Jelmyto Treatment for Your Upper Tract Urothelial Cancer (The James)

Jelmyto Treatment for Your Upper Tract Urothelial Cancer (The James)

 

Your doctor has recommended that your upper tract urothelial cancer (UTUC) be treated with a drug called Jelmyto. The upper tract of your urinary system includes the ureters and kidneys. Jelmyto is a type of chemotherapy that is injected directly into your ureter and kidney. This procedure is done under a special x-ray monitor called a fluoroscopy.

 

How is this treatment done?

 

Your doctor will place a thin tube, called a catheter, in your urinary tract and inject the chemotherapy into your ureter and kidney. Jelmyto is a liquid when it is chilled and turns into a gel at body temperature.                                                              

Once it turns into a gel inside your body, the chemotherapy can spend more time killing the cancer cells before it dissolves and is urinated out the body. When the chemotherapy is injected, the catheter will be removed and the drug will stays in place for 4 to 6 hours to kill cancer cells. The procedure takes 10 to 15 minutes. This treatment is usually given 1 time each week for 6 weeks.

                         

                                            

 

What should I know before my treatment?

  • Take your prescribed sodium bicarbonate before each Jelmyto treatment. This medicine should be taken 3 times: the day before your treatment, the morning of your treatment, and 30 minutes before your treatment.
  • You may eat before your treatment.
  • Your doctor will check your blood work before each of your Jelmyto treatments.
  • If your blood work is good, the pharmacist will start making your chemotherapy. It can take up to an hour to prepare the chemotherapy.
  • Tell your doctor if you take water pills (diuretic). This medicine may need to be stopped or adjusted before your treatment.
  • Drink the normal amount of fluids you usually drink on the day of your treatment.
  • Your first treatment may take a little bit longer to let the doctor measure how much chemotherapy your kidney and ureter can hold.

What can I expect during my treatment?

  • You will be asked to undress from the waist down and will be given a sheet to cover yourself.
  • Your nurse will ask you to lie on your back on the exam table.
  • A cleansing solution called betadine will be used on your genital area. This solution helps lower the risk of infection from your catheter placement. Tell your nurse if you are allergic to iodine or shellfish.
  • Your doctor will place the catheter into your urethra using a special camera called a cystoscope.
  • The fluoroscopy machine will take pictures of your urinary tract while your doctor measures how much Jelmyto to give you.
  • Your doctor will give you the Jelmyto through the catheter and will immediately take the catheter out once the injection is given.
  • The drug will remains in your ureter and kidney for 4 to 6 hours.

What will happen after my treatment?

  • You will be able to go home after your treatment and may drive yourself.
  • Jelmyto will cause your urine to turn a violet or blue color after treatment. Your urine will slowly turn yellow as the drug dissolves over the next 4 to 6 hours.
  • To keep urine from splashing or spraying, sit on the toilet when you urinate. You must do this for 10 to 12 hours after your treatment.
  • Flush the toilet with the lid down during the 10 to 12 hours after your treatment.
  • During the 10 to 12 hours after your treatment, it is important to wash your hands and genital area with warm soap and water each time after you urinate to keep your skin from being irritated.
  • Clothing that comes in contact with urine should be washed right away and washed separate from other clothing.
  • It is normal to have some burning the first few times you urinate after your treatment.

Important Safety Information

  • If you are able to become pregnant, you should use birth control during the time you are being treated with Jelmyto and for 6 months after your last dose.
  • If you have a partner who is able to become pregnant, you should use birth control during the time you are getting this treatment and for 3 months after your last dose.
  • Do not have sex for 24 hours after your treatment.

What are the side effects of this treatment?

You may have the following side effects from this treatment, but they do not last longer than a day or two.

  • Discomfort when you urinate
  • Side pain
  • Blood in your urine
  • Frequent urination
  • Tiredness
  • Stomach pain
  • Nausea

When should I call the doctor?

Call your doctor or nurse if you have any of the following problems:

  • Unable to urinate after 6 hours after your treatment
  • Fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher
  • Symptoms of a urinary tract infection

 

 

© October 16, 2020. The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute.

This handout is for informational purposes only. Talk with your doctor or health care team if you have any questions about your care.

For more health information, call the Patient and Family Resource Center at 614-366-0602 or visit cancer.osu.edu/PFRC