Mitomycin is an antitumor antibiotic that is made from a soil fungus called Streptomyces caespitosus. Mitomycin inhibits DNA synthesis by producing DNA cross-links which halt cell replication and eventually cause cell death. Since cancer cells, in general, divide faster and with less error correcting than healthy cells, they are more sensitive to this damage. This cell damage slows or stops the growth of cancer cells in your body.
How to Take Mitomycin
Mitomycin is given directly into the bladder (called intravesicular), through a catheter, and left in the bladder for several hours. The dosage and schedule is determined by your physician.
This drug is blue in color and may make your urine blue-green in color. This can last up to two days after each dose. If you have other urinary symptoms such as frequent or painful urination, call your doctor or nurse.
How the Intravesicular Treatment is Given
You should limit your fluid intake starting the night prior to the procedure so you will be able to hold your urine during the procedure for the full 2 hours. In addition, the area receives more concentrated (and effective) doses of the drug with less urine output during the procedure.
You may be given a medication the night before and morning of the procedure to make your urine more alkaline.
A urinary catheter is inserted into the bladder and any urine is drained. The team may confirm that the bladder is emptied using a small ultrasound machine.
The mitomycin is given, through the catheter, into the bladder. The catheter may be removed or clamped and remain in place.
You will need to hold the mitomycin in your bladder for 2 hours. You will need to change positions every 15 minutes to be sure the drug reaches all areas of the bladder. Do this by rolling on your side, back, other side and stomach.
Precautions After Treatment
You should sit to urinate for 8-12 hours after the treatment to prevent splashing urine on the skin or exposing others to the medication.
Flush the toilet twice after urinating for 2 days after treatment.
Wash your hands and genital area with soap and water after urinating to remove any traces of the medication from your skin and prevent skin irritation.
Drink plenty of fluids for 8-12 hours after your treatment to flush your bladder.
Prevent others from being exposed to the medication by washing your clothes separately from the rest of the laundry and wearing rubber gloves when cleaning the toilet or any urine spills.
Possible Side Effects of Mitomycin Given Into the Bladder
Mitomycin can cause skin irritation if it comes into contact with the skin. Washing the area with soap and water after urinating can reduce this risk.
Some patients will develop a bladder infection after this procedure. If you experience urgency to urinate, burning or pain with urination, blood in the urine or fever, notify your healthcare team right away.
Intravesicular chemotherapy may cause burning with urination, cramps and diarrhea.
In some cases, mitomycin can cause a decrease in your blood counts. This can include white blood cells (important for fighting infection), platelets (for blood clotting) and red blood cells. This is more likely to occur when the medication is given after surgery and there is injury in the bladder (cuts, tears), which can allow the medication to be absorbed into the blood stream. However, it can occur with any instillation.