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Biologic Therapy

Biologic therapy, also called immunotherapy, is a treatment that uses drugs to improve the way your body’s immune system fights disease. Your immune system is your body’s natural defense against disease. A healthy and strong immune system can detect the difference between healthy cells and cancer cells. Biologic therapy attempts to repair, stimulate, or enhance the immune system so that it can fight the cancer more effectively. These therapies can also be used to reduce the side effects that may be caused by some cancer treatments.

Biologic therapy for bladder cancer involves instilling a liquid containing Bacille Callmette-Guérin into the bladder. This liquid is a live, weakened form of the bacteria that causes tuberculosis. The bacteria seem to provoke the body’s immune system, increasing its ability to kill the cancer cells that are in the bladder.

The bacteria solution is placed into the bladder through a catheter tube inserted through the urethra and into the bladder. After the solution is in the bladder, you’ll be asked to hold it in the bladder for about two hours. These treatments usually occur once a week for six weeks. Some people require a second six-week cycle of treatments to achieve full benefit.

Biologic therapy for bladder cancer is effective against superficial bladder cancer.

This form of biologic therapy used to treat bladder cancer may cause the following symptoms:

  • Flu-like symptoms such as achiness and fatigue
  • Fever, chills
  • Nausea
  • Urinary symptoms:
    • Frequent need to urinate
    • Urgent need to urinate
    • Pain/burning with urination
    • Bloody urine
  • Rare tuberculosis-like severe infection

Call your doctor if you experience the following symptoms:

  • Cough
  • Rash
  • Severe or persistent fever and chills
  • Severe pain

In photodynamic therapy (PDT), photosensitizers, or light-sensitive molecules, are injected into the bloodstream and absorbed by cells throughout the body. These agents remain in cancer cells longer than in normal cells. A cystoscope is then inserted through the urethra into your bladder, where it shines a red laser light onto the tumor. When the cancer cells are exposed to laser light, the photosensitizers are activated and cause cell damage and death.

Photodynamic therapy is only effective against very superficial forms of bladder cancer. Its effects do not penetrate to deeper areas of the bladder.

Photodynamic therapy may cause the following side effects:

  • Severe photosensitivity, which is a greatly increased tendency to sunburn due to the chemicals used
  • Flu-like symptoms such as achiness and fatigue
  • Fever, chills
  • Nausea
  • Urinary symptoms:
    • Frequent need to urinate
    • Urgent need to urinate
    • Pain/burning with urination
    • Blood urine

Because photodynamic therapy makes you more sensitive to sunlight, check with your doctor regarding appropriate sun precautions. You should avoid being outside during the sunniest times of day, which is about 10 in the morning until late afternoon. If you do have to go outside, always use a sun block with an SPF of at least 30. Also, wear protective clothing and a wide-brimmed hat.

Call your doctor if you experience the following symptoms:

  • High fever
  • Severe pain
  • Serious sunburn
References:

Bladder cancer. American Cancer Society website. Available at: http://www.cancer.org/cancer/bladdercancer/. Accessed June 5, 2013.

Bladder cancer. Urology Care Foundation website. Available at: http://www.urologyhealth.org/urology/index.cfm?article=100. Updated March 2013. Accessed June 5, 2013.

What you need to know about bladder cancer. National Cancer Institute website. Available at http://www.cancer.gov/cancerinfo/wyntk/bladder. Updated August 30, 2010. Accessed June 5, 2013.

Last reviewed June 2013 by Mohei Abouzied, MD; Michael Woods, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


 
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