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Managing Treatment Side Effects at Home: Practical Tips for NMIBC Patients

  • Writer: Polygon Health Team
    Polygon Health Team
  • May 13
  • 3 min read

Updated: May 14

Non-muscle invasive bladder cancer (NMIBC) treatments, particularly intravesical therapies like BCG and chemotherapy, commonly cause side effects that can affect quality of life. This guide provides evidence-based strategies to manage these symptoms at home.


Urinary Frequency and Urgency


Understanding the symptoms: Increased urinary frequency and urgency are among the most common side effects of NMIBC treatments, affecting up to 80% of patients receiving intravesical therapy (Lamm et al., 2018).

Home management strategies:

  • Timed voiding schedule: Use a bladder diary to establish regular voiding intervals, gradually increasing time between bathroom visits (American Urological Association [AUA], 2022)

  • Fluid management: Maintain hydration while avoiding excessive fluid intake 2-3 hours before bedtime (Kamat et al., 2021)

  • Limit bladder irritants: Reduce caffeine, alcohol, spicy foods, acidic juices, and artificial sweeteners (National Comprehensive Cancer Network [NCCN], 2023)

  • Pelvic floor exercises: Regular Kegel exercises can improve urgency control (Witjes et al., 2021)


Urinary Discomfort and Pain


Home management strategies:

  • Warm sitz baths: Soak in warm water for 10-15 minutes to relieve discomfort (Society of Urologic Nurses and Associates [SUNA], 2022)

  • Over-the-counter medications: Phenazopyridine (Azo) may provide temporary relief of urinary burning (consult healthcare provider first) (Bellmunt et al., 2019)

  • Anti-inflammatory foods: Incorporate foods with natural anti-inflammatory properties such as fatty fish, berries, and turmeric (Memorial Sloan Kettering Cancer Center, 2023)


Hematuria (Blood in Urine)


When to manage at home vs. seek care: Mild hematuria may occur after treatment but should resolve within 48 hours (Babjuk et al., 2022).

Home management strategies:

  • Increased hydration: Drink 8-10 glasses of water daily to dilute urine and help flush the bladder (European Association of Urology [EAU], 2023)

  • Rest when needed: Reduce physical activity if hematuria worsens with exertion (Sylvester et al., 2021)

When to seek medical attention:

  • Bright red blood or clots in urine

  • Hematuria persisting beyond 48 hours after treatment

  • Inability to urinate or severe pain (AUA, 2022)


Flu-like Symptoms (Common with BCG)


Home management strategies:

  • Acetaminophen: Take as directed prior to treatment and after (if approved by healthcare team) (Lamm et al., 2020)

  • Temperature management: Use cool compresses for fever, dress in layers (NCCN, 2023)

  • Rest and hydration: Schedule treatment days when recovery time is available (Kamat et al., 2021)


Skin Irritation (External)


Home management strategies:

  • Gentle hygiene: Use mild, fragrance-free soap and warm water (SUNA, 2022)

  • Loose clothing: Wear cotton underwear and loose-fitting pants (Memorial Sloan Kettering Cancer Center, 2023)

  • Barrier creams: Apply zinc oxide cream to affected areas if recommended by healthcare provider (Witjes et al., 2021)


Communication Strategies


When to contact healthcare providers:

  • Fever above 101.5°F (38.5°C)

  • Severe or worsening symptoms

  • Symptoms not improving after 48 hours

  • Difficulty urinating or complete inability to void

  • New or concerning symptoms (AUA, 2022)

Tracking tool: Keep a symptom diary including:

  • Symptom type, duration, and severity

  • Management strategies attempted

  • Effect of interventions

  • Impact on daily activities (Babjuk et al., 2022)


References


American Urological Association. (2022). Diagnosis and treatment of non-muscle invasive bladder cancer: AUA/SUO guideline.

Babjuk, M., Burger, M., Capoun, O., et al. (2022). European Association of Urology Guidelines on Non-muscle-invasive Bladder Cancer. European Urology, 81(1), 75-94.

Bellmunt, J., Orsola, A., Leow, J.J., et al. (2019). Bladder cancer: ESMO Clinical Practice Guidelines. Annals of Oncology, 30(11), 1697-1705.

Kamat, A.M., Sylvester, R.J., Böhle, A., et al. (2021). Definitions, end points, and clinical trial designs for non-muscle-invasive bladder cancer: recommendations from the International Bladder Cancer Group. Journal of Clinical Oncology, 39(4), 361-370.

Lamm, D.L., McGee, W.R., & Hale, K. (2018). Bladder cancer: current optimal intravesical treatment. Urologic Nursing, 38(1), 43-53.

National Comprehensive Cancer Network. (2023). NCCN Clinical Practice Guidelines in Oncology: Bladder Cancer, Version 2.2023.

Society of Urologic Nurses and Associates. (2022). Care of the patient receiving intravesical therapy.

Sylvester, R.J., Rodríguez, O., Hernández, V., et al. (2021). European Association of Urology (EAU) Prognostic Factor Risk Groups for Non-muscle-invasive Bladder Cancer (NMIBC) Incorporating the WHO 2004/2016 and WHO 1973 Classification Systems for Grade: An Update from the EAU NMIBC Guidelines Panel. European Urology, 79(4), 480-488.

Witjes, J.A., Bruins, H.M., Cathomas, R., et al. (2021). European Association of Urology Guidelines on Muscle-invasive and Metastatic Bladder Cancer: Summary of the 2020 Guidelines. European Urology, 79(1), 82-104.



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