Anyone had gemcitabine and docetaxel for Bladder Cancer?

Posted by rjlpool502 @rjlpool502, Oct 18, 2024

Just had second of six weekly doses Gem/Doc chemo infusion for my bladder cancer. Had six doses BCG but cancer came right back. Mine is aggressive but non invasive at present. Been scraped out twice. Any one else having this type chemo? Would like to compare notes.

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Profile picture for bethcamp @bethcamp

I have been on gemdoce since surgery to remove noninvasive high grade tumors in the neck of the bladder.

I had one major surgery and a second in which they found a tiny remaining spot. Then I had six weekly gemdoce treatments. The cystocsopy following that was clear. Then I began once per month. I am told for sure I will have it for 12 months, but I get another cystoscopy at the six month point to see how I am doing. Fortunately that month off of chemo will be in December!

So, it is basically a general regimen that can be found for high-grade non-invasive bladder cancer.

At first, I thought my hair was thinning some, but I have not seen any increase in hair loss since the first of it at the beginning. For me, the side effects include tiredness, always a headache that responds to something like Excedrin, and mostly it doesn't come back. Sometimes I have been dizzy, and/or nauseated. I sleep quite a bit the first couple of days, and do not plan anything that requires much effort or thought for the first week after the treatment.

Even though I have a month to recuperate before the next one, I still am reacting after each one. I thought it would be easier and more like the first one of the initial six-week treatment, since I have so long to clear it out each time, but unfortunately, that is not the case. One friend suggested that perhaps my immune system recognizes the chemicals and responds with more vigor each time. I don't know, but I have adjusted my expectations now for the week of the treatment and stay out of crowds as much as I can - all of the time. Otherwise, I will get small "colds" after being out in public.

I think adjusting expectations about lifestyle is one of the kindest things we can do for ourselves, since one treatment per month for one or two years is a long haul. I plan my activities around the chemo schedule and I am kind to myself. I still do therapy sessions with my clients on Zoom and still keep up with volunteer work that I can do from home (keeping organizations' websites, etc.). I just don't do any of that during the week of a chemo treatment. I rest and only do as much as I feel like doing during that week. I am in my mid-70's.

Each of us will respond differently. Having this forum is a way to feel less alone about all of this.
I think that since we generally look like we are OK, we have to protect our own needs against the expectations of others who want or need our time and attention.

Well, that is a long answer that began as a response about hair thinning!

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@bethcamp I thought that this treatment would be easier to tolerate than systemic chemo. Oh was I wrong. I had two days of feeling awful. I’m just anxious for the scope. Cancer is so darn scary. First experience with cancer. It was so uncomfortable and almost felt humiliated as well as fearful.

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Profile picture for linda0234 @linda0234

@grifftg07 my treatments were on Fridays. I felt miserable on Saturday and Sunday. By Monday, I was back to my usual routine.

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@linda0234 thank you for your response I hope everything goes well for you.

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I am receiving gemdoce treatment for noninvasive high grade bladder cancer, as well.

Mine is high grade due to the number of noninvasive spots (I waited too long to see about those syptoms..).

First I had the six weekly treatments and now have gone into the monthly doses, having received six of those and now it is time in December for a cystoscopy - very shortly! So far, every cystoscopy has been clear. My reward for being clear after the 6 weeks of gemdoce was another year of monthly treatments 😉

I know that the possibility is two years of the monthly treatments, (the remaining six months plus another year), but my physician seems to dole out the information about what is next when he does the cystoscopies.
I will ask what the choices might be. I am self-employed and can manage my schedule, but I still need information. That part has been tough.

So far, I have been clear at each cystoscopy - the one prior to beginning gemdoce and the one after the six weekly treatments. Now it is time to see what has happened after the six once/month treatments. The nice thing about this is that when I have the cystcopy, I don't have the treatment, so i get December off. That means feeling better for the holidays. I find that my energy is lower than normal all the time, and my immune system is weak - if I go out in a crowd, I seem to catch something, so I wear a mask and stay home as much as possible.

The side effects are worse in the days right after the treatment, and vary each time.

What has helped the most is that I am involved on a couple of boards of community service organizations and that keeps me in touch with others, even if I cannot attend everything. So many of them have had cancer and have given me encouragement and information about their own journeys.

I suggest that at whatever level you are comfortable, you don't try to keep it from everyone. You may find as I have that people are helpful and understanding about your reduced energy, etc.

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Profile picture for deb2024 @deb2024

I have high grade non invasive bladder cancer. I did the six weekly treatments of gem/docetaxel & then 1 treatment monthly for 3 months then a cysto & then another 3 month cycle of chemo & now in my 2nd year of treatment cycles. Have had good results with these treatments. I have a few side effects after each treatment but am able to deal with it.

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@deb2024
I have the same diagnosis. Had my TURBT on Sept 5, 2025 and have had 4 of the six weekly Gem/Doce treatments, which have been interrupted by two weeks between instillations 3 and 4 due to a UTI and has again been interrupted due to another UTI, so 5 will not take place for another couple of weeks. Oncologist says interruptions of a couple of weeks should not affect efficacy, but that's not what my AI source says! Whom to believe?? Anyone else had similar UTI experience and interrutions?
I've not had any problem with the instillations, once they used the correct catheter, and after-effects are urgency and nocturia. I have to get up about 6 times per night, which is a bit wearing.
The choice of Gem/Doce was based on the Vesta system biomarker analysis.

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Profile picture for bethcamp @bethcamp

I am receiving gemdoce treatment for noninvasive high grade bladder cancer, as well.

Mine is high grade due to the number of noninvasive spots (I waited too long to see about those syptoms..).

First I had the six weekly treatments and now have gone into the monthly doses, having received six of those and now it is time in December for a cystoscopy - very shortly! So far, every cystoscopy has been clear. My reward for being clear after the 6 weeks of gemdoce was another year of monthly treatments 😉

I know that the possibility is two years of the monthly treatments, (the remaining six months plus another year), but my physician seems to dole out the information about what is next when he does the cystoscopies.
I will ask what the choices might be. I am self-employed and can manage my schedule, but I still need information. That part has been tough.

So far, I have been clear at each cystoscopy - the one prior to beginning gemdoce and the one after the six weekly treatments. Now it is time to see what has happened after the six once/month treatments. The nice thing about this is that when I have the cystcopy, I don't have the treatment, so i get December off. That means feeling better for the holidays. I find that my energy is lower than normal all the time, and my immune system is weak - if I go out in a crowd, I seem to catch something, so I wear a mask and stay home as much as possible.

The side effects are worse in the days right after the treatment, and vary each time.

What has helped the most is that I am involved on a couple of boards of community service organizations and that keeps me in touch with others, even if I cannot attend everything. So many of them have had cancer and have given me encouragement and information about their own journeys.

I suggest that at whatever level you are comfortable, you don't try to keep it from everyone. You may find as I have that people are helpful and understanding about your reduced energy, etc.

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@bethcamp
Dear bethcamp, thankyou for your information. Similar situation with myself. Question: Did you have to go down the BCG treatment road before your current treatment with Gem/Doc?

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Profile picture for honey750 @honey750

Hi, I am on my 5th Gemstone/ Docetaxel. The first two were fine. The 3rd, 4th and 5th have been tough. I get a burning that feels awful. I get urine cultures and they find bacteria and treat it as a UTI. This is my 5th one and I feel awful from the burning. Waiting on a call back from the Dr. Just finished Moxifloxacin after 14 days. I take AZO and Tylenol.
I was diagnosed 7/2023 with high risk NMIBC
Had 9 BCG treatments but couldn't tolerate anymore because of UTI's. Had at least 4 TURBTS and many Cystoscopies. If anyone can help me understand why I am so prone to UTI's and the burning, I would really appreciate it. I have a Urologist and a Infections Disease Dr., but I don't get any answers from them.

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@honey750 I too always get a UTI after a treatment and get a script for an antibiotic.
I have had 6 weekly lots of BCG that didn’t work. Then 6 lots of weekly GemDoc, then Cystoscopy which showed all clear. Am now about to take my 3rd monthly maintenance dose, and still having UTIs after each treatment.
Suggestions are to take Hiprex, twice daily, as a UTI preventative, also to use Ovestin cream 3 times weekly around the area.

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Profile picture for grifftg07 @grifftg07

Will be starting my first treatment in 2 weeks. Any suggestions on downtime after treatments I still work?

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@grifftg07, thinking of you as you have you first treatment this week. Let us know how it goes.

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Thank you for your thoughts. It wasn't as bad as I expected but it did take about 4 hours but I figured it would the first time. Medication was uncomfortable but not as difficult as I thought it would be. Next day fatigue and burning was heavy. I have learned more from the support group then from my nurses so thank you guys for help prepare me for the 1st one.

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Profile picture for mochat @mochat

@honey750 I too always get a UTI after a treatment and get a script for an antibiotic.
I have had 6 weekly lots of BCG that didn’t work. Then 6 lots of weekly GemDoc, then Cystoscopy which showed all clear. Am now about to take my 3rd monthly maintenance dose, and still having UTIs after each treatment.
Suggestions are to take Hiprex, twice daily, as a UTI preventative, also to use Ovestin cream 3 times weekly around the area.

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@mochat
Do they pause your treatment until you finish the antibiotics?They paused mine twice for two weeks and I ended up getting only 5 Gem/Doce, which the oncologist said would be OK. Finished on Tuesday, cystoscopy mid February.🤞
Still have urgency and getting up 5-6 times during the night. Other than that, no problems.

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Profile picture for gemdoc25 @gemdoc25

@mochat
Do they pause your treatment until you finish the antibiotics?They paused mine twice for two weeks and I ended up getting only 5 Gem/Doce, which the oncologist said would be OK. Finished on Tuesday, cystoscopy mid February.🤞
Still have urgency and getting up 5-6 times during the night. Other than that, no problems.

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@gemdoc25 I was diagnosed with a UTI after my last gem/doc. I was then prescribed Cephalexan antibiotic capsules 500mg taken 3 times daily. After that I was put onto more of the same antibiotic but taken only twice daily which continued through my next gem/doc. I found I had a much quicker recovery this time than previously.
I feel that it’s the UTIs that have been making things so painful. Good luck.

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