Chemo For Bladder Cancer Stage 2

Take Charge Of Your Health With Cxbladder

Treatment Talk | Explaining Chemotherapy for Bladder Cancer

Early detection saves lives and is a crucial factor when it comes to the treatment of bladder cancer. Cxbladder is a clinically proven cutting-edge genomic urine test that quickly and accurately detects or rules out bladder cancer in patients presenting with blood in the urine and those being monitored for recurrence. The test works at a molecular level, measuring five biomarker genes to detect the presence or absence of bladder cancer.

Cxbladder is discreet, quick, non-invasive and painless, typically giving you meaningful results within five working days. It comes as a suite of test options, each optimized for a different point in the patient journey.

Triage: Incorporates known bladder cancer risk factors to help rapidly rule out the disease.
Detect: Designed to work alongside other tests to improve overall detection accuracy.
Monitor: Optimised for bladder cancer surveillance, reducing the need for further invasive tests

Cxbladder gives you peace of mind and will help your doctor make informed treatment decisions. Speak to your general practitioner or urologist to learn more about Cxbladder and which test might be right for you. You can also contact our Customer Service Team directly.Contact us for more information

There Are Different Types Of Treatment For Patients With Bladder Cancer

Different types of treatment are available for patients with bladder cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

Chemotherapy Prior To Cystectomy

Following a radical cystectomy, local recurrence of cancer is uncommon because the cancer was removed. Despite undergoing complete removal of the bladder, however, some patients will still develop distant recurrences because undetected cancer cells called micrometastases spread to other locations in the body before the bladder was removed. Treatment with a systemic therapy such as chemotherapy may reduce or eliminate these micrometastases.

Neoadjuvant chemotherapy refers to chemotherapy that is given before surgery. The rationale behind neoadjuvant therapy for bladder cancer is twofold. First, pre-operative treatment can shrink some bladder cancers and therefore, may allow more complete surgical removal of the cancer. Second, because chemotherapy kills undetectable cancer cells in the body, it may help prevent the spread of cancer when used initially rather than waiting for patient recovery following the surgical procedure.

A study published in the New England Journal of Medicine reported that patients with muscle-invasive bladder cancer who received chemotherapy prior to cystectomy had better survival than patients treated with cystectomy alone.1

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Non Muscle Invasive Bladder Cancer

Most bladder cancers are diagnosed when they are still only in the bladder lining. These are called non muscle invasive bladder cancers. The prognosis for non muscle invasive bladder cancers depends on several factors, including:

exactly how far the cancer cells have gone into the bladder lining
the number of tumours
how wide the tumours are
how abnormal the cancer cells look under the microscope
whether CIS is present
whether this a recurrence and how often a tumour has recurred

Your doctor looks at all these factors. They use them to decide whether there is a low, medium or high risk of the cancer coming back or spreading into the muscle of the bladder. Your doctor will be able to tell you about your risk group and how this affects your outlook.

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Cellular Classification Of Bladder Cancer

More than 90% of bladder cancers are transitional cell carcinomas derived from the uroepithelium. About 2% to 7% are squamous cell carcinomas, and 2% are adenocarcinomas. Adenocarcinomas may be of urachal origin or nonurachal origin the latter type is generally thought to arise from metaplasia of chronically irritated transitional epithelium. Small cell carcinomas also may develop in the bladder. Sarcomas of the bladder are very rare.

Pathologic grade of transitional cell carcinomas, which is based on cellular atypia, nuclear abnormalities, and the number of mitotic figures, is of great prognostic importance.

References

Al-Ahmadie H, Lin O, Reuter VE: Pathology and cytology of tumors of the urinary tract. In: Scardino PT, Linehan WM, Zelefsky MJ, et al., eds.: Comprehensive Textbook of Genitourinary Oncology. 4th ed. Lippincott Williams & Wilkins, 2011, pp 295-316.

Koay EJ, Teh BS, Paulino AC, et al.: A Surveillance, Epidemiology, and End Results analysis of small cell carcinoma of the bladder: epidemiology, prognostic variables, and treatment trends. Cancer 117 : 5325-33, 2011.

Fahed E, Hansel DE, Raghavan D, et al.: Small cell bladder cancer: biology and management. Semin Oncol 39 : 615-8, 2012.

Figure 1 Provisional Analytic Framework For Treatment Of Non

a Questions on diagnostic testing and identification of patients with muscle-invasive bladder cancer are addressed in a complementary review of non-muscle-invasive bladder cancerb Treatments include: bladder-preserving chemotherapy and/or radiation therapy, partial cystectomy, maximal transurethral resection of bladder tumor regional lymph node dissection neo-adjuvant or adjuvant chemotherapy

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Monitoring For Bladder Cancer Recurrence

Those who have already been treated for bladder cancer have unique monitoring needs to protect against the threat of recurrence. Generally doctors recommend a cystoscopy to examine the inside of the bladder and urethra every 3 to 12 months, depending on your risk of recurrence, for several years after bladder cancer treatment. If several years of surveillance have gone by and no cancer recurrence has been detected, a cystoscopy once a year may be enough, though the final decision rests with the doctor and additional testing may be required depending on the nature and severity of the original cancer.

If you’re recovering from treatment, ask your doctor about Cxbladder. Cxbladder is an accurate and non-invasive surveillance alternative designed to detect or rule out the return of bladder cancer. The test provides reliable results with a single urine sample, reducing the need for frequent cystoscopies in some patients, which can be both uncomfortable and inconvenient.Learn more about Cxbladder

Is Combination Chemotherapy And Radiation Used For Bladder Cancer Treatment

Diagnosing Bladder Cancer 2 – Stages, Grades & Pathology

In recent years, chemotherapy and radiation have been combined to provide a bladder preservation therapy for higher risk cases. In the past radiation therapy alone was used because it effectively shrunk tumors. Bladder cancer tumor cells are chemosensitive, susceptible to the cell-killing effects of anticancer drugs. Adding combined chemotherapy to radiation has improved results. To ensure the success of bladder preservation therapy, there are at least three requirements which should be met: 1) complete resection of the tumor by TURBT 2) no obstruction of 1 or both kidneys as a result of the bladder tumor and 3) no T4 bladder tumors.

If the tumors do not respond to an initial course of chemotherapy and radiation, it may be reasonable to perform, if medically possible, a cystectomy.

Information and services provided by the Bladder Cancer Advocacy Network are for informational purposes only. The information and services are not intended to be substitutes for professional medical advice, diagnosis, or treatment. If you are ill or suspect that you are ill, seek professional medical attention immediately! BCAN does not recommend or endorse any specific physicians, treatments, procedures, or products even though they may be mentioned on this site.

What Medications Are Used To Treat Bladder Cancer

Even if your bladder cancer is non-invasive and non-aggressive, you still are a candidate for drugs, especially chemotherapy and immunotherapy. When you have non-invasive bladder cancer , doctors will prevent tumors from spreading by injecting drugs directly into your bladder via a catheter, where they stay for two hours before you pee them out. This is called intravesical therapy.

Patients with stage 2 and 3 bladder cancer will typically have chemo for two to four months before surgery to shrink tumors. And patients with stage 4 bladder cancer typically dont have surgery, but do get chemotherapy, targeted drugs, or immunotherapy to slow and control their disease.

Here are the drugs that are typically used:

What Causes Bladder Cancer

Healthcare providers and researchers dont know exactly why certain bladder cells mutate and become cancerous cells. Theyve identified many different risk factors that may increase your chance of developing bladder cancer, including:

Cigarette smoke: Smoking cigarettes more than doubles your risk of developing bladder cancer. Smoking pipes and cigars and being exposed to second-hand smoke may also increase your risk.
Radiation exposure: Radiation therapy to treat cancer may increase your risk of developing bladder cancer.
Chemotherapy: Certain chemotherapy drugs may increase your risk.
Exposure to certain chemicals: Studies show that people who work with certain chemicals used in dyes, rubber, leather, paint, some textiles and hairdressing supplies may have an increased risk.
Frequent bladder infections: People who have frequent bladder infections, bladder stones or other urinary tract infections may be at an increased risk of squamous cell carcinoma.
Chronic catheter use: People who have a chronic need for a catheter in their bladder may be at risk for squamous cell carcinoma.

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Treating Bladder Cancer That Progresses Or Recurs

If cancer continues to grow during treatment or comes back after treatment , treatment options will depend on where and how much the cancer has spread, what treatments have already been used, and the patient’s overall health and desire for more treatment. Its important to understand the goal of any further treatment if its to try to cure the cancer, to slow its growth, or to help relieve symptoms as well as the likely benefits and risks.

For instance, non-invasive bladder cancer often comes back in the bladder. The new cancer may be found either in the same place as the original cancer or in other parts of the bladder. These tumors are often treated the same way as the first tumor. But if the cancer keeps coming back, a cystectomy may be needed. For some non-invasive tumors that keep growing even with BCG treatment, and where a cystectomy is not an option, immunotherapy with pembrolizumab might be recommended.

Cancers that recur in distant parts of the body can be harder to remove with surgery, so other treatments, such as chemotherapy, immunotherapy, targeted therapy, or radiation therapy, might be needed. For more on dealing with a recurrence, see Understanding Recurrence.

How Long Will You Live If You Have Bladder Cancer

The survival rate depends on the stage of cancer at diagnosis and other health issues.

Overall, 70 to 90 percent of people with localized bladder cancer will live for at least five years or more. The physician calculates this with the help of survival rates. Survival rates indicate the percentage of people who live with a certain type of cancer for a specific time. The physician often uses an overall five-year survival rate. Factors that may affect survival rate include

Table. Five-year survival rates of different stages of bladder cancer

Bladder cancer SEER stages
All SEER stages combined	77

The surveillance, epidemiology, and end results stages are taken from the SEER database, maintained by the National Cancer Institute. SEER database groups cancers into localized, regional, and distant stages.

Localized: There is no indication that cancer has spread outside the bladder.
Regional: Cancer has invaded the nearby structures or lymph nodes.
Distant: Cancer has spread to distant parts of the body, such as the lungs, liver, or bones.

Thus, bladder cancer, if detected in the early stage is treatable and has higher survival rates. However, if the cancer is detected in the advanced stages, treatment becomes difficult and the survival rate is low.

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Five Types Of Standard Treatment Are Used:

Surgery

One of the following types of surgery may be done:

Transurethral resection with fulguration: Surgery in which a cystoscope is inserted into the bladder through the urethra.A tool with a small wire loop on the end is then used to remove thecancer or to burn the tumor away with high-energy electricity. This is known as fulguration.
Radical cystectomy: Surgery to remove the bladder and anylymph nodes and nearby organs that contain cancer. This surgery may bedone when the bladder cancer invades the muscle wall, or when superficialcancer involves a large part of the bladder. In men, the nearby organs that areremoved are the prostate and the seminal vesicles. In women, the uterus, theovaries, and part of the are removed. Sometimes, when the cancer hasspread outside the bladder and cannot be completely removed, surgery to removeonly the bladder may be done to reduce urinary symptoms caused by the cancer.When the bladder must be removed, the surgeon creates another way for urine toleave the body.
Partial cystectomy: Surgery to remove part of thebladder. This surgery may be done for patients who have a low-grade tumor thathas invaded the wall of the bladder but is limited to one area of the bladder.Because only a part of the bladder is removed, patients are able to urinate normally afterrecovering from this surgery. This is also called segmental cystectomy.
Urinary diversion: Surgery to make a new way forthe body to store and pass urine.

Radiation therapy

Chemotherapy

Treatment Of Recurrent Bladder Cancer

For information about the treatments listed below, see the Treatment Option Overview section.

Treatment of recurrent bladder cancer depends on previous treatmentand where the cancer has recurred. Treatment for recurrent bladder cancer mayinclude the following:

Radiation therapy as palliative therapy to relieve symptoms and improve quality of life.
A clinical trial of a new treatment.

Use our clinical trial search to find NCI-supported cancer clinical trials that are accepting patients. You can search for trials based on the type of cancer, the age of the patient, and where the trials are being done. General information about clinical trials is also available.

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How You Have It

You have chemotherapy into a vein . This means you have treatment through a thin short tube that goes into a vein in your arm each time you have treatment.

You usually have chemotherapy as cycles of treatment. Each cycle is either a 2, 3 or 4 week period. The cycle length varies in time depending on the chemotherapy you are having.

You usually have 3 cycles of chemotherapy before surgery or radiotherapy. After surgery or radiotherapy, you might have 6 or more cycles.

Your specialist will explain how you have treatment, and how long they expect your treatment course to be.

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Mechanistic Interactions Between Bladder Cancer And Aging

Bladder Cancer: What to Know If Youve Just Been Diagnosed

Several broad hypotheses have proposed potential mechanisms for the association between cancer and aging, whereby the biological processes of aging could influence the development and/or progression of cancer in older adults. The processes interact at multiple levels for example, tumor protein 53 a tumor suppressoris involved in both cancer and aging: alteration of the p53 gene is the most frequently encountered mutation in human cancers , and the efficiency of the response to p53 has been found to vary according to age. In a mouse study, Feng et al. reported that the efficiency of the p53 response was significantly reduced in older mice compared with their younger counterparts. The reduced response predominantly resulted from decreased transcriptional activity and p53-dependent apoptosis decreased stabilization of p53 after stress was found to be the major factor in this decline.

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