Trying to make a decision. Removal of the bladder or Chemo and Radiation.

[Chris1950]

HELP!

I am facing a crucial and difficult situation. Removing the bladder or chemo and radiation. I am a 68 year old male. Looking for imput/advice from other males who have faced the same decision. Which one did you choose? How are you feeling now. Just looking for guidance.

Thank you

[Nightingale]

Hello Chris1950,

I am pasting the link to a discussion on the topic of bladder removal for you to review.  The majority of the response is to get a second professional opinion on whether to remove the bladder or get other treatments.  Have a read and I hope it helps you in your decision makeing

Radiation with Chemotherapy – a bladder preservation strategy

My best,

• This reply was modified 5 years, 10 months ago by Nightingale.
• This reply was modified 5 years, 10 months ago by Jack Moon.
• This reply was modified 5 years, 10 months ago by Jack Moon.

[Nightingale]

Hello Chris1950,

Here is another link that contains information about neobladder.  This was posted by Sjay.  You may find this additional information to be useful in your decision making.

https://forums.bladdercancercanada.org/forums/topic/new-to-neobladder-not-yet-3-weeks-post-op/

My best,

[Nightingale]

Hello Chris1950,

I found this response from a person on one of the US Forums and thought I would share with you.  I hope this helps you in your decision making.  I saw another post favouring Chemo that I will post in here for you to review.

Removed the Bladder

• Hi, I made the decision to not have the chemo before surgery. I was at the point after many TURBT surgeries, and BCG’s that I just wanted the cancer out of me. Now 2 1/2 years after the cystectomy, and some post op chemo due to 2 lymph nodes were postive, I know I would have been in such a weakened state for surgery that recovery would have been much more difficult. As it was, recovery from such a major surgery is very tough. Everyone reacts differently to the chemo drugs. some people are not bothered by the chemo very much. I became so weak, could not eat and my WBC’s bottomed out. So that is something you have to make the decision on. Do what makes you comfortable. I have no regrets on my decision to just have the surgery. I was much stronger for the surgery then I would have been if I had had chemo before. You have much to consider. I hope it goes well. Friend me if you want to discuss it more.

• This reply was modified 5 years, 10 months ago by Nightingale.

[Nightingale]

Hello Chris1950,

Here are two more opinions I found for your review.

• It’s important to explore all options. The reasons dr’s have for taking the seemingly extreme measure to remove the bladder entirely are many – Mainly the chances for relapse and often the depth and location of the visible cancer in the bladder which may make it impractical to perform a partial resection and still have a usable bladder. Talk to your urologist about those reasons and get a clear picture and if not satisfied, definitely talk to another urologist for a second opinion.
  Trimodal therapy is a type of bladder-sparing approach for patients that meet certain conditions as well. You may ask your oncologist about that as an emerging option as well, but do know that doctors often will stick with a proven, gold-standard treatment in most locations.
  I went through chemotherapy before my full bladder removal and neobladder surgery and have had no regrets nor complications.
• I agree to what’s been said here — individuals need to choose the path best for them. I had researched my oncologist/surgeon and had faith in them — so when they both said I should do chemo then RC (I was stage 4, adjacent lymph nodes already positive), I did as they said. I did not research other options (although they were very encouraging to my getting another opinion if it would make me feel better)… I felt generally overwhelmed and didn’t have it in me to become a medical expert on this topic.

  And yes the chemo was awful (I required several transfusions during this period, and near the end was passing out regularly)… and yes, I still feel affected by the chemo (cognitively, tinnitus, neuropathy) — but I would not do anything differently. I’m two years’ clean, and fingers crossed, it will be forever. The surgeon/oncologist were practically giddy by how successful my tumor/lymph nodes responded to the chemo onslaught, taking things from tennis ball sized to pea-sized… certainly increasing hugely the possible success of the surgery.

  This all sucks, and I’m sorry you’re having to deal with it. Ask people, read articles — but ultimately, listen to your gut and do what’s best for YOU. Good luck in your journey.

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