it is recommended that the medication be instilled into an empty bladder and remain in contact with the bladder lining for 50 minutes. Please limit fluid intake 8-12 hours prior to instillation and hold all fluids for 4 hours prior to instillation. Please notify us if you are have any symptoms or side effects, or, are being treated for another illness elsewhere.

You will need to give a urine sample prior to each instillation to test for infection. If this test is positive or you are reporting fever, blood in urine or severe irritative symptoms, treatment may be delayed.

How Adriamycin is Administered

Adriamycin is a red powder reconstituted in 50cc of sterile water. You will need to undress from the waist down and cover with a sheet. You will lie on your back on an exam table. After skin preparation, a urethral catheter is gently placed into the urethra(urine tube) and all urine is drained. A medication filled syringe is attached to the catheter and the solution is gently instilled via the same catheter and then the catheter is removed. The catherization and instillation only takes a few minutes. Then you will dress and be able to go home. You are asked to hold the medication in your bladder for up to 50 minutes. Your treatments will be scheduled as either a one time instillation or weekly instillations for 3 or 6 weeks.

After Treatment

Avoid direct skin contact during and after urination to prevent skin rash and irritation. Sit while urinating and thoroughly cleanse genital area and hands after urination. Flush the bladder thoroughly by increasing fluid consumption after the first urination.

Adriamycin treatments are generally well tolerated. The primary side effect is irriation of the bladder. Bladder irritation may mean you need to void more frequently and/or have pain with urination. If this symptom is severe, you next treatment may be delayed or you may be asked to take a  medication  to control this symptom.. Skin irritation may occur if drug comes in direct contact with your skin after the 1st void after the instillation. To prevent, rinse the genital area. Always wash your hands well with soap and warm water after urinating.


Signs of an infection (rare) such as fever(over 100 degrees), chills, cough, sore throat, redness, pain or swelling of any part of your body, sores formin on any part of your body.

Sexual Activity

  It is recommended that a condom be used for the first 48 hours after the instillation. urinationsexual  It is recommended to use birth control while being treated. Tell your doctor if you or your partner becomes pregnant during treatment. It is recommended to use a condom for the duration of therapy (3 or 6 weeks) and for 6 weeks following completed therapy.

Follow Up Care

After your weekly treatments, you may be given regular follow-up treatments for up to a year or more. These follow-up treatments help keep the cancer from coming back. After the treatments are over, cystoscopy and urine cytology may be done every 3 months or so to help check for cancer cells.

© 2000-2020 The StayWell Company, LLC. 800 Township Line Road, Yardley, PA 19067. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.