This question still creates some controversy. Based on the results of the studies, most experts recommend giving perioperative chemotherapy to almost everyone at the time of TURBT, unless the bladder is perforated during the surgery. The efficacy of all of the different agents seems about the same.
A meta-analysis (a composite review of a number of all studies in the literature that fit the analysis criteria) was performed to determine if immediate instillation of chemotherapy after TURBT decreased the risk of recurrent bladder cancer in patients with stage Ta T1 single and multiple bladder cancer overall and separately.
In this review, patients received a single dose of epirubicin, mitomycin C, thiotepa, or pirarubicin. The authors found that overall, the instillation of one of these chemotherapeutic agents significantly decreased the risk of recurrence of bladder cancer after TURBT for patients with Ta/T1 bladder cancer. We should point out that although most experts agree that perioperative chemotherapy is beneficial, its use has been slow to catch on among urologists in this country.
A few experts feel that the benefit is small and therefore do not recommend its use. Mitomycin C is the most commonly used at this time. It may produce a significant inflammatory reaction, which may cause urgency, frequency, or discomfort. This typically resolves within a few weeks, but occasionally can take several months to completely improve. Thus, you should talk with your doctor specifically about this treatment if you are interested in it.