Radiation therapy is often used in bladder cancer treatment to destroy cancer cells.  Often used as an adjuvant therapy after a surgery to destroy small deposits of cancer cells that may still remain.  Some patients prefer a treatment of radiation therapy and chemotherapy to avoid otherwise invasive surgeries (including cystectomy, the removal of the bladder). 

There are two main types of radiation therapy used in bladder cancer treatment.  The type of radiation used for treatment is dependent on the type and location of the cancer:

External Radiation Therapy

In external radiation therapy, the doctor will conduct a review of the patient's medical history and test results.  Afterward, the doctor will determine the area to receive the radiation therapy.  When the doctor determines the amount of radiation and how it will be given, treatment begins.  In most cases, radiation is not capable of destroying a tumor within one session.  Therefore, external radiation is usually given in fractions, most often on a daily basis, five days a week for 5 to 8 weeks.  The amount of therapy a patient undergoes is dependent on the size, location, and type of the cancer as well as the specifications of the patient.

Procedure

The procedure of external radiation therapy is painless, much like a normal x-ray.  The patient is often require to undress and lie on the treatment table near the radiation machine, called a linear accelerator.  Before the treatment begins, the doctor may place shields between the radiation and healthy tissue, as to avoid unnecessary damage.  During the treatment, the doctor will enter another room and begin operating the machine.  The patient is advised to remain still and breathe normally as the machine begins to aim radiation on the targeted area.

There are a number of new machines that allow doctors to shape the radiation to match the tumor.  Additionally, there are newer forms of radiation that do not damage normal tissue as much.  In three-dimensional conformal radiation therapy (3D-CRT), shaped beams are directed at the targeted area from different angles.  Intensity modulated radiation therapy is much like the 3D-CRT, as it conforms to the tumor shape.  It also, however, allows for changes of the strength of the radiation. 

Side Effects and Risks

External radiation therapy is relatively safe, but may procure certain side effects and risks.  The most common side effects are fatigue and changes in the skin.  These side effects typically subside within a week after treatment.  Other side effects include diarrhea, hair loss, and mouth problems. 

Internal Radiation Therapy

Also known as brachytherapy, internal radiation therapy consists of inserting an implant of a radiation source into the bladder.  The proximity to the bladder allows the radiation to reach the tumor without unnecessarily damaging too many normal, healthy cells.  There are two main types of internal radiation therapy commonly used in bladder cancer treatment: intracavitary radiation and interstitial radiation.  In intracavity radiation, the radioactive material is placed inside a space in the body.  In interstitial radiation, the radioactive implant is placed in or near the cancer.

Procedure

The procedure for placing implants in the body is done through a catheter.  The patient receives anesthesia, which may be general or local.  The doctor uses an MRI or x-ray to pinpoint where to insert the implant.  During the actual treatment, the implants are placed through the catheter.  Some implants may be left in for a few minutes, while others may be permanent, depending on the type of bladder cancer.

After the procedure, discomfort may linger in the affected area.  Otherwise, patients are usually capable of returning to normal activities within a day.

Side Effects and Risks

The side effects of internal radiation therapy are similar to that of external radiation therapy.  As there is general anesthesia involved, there are risks and side effects associated with the anesthesia.  During the therapy, the patient may feel significant amount of pain and sickness.  Other common side effects include changes in the skin, nausea, fatigue, diarrhea, and bladder symptoms such as painful urination. 

The side effects of radiation therapy are relatively harmless and temporary.  However, the long-term problems associated with radiation therapy may prove to be more harmful.  A discussion with the doctor can determine what type of radiation therapy to choose, if any at all, and the amount required to cure bladder cancer.  While radiation therapy is generally used with another type of treatment, it can prove to be a relatively harmless but effective bladder cancer treatment.