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Bladder cancer chemotherapy |
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The decision to recommend bladder cancer chemotherapy depends on the characteristics of the individual patient. The three main reasons for recommending bladder cancer chemotherapy are: Neoadjuvant This is usually used for otherwise fit patients whose malignant cells have invaded the wall of the organ. Evidence has demonstrated that this improves the outcome of the radiotherapy or surgery. In some cases if the tumour is particularly bulky it could shrink the tumour down and make surgery possible. Adjuvant In this situation bladder cancer chemotherapy is given to patients after primary treatment (surgery or radiotherapy) as an added insurance policy to reduce the chance of it returning in another part of the body in the future. For this particular condition current evidence does not suggest a strong benefit but it is still considered useful in some individual circumstances. Palliative The aim is not to cure, but to control or shrink the tumour especially if it is causing a specific symptom. The aim of this treatment is to improve the quality of life (QOL); therefore the side effects from the treatment should not outweigh the benefits of shrinking the tumour. Your oncologist would require a full re-assessment of your disease after two or three cycles, to check whether the treatment given is working effectively or not adversely affecting QOL . Re-assessment can be a combination of factors. First and foremost the patients symptoms should have improved, secondly there may be a lump or node on examination which should have reduced in size. Thirdly, response could be seen on an x-ray, CT or MRI scan. Finally some tumours secrete a chemical into the blood stream which can be measured (these include CEA) - the levels of these reduce when a patient responds to the therapy given. If there is no clear response, the treatment regime could be stopped or changed. The most common regimens are: |
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