Alopecia following single-dose postoperative intravesical gemcitabine in nonmuscle-invasive bladder cancer: A multi-institutional case series

INTRODUCTION: Single-dose intravesical gemcitabine therapy (IVGT) is a standard of care option following transurethral resection (TURBT) for low- to intermediate-risk nonmuscle invasive bladder cancer (NMIBC). The side-effect profile of IVGT has primarily focused on well-established urinary symptoms. Herein we present several cases of treatment-related alopecia following a single postoperative dose of IVGT for NMIBC. METHODS: Urologic oncologists from 7 high-volume bladder cancer referral centers in the United States were surveyed about incidents of alopecia, as well as the severity of hair loss, following a single postoperative dose of IVGT after TURBT- either for primary or for known NMIBC. Patients were identified either through self-reported concerns or by physician-observed alopecia during follow-up visits. RESULTS: Between January 2020 and December 2024, a total of 20 patients (6 male, 14 female) experienced hair loss, with the majority (N = 12, 60%) occurring within the first month post-TURBT. Thirteen of the 20 patients (65%) experienced severe alopecia. None of the patients were on medications known to cause hair loss or receiving other chemotherapy. Five patients had large resections (>5 cm), ten had medium (2-5 cm), and 5 had small (