Bladder Cancer

[livingwith]

I had blood in my urine on and off for about 4 mths. Whenever I had it tested with my gen practioner it would be negative. I decided to see a urologist and he performed a cystoscope [cystoscopy] and discovered the growths. He has removed the growths and I now have an appointment scheduled with an oncologist for the 5th of March. Does anyone know what the preferred treatment is for superficial, stage 1 bladder cancer? I had the surgery over two weeks ago and I still have blood in my urine. I rea...Read the full article

[RICKNAMBER]

HOPE THIS HELPS YOU..... MY HUSBAND WAS DIAGNOSED 08-07-06 WITH CIS (FLAT TUMORS) GRADE 3 ON HIS ENTIRE BLADDER. THE DR. DID 26 BIOPSY'S INCLUDING 6 ON HIS PROSTATE. PROSTATE HAD NO CANCER. WE HAD TO WAIT FOR HIM TO HEAL A BIT TO START. I THINK 3 WEEKS OR SO B/C ALL THE BIOPSY'S. THE TREATMENT FOR THAT WAS BCG (IMMUNOTHERAPY) A CATH. IS INSERTED IN THE BLADDER AND THEY PUT THE BCG IN AND YOU ROTATE LAYING DOWN FRONT,BACK, SIDE TO SIDE FOR 2 HOURS THEN YOU GO PEE. YOU GOTTA BE CAREFUL NOT TO GET IT ON YOU OR ANYONE ELSE. THEY USUALLY SEND YOU HOME AFTER IT'S INSTILLED. HE DID 1 TIME A WEEK FOR 6 WEEKS. AFTER 2 MOS (YOU HAVE TO HEAL AGAIN). HE HAD ANOTHER CYSTO. IT WAS STILL IN THERE. SO 1 TIME A WEEK FOR 3 MORE WEEKS. HEALED AGAIN 2 MOS. IT WAS GONE WHEN THEY DID THIS CYSTO. WENT IN FOR 3 MONTH CHECK UP WITH CYSTO. HE HAD 3 TUMORS THIS TIME. HAD THE SURGERY AND THEY REMOVED THEM AFTER THEY REMOVED THE TUMORS THEY INSTILLED MYTOMICIN C (TYPE OF CHEMO & IMMUNO) PATH REPORT CAME BACK SHOWING NOT CANCER. CYTOLOGY (URINE TEST) REPORT SHOWED NO CANCER CELLS EITHER. WENT FOR ANOTHER CHECK UP END OF JAN 08 CYSTO FOUND 1 TUMOR CYTOLOGY SHOWED ABNORMAL PROBABLE CANCER CELLS.PATH REPORT SHOWED CANCER. T1 GRADE 3. STARTING 3 MORE WEEKS OF BCG THIS WEEK 1 TIME A WEEK MAR 08. GOOD LUCK, KNOW THAT YOU ARE NOT ALONE. I KNOW THE EMOTIONS YOU AND YOUR FAMILY ARE GOING THROUGH.ONE MINUTE YOU CAN TAKE ON THE WORLD AND THE NEXT YOU CAN BE CRYING YOUR EYES OUT. STAY POSITIVE AND TRY NOT TO LISTEN TO EVERYBODY'S STORIES ABOUT CANCER WHEN THEY FIND OUT YOU HAVE IT BECAUSE YOU WILL BE A NERVOUS WRECK AND PANIC ABOUT EVERYTHING. BY THE WAY MY HUSBAND IS 50 AND IM 25.

[RICKNAMBER]

HOPE THIS HELPS YOU..... MY HUSBAND WAS DIAGNOSED 08-07-06 WITH CIS (FLAT TUMORS) GRADE 3 ON HIS ENTIRE BLADDER. THE DR. DID 26 BIOPSY'S INCLUDING 6 ON HIS PROSTATE. PROSTATE HAD NO CANCER. WE HAD TO WAIT FOR HIM TO HEAL A BIT TO START. I THINK 3 WEEKS OR SO B/C ALL THE BIOPSY'S. THE TREATMENT FOR THAT WAS BCG (IMMUNOTHERAPY) A CATH. IS INSERTED IN THE BLADDER AND THEY PUT THE BCG IN AND YOU ROTATE LAYING DOWN FRONT,BACK, SIDE TO SIDE FOR 2 HOURS THEN YOU GO PEE. YOU GOTTA BE CAREFUL NOT TO GET IT ON YOU OR ANYONE ELSE. THEY USUALLY SEND YOU HOME AFTER IT'S INSTILLED. HE DID 1 TIME A WEEK FOR 6 WEEKS. AFTER 2 MOS (YOU HAVE TO HEAL AGAIN). HE HAD ANOTHER CYSTO. IT WAS STILL IN THERE. SO 1 TIME A WEEK FOR 3 MORE WEEKS. HEALED AGAIN 2 MOS. IT WAS GONE WHEN THEY DID THIS CYSTO. WENT IN FOR 3 MONTH CHECK UP WITH CYSTO. HE HAD 3 TUMORS THIS TIME. HAD THE SURGERY AND THEY REMOVED THEM AFTER THEY REMOVED THE TUMORS THEY INSTILLED MYTOMICIN C (TYPE OF CHEMO & IMMUNO) PATH REPORT CAME BACK SHOWING NOT CANCER. CYTOLOGY (URINE TEST) REPORT SHOWED NO CANCER CELLS EITHER. WENT FOR ANOTHER CHECK UP END OF JAN 08 CYSTO FOUND 1 TUMOR CYTOLOGY SHOWED ABNORMAL PROBABLE CANCER CELLS.PATH REPORT SHOWED CANCER. T1 GRADE 3. STARTING 3 MORE WEEKS OF BCG THIS WEEK 1 TIME A WEEK MAR 08. GOOD LUCK, KNOW THAT YOU ARE NOT ALONE. I KNOW THE EMOTIONS YOU AND YOUR FAMILY ARE GOING THROUGH.ONE MINUTE YOU CAN TAKE ON THE WORLD AND THE NEXT YOU CAN BE CRYING YOUR EYES OUT. STAY POSITIVE AND TRY NOT TO LISTEN TO EVERYBODY'S STORIES ABOUT CANCER WHEN THEY FIND OUT YOU HAVE IT BECAUSE YOU WILL BE A NERVOUS WRECK AND PANIC ABOUT EVERYTHING. BY THE WAY MY HUSBAND IS 50 AND IM 25.

[dineshsingh]

Adjuvant Treatment

Since recurrences of bladder cancer can occur frequently, it is important to develop strategies to prevent these recurrences. Adjuvant therapy is additional treatment that increases the effectiveness of a primary therapy. The goal of adjuvant treatment is to improve the chance of a cure, prevent cancer from recurring or progressing to a worse stage and/or to improve the duration of overall survival. Adjuvant therapy typically consists of chemotherapy and/or biologic therapy following surgery. Delivery methods for adjuvant therapy differ depending on the needs of patients. While some adjuvant treatments are delivered systemically, others are delivered directly into the bladder. One form of adjuvant treatment for bladder cancer utilizes instillation of anti-cancer substances through the urethra into the bladder.

Patients with stage I bladder cancer are at particular risk not only for superficial cancer recurrences, but also for progression to more aggressive invasive bladder cancers. All patients with this stage of disease should consider adjuvant treatment.Bladder Instillation of Bacille Calmette-Guérin (BCG): Bacille Calmette-Guérin (BCG) is one of the most common adjuvant therapies for treatment of superficial bladder cancer. In fact, BCG instilled directly into the bladder is considered to be a standard adjuvant treatment for bladder cancer. BCG is an immunotherapy derived from a weakened form of the bacterium related to bacteria causing tuberculosis. BCG is instilled directly into the bladder through the urethra and exerts its anti-cancer effect by stimulating the body's immune system to kill cancer cells. The primary side effects of BCG are pain in the bladder, blood in the urine and rarely, autoimmune disorders. Because BCG is a live bacteria, it may occasionally grow and cause an infection that requires antibiotic treatment.

The anti-cancer response rate of superficial bladder cancers to the periodic instillation of BCG into the bladder is approximately 70%. Treatment with BCG delays progression to muscle-invasive and/or metastatic bladder cancer, improves the rate of bladder preservation and decreases the risk of death from bladder cancer. With BCG immunotherapy, 65% of patients who have a complete response will remain cancer-free for 5 years. With improved maintenance, BCG schedules (booster doses given at 3 month intervals up to 2-3 years), complete responses have been increased to over 80% with 80% of the complete responders remaining disease-free. In some situations, BCG is also given by injection into the skin similar to the method for prevention of tuberculosis. Currently, the exact contribution of systemic vaccination to overall outcome is not clear and most urologists no longer use this technique.

At the Memorial Sloan-Kettering Cancer Center, a clinical trial was performed that evaluated BCG that was administered to prevent recurrence of superficial bladder cancer. In this clinical trial, treatment with surgery alone (TUR) was compared to surgery (TUR) followed by BCG injected into the bladder weekly for 6 weeks. Eighty-six patients were randomly assigned to one of the two treatment regimens and the results were then directly compared. At 10 years from initiation of treatment, 62% of patients receiving BCG survived without progression to more invasive bladder cancer, compared to only 53% for patients treated with surgery alone. Eighteen patients treated with surgery alone were also given BCG an average of 29 months after initial treatment and 15 did not experience cancer progression. Management of superficial bladder cancer with surgery plus BCG resulted in a 10-year cancer-specific survival of 75%, compared to 55% with surgery alone.Results from this clinical study demonstrated that BCG is a standard treatment for patients with superficial bladder cancer because it showed that BCG administered into the bladder after surgery delayed cancer progression and death from invasive bladder cancer. However, even with optimal BCG therapy, almost half of all patients with superficial bladder cancer will ultimately have progression to invasive bladder cancer. This indicates the importance of frequent follow-up examinations (cystoscopy) to detect early progression to invasive cancer or new superficial cancers. Early invasive bladder cancer can be treated effectively.

Bladder Instillation of Chemotherapy: Instillation of chemotherapy into the bladder is considered a second-line therapy, while the preferred initial adjuvant therapy is BCG. Although chemotherapy may be effective in some patients, a recent clinical trial suggests that BCG is superior. TA and T1 grades I and II) Instillation of chemotherapy drugs (Mutamycin®, Thioplex®, or doxorubicin) into the bladder can reduce the incidence of superficial cancer recurrences but no single drug has been confirmed to reduce progression of superficial cancer to invasive bladder cancer. This means that multiple small new cancers can be prevented but progression to a more invasive bladder cancer may occur despite treatment.

The optimal time to administer chemotherapy is immediately after TUR as the drugs might prevent reseeding of cancer cells disrupted with surgery. Mutamycin® is probably the preferred drug because it produces few side effects and is not well absorbed into the system, which allows more of the drug to remain in the bladder to treat the cancer. Thioplex® is rapidly absorbed and produces low blood counts. Doxorubicin produces the most local side effects.