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Late Effects

Renal and Genito-Urinary


Bladder Cancer


Secondary malignancies can develop in the bladder as a result of previous therapy.

Cyclophosphamide therapy is associated with the development of bladder carcinoma and also less frequently leiomyosarcoma of the bladder.

The risk of bladder cancer after cyclophosphamide is dose dependent in adults.  There is an increased risk of bladder cancer after high dose cyclophosphamide Rx in
older patients with non-Hodgkin lymphoma.

In children the relationship is less clear cut and bladder cancer is a rare complication. However, the combination of cyclophosphamide and pelvic RT for a tumor such as rhabdomyosarcoma of the bladder is likely be associated with a significantly increased risk of bladder cancer in the long term.

Bladder cancer presents with:

  • Gross hematuria (most common presentation)
  • No symptoms - may be silent and detected incidentally on imaging
    evaluation for other problems

Most of these tumors are of low grade and stage and can be managed endoscopically.

The risk of recurrence is higher in patients whose bladder carcinoma develops
after cyclophosphamide.



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