Mitomycin Bladder Instillation (201kB pdf)
Introduction
We hope this guide will answer your questions about Mitomycin. Please contact the team if you require further information via the details at the end of this leaflet.
What is Mitomycin?
Mitomycin is an Anti-Cancer drug, sometimes referred to as chemotherapy. It is used to treat many types of cancer, but is commonly used for superficial bladder cancer. It works by damaging the DNA of the cancer cells directly preventing them from dividing and growing. It is administered through a thin catheter directly into the bladder – this is called ‘Intravesical’ therapy or treatment – and it is left inside the bladder for between 1 to 2 hours.
The procedure itself will be explained in more detail when you arrive but in terms of preparation the following information will be useful to you:
- You should limit your fluid intake starting the night before your planned treatment, and should have NO fluids for 4 hours immediately prior to your treatment time. This is to enable you to hold your urine longer reducing the risk of you needing to pass urine too soon whilst the drug is in your bladder, and reduce the amount of urine your body produces whilst having treatment
- If you take diuretics (water tablets) please let your CNS know, but you should not take your medication on the day of treatment – you can restart after the two hours post treatment.
- Once the treatment has been instilled you should not drink for 2 hours after
- You can have a light breakfast before your treatment if you wish, and although you cannot drink immediately after for 2 hours, you can have something light to eat
How does Mitomycin work?
Mitomycin inhibits DNA synthesis by producing DNA Cross-Links that reduces tissue cell ability to divide and replicate, leading to cell death.
As cancer cells generally divide quicker than normal cells, with less error correcting ability, cancer cells are more susceptible to this type of treatment. The damage caused to the cell halts or slows the growth of cancer cells in your body.
Mitomycin is administered once a week for six weeks. Depending on the follow-up cystoscopy, the regime may need to be repeated but your consultant or CNS will be able to advise you on this.
What happens on day of treatment?
When you arrive for your treatment you will be asked to provide a sample of urine to test before giving the Mitomycin (if you have not already brought one with you), and asked to empty your bladder. Please note that we will not be able to administer the Mitomycin if you have a lot of blood in your urine or there are any signs of a UTI.
If there is a suspicion that you may have an infection then you will be given some anti biotics and rebooked to return the following week. Assuming that there is no infection, you will then go on to have your treatment.
For your very first Mitomycin treatment you will be asked to stay within the unit for two hours after the instillation. This is to ensure that you do not react to the Mitomycin drug itself, and to allow you to understand what it feels like to hold the Mitomycin in your bladder for two hours.
For the treatment you will then be asked to lay flat on a couch and to remove the bottom half of your clothes. Your genital area will be cleansed with a sterile solution. In some cases, some lubricating/ local anaesthetic gel may be instilled in to your urethra (water pipe), before passing a fine flexible tube (called a catheter) through the urethra into the bladder. Any remaining urine will be drained and the Mitomycin will then be instilled through the catheter (this is a liquid solution of about 50ml).
Unless this is your first treatment you will be able to go home after. Ideally you should hold the Mitomycin solution in your bladder for a maximum of 2 hours to ensure the most beneficial effect.
A further clinic appointment will be made for you before you leave the department.
Are there any side-effects?
Mitomycin can affect healthy cells as well as cancerous cells, and does affect the body as a whole.
However, side effects of the drug are not unlike many other medications.
Side-effects of Mitomycin affect between 1% & 10% of patients and most common are;
- Inflammation of the bladder lining causing soreness or pain in the bladder area
- Frequency and/ or urgency
- Blood in urine
- Allergic reaction, skin irritation, rash or itchiness
- General tiredness/ lack of energy
Some patients may experience one or more of these, and some effects can last for a few days. Before each treatment you will be asked how you have been since the last, and any persistent or significant side effects will be discussed with your CNS before continuing with the treatment.
What happens afterwards?
2 hours after the instillation you can start to drink again. You should drink plenty of water based fluids to help flush through – between 1lt-1.5lt per day – rather than (and in addition too) just tea or coffee.
When passing urine within the first six hours after you have been treated, you should put two cups of bleach into the toilet bowl after you have passed urine and leave it for 15 minutes before flushing the toilet.
Once flushed you should then put two cups of bleach into the toilet bowl and leave this until you use the toilet again. Sit down whilst passing urine as this will lessen the chance of splashing which may cause skin irritation.
Wash your hand with soap and water after passing urine.
Contacting the team
If you have any further questions, please contact the Urology Booking Team on:
Telephone – 01279 962391 or 01279 952807
Office hours: 09:00 to 16:00
There is an answerphone available outside of these hours. Please leave a message and a member of the team will contact you.
If you would like this leaflet in another language or format, or you would like to give feedback on your care, please contact our patient experience team on [email protected]