Chemo question

[Peridot]

Hello, Eve here. My husband’s results are in. Bad news. His cancer is high grade invasive:( Bone scan was clean , next step CT abdominal and pelvic,fingers crossed. We met with an oncologist and he wants to start 4 rounds of chemo with 2 drugs before the surgery to remove the bladder. My husband is really set against the chemo. Has anyone been in this position? Refused chemo ? I am having really tough time coping.

[Greg]

Eve, the standard course of treatment is the neo adjuvant chemo which is what has been offered to him. It is designed, as I understand it, to kill any possible micro metastacies that may or may not be in the blood stream. If the cancer is fully contained in the bladder (something they really do not fully know till they get it out and have pathology look at it) there may be an argument for not having the chemo. But I can tell you the doctors, especially the medical oncologist, will always want to go with the route they know. They feel, and rightly so, that to take every action against the cancer is the preferred route rather than leaving anything to chance.
My own situation was that my invasive bladder cancer T2b3G was discovered months before the surgery took place and there was no quick action until I got a second opinion at a major cancer centre and the uro wanted to get the bladder out asap. That happened two weeks later so there was no chance for neo adjuvant chemo (prior to surgery). He made me promise I would do chemo AFTER the surgery (called adjuvant chemo). When I was getting better and the week before my scheduled first chemo treatment, he and I met to review the surgical pathology report. He told me the cancer was all contained, no lymph node involvement in the fifteen they took out and no known metastatic disease. He told me I did not need the chemo, in his view. So on that basis, I declined the chemo. The medical oncologist was not happy, but could not offer me any persuasive reason to take it since she could not make any promise of reducing the chance of recurrence with or without the chemo.
I weighed the tions, put my trust in God and took my uro’s counsel and declined the chemo.
I will have my two year post surgery anniversary next Saturday!
Was I right? Only time will tell, I suppose.
Tough decision. Been there, understand the fears and worries and concerns.
Keep us in the loop. Praying for you.
Greg

[Ieva]

Hi Eve,
Malcolm has his TURBT in April 2011 and the path report showed aggressive cancer, and that it into the bladder muscle. Otherwise, his scans were clear, except for the bladder. He was scheduled asap for RC surgery May 3rd. The post op pathology showed that his cancer had spread into lymph nodes outside of his bladder: T2aN2M0 grade 3. Therefore he was scheduled for chemo, because the cancer had spread beyond the bladder. (Not like Greg, who’s lymph nodes were negative). The chemo (Gem & Cis combo) was given for 4 cycles, from July – mid September. If his lymph nodes had been negative, he would not have had chemo.

[marysue]

HI Eve. Sorry about your hubby’s bad news and that you have reason to be here. Welcome all the same. Greg’s advice is sound. While I haven’t had to go down the road Greg did or what your hubby is facing, I understand his feelings about chemo. I had to do BCG immunotherapy. While not as drastic as chemo for side effects it does have an adventure all its own. I really resisted the idea at first because I’m anti drug for a lot of things but I reconsidered because the only other option was to remove my bladder should it reoccur. While our situations are different the fear is the same. Fear of the unknown and not knowing if the drug will help at all. When dealing with cancer docs tend to deal on the side of caution and go the extra mile. They need to be sure that they have done everything and offered the best known treatment for a patient in order to protect the patient’s health and themselves against a possible lawsuit. For example if the doc didn’t offer the chemo option and your hubby died not knowing that chemo could have saved his life and you found out afterwards I think that you’d be pretty peed off. (Sorry no pun intended here). However that being said it is up to the individual facing the treatment to ultimately decide what is right for them. I suggest that you try to get him to sit down with you and discuss his real reasons for objecting to the chemo. Chemo is serious stuff and if it is the fear of side effects that is well justified. You both then need to discuss with the doc about the potential side effects and if he opted for the treatment how they would be managed should they become heavy. Also, I suggest asking if it is possible to wait until after the CT scan to make a final decision about chemo. Hopefully the news isn’t as bad as they first think. Good luck and keep us posted. There are lots of folks on this site that have dealt with chemo. I think that you will hear before long.

[G and M]

Hi Eve, my doctor suggested the chemo treatment prior to RC surgery, which I agreed to undergo. I can tell you that I was very sick throughout the later rounds of chemo. Prior to and post RC surgery I have developed blood clots (mostly in the leg and pelvic area) which may or may not be associated with the chemo treatment. I suggest you discuss the possibility of getting blood clots, due to chemo treatment, further with your doctor. On the good side the grade of my bladder cancer was reduced after the chemo treatment was completed, this was confirmed after surgery. My advice would be to get as informed as possible, and ask doctor lots of questions. Only you and your husband can make the right choice for him. Did I make the right decision? as someone here already said, only time will tell. Good luck!

[Author]

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