chemo?

[Saldcorn]

I recently watched a learning video on the Odette Centre’s web site. A Dr. Raj Satkunasivam was giving a talk/lecture on the topic of bladder cancer treatment. He said that the “gold standard” for treatment where an RC was indicated was chemo followed by surgery.

Of course I haven’t read every post in this site, but I see very few people mentioning chemo. Has anyone gone this route? Is it a likely treatment with muscle invasive bladder cancer? I know mine is muscle invasive, but I wasn’t told the grade.

Just still trying to anticipate what may happen. I guess I’m wondering if any chemo besides the BCG is ever used?

[Ieva]

My husband’s bladder cancer was muscle invasive. His surgery was in 2011 – neobladder. He had chemotherapy after the surgery cisplatin and gem. combination. It was a series of once a week for three weeks, one week off, repeat for a total of four. Happy to answer any questions.

Ieva

[SJay]

I had neoadjuvant (before surgery) chemo starting December 2015. It was Cisplatin and Gemcitabine on a cycle of once in week 1, once in week 2 and nothing in week 3 for four cycles; 8 treatments in all over 12 weeks. I finished in March and had the surgery 5 weeks later on April 13. It would have been 6 weeks, but one treatment was delayed due to low platelets in my blood and the surgery date was already set. They want enough time between chemo and surgery to make sure you have recovered from the chemo and are strong for the surgery. The path report on the removed bladder, prostate and lymph nodes showed no sign of the cancer.

My understanding is that this is how it is done now. There is a few percentage uptick in survival rates over chemo after surgery.

Take a look at the white paper in the Facing Bladder Cancer / Patient Resources section of this website. It has a lot of very current information on the standard of care for bladder cancer and covers this area.

An odd side effect was the anti-nausea drug dexamethasone is a steroid and gives you a big appetite. I gained 5 pounds during chemo!

[Saldcorn]

SJay,
Thank you for all the information. I will absolutely give that section of the booklet a thorough reading. Your help was much appreciated.

[marysue]

Hi Saldcorn!

Here in Calgary, those in my support group that have had chemo have done it before having their bladders removed.

Just to clarify:

Stage: means how far the cancer has progressed.

Grade: how aggressive the cancer is. A low grade cancer means it is growing and spreading very slowly. A high grade cancer is the opposite – it is growing and spreading quickly. The large majority of invasive bladder cancer is high grade.

BCG is an immunotherapy drug that is only used as a bladder installation via catheter as treatment for early stage non-muscle invasive bladder cancer – if the bladder is not being removed. This is used as a follow up to the TURBT (tumour removal – not bladder removal) surgery. Other drugs like Mitomycin-C are chemo agents and can be used as a bladder instillation drug instead in certain circumstances. They are sometimes prescribed if a patient doesn’t tolerate BCG well or it doesn’t work. Other chemo drugs like Interferon have been used in combination with BCG in bladder instillation treatments as well.

I’ve had some people in the support group get through the chemo – this is via IV (GEM and Cisplatin) in cycles and then the surgery quite well and others couldn’t finish the chemo and treatments were suspended due to side effects and after a bit of a rest they went on to have the surgery. Some didn’t have chemo because their doctor told them the cancer was contained to the bladder and it wasn’t necessary in their case.

The decision to have chemo is not one to be made lightly as the drugs are very powerful and can have long lasting side effects. So a big conversation with your doctor is in order to see if you would benefit from chemo treatments or not. It may also depend on how far the cancer has progressed in your situation, plus any other health conditions you have and any meds you take for them.

Best wishes going forward. (((((HUGS)))))

[Saldcorn]

Hi marysue,

Thank you for all this information. Quite frankly, at this point I still know nothing more than I did 7 weeks ago. On June 8, I was told it was likely bladder cancer. On June 22, after an ultra sound and CT scan I was told it was definitely bladder cancer. I had a turbt procedure on July 8th. On July 25th, I was told an RC was necessary. I wasn’t told the stage or the grade, but I’m assuming Stage 2 because of the RC. There was mention of a referral to a doctor at the Odette Cancer Centre, but all I was told was that if a neobladder was possible, it would be at Sunnybrook at the Odette Centre. If a neobladder wasn’t possible, the surgery would be done at the local hospital (Owen Sound).

I suppose because of vacations, that’s the last I’ve heard. I emailed the doctor’s office at Sunnybrook this morning and had to send a fax to the urologist as his office is closed until Aug. 15. (His secretary may or may not be there.) Both were basically pathetic pleas for help. If I don’t get any response by this afternoon, I’ll ask Jack for help.

How am I supposed to have the least amount of trust in these people?

[Author]

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