Mitomycin treatment

About mitomycin

Mitomycin is a drug which we administer directly into the bladder. It is a liquid form of chemotherapy.

We use it to treat superficial bladder cancer or tumours. (Superficial means early-stage, or limited to the top layer of body tissue).

Mitomycin helps to reduce the frequency of tumours that return.

We will explain why we believe mitomycin is an appropriate treatment for you.

About treatment

• Each treatment takes about 30 minutes.
• Treatments take place in either the Urodynamics Unit or Albany Unit at Kingston Hospital. Your appointment letter will tell you which Unit to go to.
• After treatment, you must go straight home and hold the drug in your bladder for 1 hour. You must not pass urine or drink fluids during this 1 hour period.
• If your journey home takes longer than 1 hour, the maximum time you can retain the drug in your bladder is 2 hours.

We will give you either:

• a one-off treatment with mitomycin

or

• or a course of 6 treatments (one every week, for 6 weeks).

We will discuss this with you.

Preparing for treatment

Fluids

By drinking less you will produce less urine, and prevent the mitomycin from becoming too diluted. This will improve its effectiveness. Drinking less will also make it easier for you to hold onto the drug once it is in your bladder.

Water tablets (diuretics)

If you usually take water tablets in the morning, do not take them before your treatment (unless we tell you otherwise). You can take them when you are home after your mitomycin treatment.

Eating

You can have solid food before your treatment, but no fluids.  Do not drink milk, tea or coffee.

Driving

You can drive yourself home after each treatment.

Do not take public transport in case you urgently need the toilet while travelling.

On the day

When you arrive at the Unit, we will ask you a few questions. We will ask you to provide a urine sample. 

You can bring a sample with you from home. If you do this, follow these instructions.

• Collect the sample from the middle of your urine stream.
• Collect it in a sterile container.  We usually send you one with your appointment letter. You can also buy one from any chemist.
• Your sample must be no more than 2 hours old when you give it to us.

To carry out the treatment, we will do the following.

• Insert a catheter (small, flexible tube) into your bladder through your water pipe (urethra). Most people do not find this painful, although it can be uncomfortable.
• Pass mitomycin (which is purple in colour) into your bladder via the catheter.
• Remove the catheter.

If you are an outpatient, you can go home after treatment. 

1 hour after treatment (action to take)

After 1 hour, do the following.

• After 1 hour, you must pass urine (wee) into the toilet and flush the toilet twice, with the lid closed.
• We advise men to sit when they do this, to prevent splashes.
• Use soap and water to wash your genital area and hands after passing urine. (This will reduce the risk of a rash on your hands and genitalia, as contact with Mitomycin can irritate the skin.)
• Repeat these steps every time you pass urine over the next 3 hours.
• As soon as you have passed urine for the first time, you can start to drink. Make sure you have plenty of fluids over the next 24 hours. This will flush the rest of the mitomycin out of your bladder.
• Do not drink alcohol on the day of your treatment.

Side effects

Although this treatment is a form of chemotherapy you will not lose your hair.

Common

Common side effects usually disappear 3 days after treatment. You can reduce some of these side effects by drinking plenty of fluids to flush the mitomycin out of your bladder. You can also take over-the-counter painkillers if you need them.

Common side effects include:

• needing to pass urine urgently and often
• discoloured urine (purple)
• bladder discomfort
• pain when you pass urine
• blood in the urine.

If these side effects do not clear after 3 days, make a GP appointment.

Rare

• allergy to mitomycin, resulting in widespread body rash. If this happens, you will notice it after 1 or 2 treatments
• urinary tract infection (UTI).

If you develop this type of rash, make a GP appointment or get in touch with us (see Contacts below).

Call 999 if you develop a severe allergy (difficulty breathing, swollen lips or tongue).

Follow-up

When you have finished your Mitomycin treatment (one-off or course of 6), we will send you an appointment for a flexible cystoscopy.

A flexible cystoscopy is a bladder and urethra examination. We will perform it using local anaesthetic, in our Albany Unit.

We will schedule it to take place 4 to 6 weeks after your Mitomycin treatment finishes.