Nursing implications in the management of superficial bladder cancer

Intravesical therapy is preferred over systemic treatment for superficial bladder cancer. Four agents commonly used are thiotepa, doxorubicin, mitomycin, and bacille Calmette-Guérin. A thorough understanding of the unique methods involved in the instillation of these drugs and the special patient-management procedures associated with their use is critical for nursing personnel. Occupational Safety and Health Administration guidelines exist to ensure safe handling of intravesical agents. Nurses are urged to take precautions to limit their exposure to these potentially hazardous drugs. For example, bacille Calmette-Guérin, a live virus, represents a biohazard and extreme caution is required in all aspects of handling, particularly in its disposal. Because of the potential complications associated with intravesical therapy, a significant responsibility of the nurses who administer it is patient education. Patients need to know what to expect during the treatment process as well as how to recognize the signs and symptoms of complications. In addition to gaining a thorough knowledge of the techniques involved in the intravesical treatment of superficial bladder cancer, nurses can also serve their patients better by using sensitive to the unique psychosocial problems they face.