Bladder Radiotherapy with Carbogen and Nicotinamide

Your cancer in the bladder requires a course of radiotherapy.

This information is for patients with bladder cancer who have been prescribed Carbogen and Nicotinamide alongside their radiotherapy.

We know that cancer cells which have low levels of oxygen are less sensitive to radiation treatment than those with normal or high levels of oxygen. Therefore, your radiotherapy treatment will involve giving you two extra substances (something to breathe and a tablet to take) to help increase the levels of oxygen in the cancer cells. This will help the radiotherapy to work better.

1. Carbogen is a gas made up of 98% Oxygen and 2% Carbon Dioxide which is given through a breathing mask while you are lying on the radiotherapy couch receiving treatment. Most patients cope well with breathing Carbogen and do not experience any side effects; however, should you experience any problems please inform the Radiographer treating you. On your first visit to the department, when you have your pre-treatment (planning) CT scan, you will be shown the equipment and practice using this before your treatment starts. We ask that, whilst you are receiving Carbogen, you avoid the use of petroleum-based lotions, creams, or makeup on your face and upper chest. Water-based products can be used instead.
2. Nicotinamide is a modified vitamin. It helps to increase blood flow in the tumours.
   It is taken as a tablet an hour before the radiotherapy treatment. Nicotinamide has a few possible side effects which you may experience. These include nausea, headaches and flushing. If you suffer from any of these please let us know straight away as the dosage may be reduced or we may advise you to stop taking the tablet entirely. If you do not have any problems, you will be asked to take the tablet 1 hour before each treatment for the whole course of radiotherapy.

Both Carbogen and Nicotinamide have been widely used by many patients in developing this treatment.

Some side effects of the radiotherapy to the bladder include the need to urinate more often, and an increase in the number of times that you open your bowels each day. You will be asked to empty your bladder before treatment as this helps limit the side effects. Further information is written in Radiotherapy Treatment for Bladder Cancer which will be given to you.

If you have any further questions or concerns, please feel free to ask your Oncologist or Radiographer.

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.