If you have metastatic bladder cancer, when the disease has spread to other parts of your body, you’ve probably already tried other treatments. If they haven’t worked, you still have options, including immunotherapy.
These medicines can spur your body's immune system to identify and destroy cancer cells. The FDA has approved three of these drugs for advanced, or metastatic, bladder cancer: atezolizumab (Tecentriq), enfortumab vedotin-ejfv (Padcev), and nivolumab (Opdivo).
You’ll need to talk carefully with your doctor to decide if this option really is a good choice for your disease.
Making Your Decision
Your doctor will think about a few things before she recommends immunotherapy for you:
- The type of cancer you have. Atezolizumab, nivolumab, and padcev (newly approved) are for urothelial carcinoma, which is the most common type of bladder cancer.
- How far the disease has spread in your body, called the stage of your cancer
- The chances your disease will come back
- The size and number of tumors
- Other treatments you’ve already tried
When making your decision, ask your doctor a few questions to get a better idea of the role immunotherapy might play in your overall treatment plan, such as:
- Why are you recommending immunotherapy for me?
- Will immunotherapy be the only treatment I get right now? How does it work with other types of bladder cancer treatment?
- How will it help me?
- What kind of side effects should I expect?
- How long will the treatment last? What is the process like?
A Few Things to Keep in Mind
To get treatment with immunotherapy, you’ll go to a treatment center every 2 or 3 weeks to get the medicine through an infusion, a tube that goes into a vein. Your doctor will decide how many rounds of treatment you need.
While immunotherapy helps your body to recognize cancer cells, there's also a chance that it may cause your immune system to work against normal, healthy cells. That can cause serious problems with your lungs, intestines, kidneys, and other organs. Make sure to tell your doctor if you’re having side effects, including fever, that don’t go away. They could be signs of a more serious infection.
Immunotherapy usually causes side effects. You might feel very tired, have discomfort or burning in your bladder, need to pee often, have flu-like symptoms such as chills and fever, or in rare cases, an infection. If you're concerned about a symptom, call your care team right away. They're there to help make your treatment as safe, effective, and comfortable as possible.