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Treatment of Metastatic Bladder Cancer
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For patients with good performance status (still able to move around and perform their activities of daily living) WITH good kidney function here are the recs for treatment of metastatic or advanced renal cell carcinoma (transitional cell CA)
1) Initial treatment using cisplatin-based chemotherapy with either gemcitabine plus cisplatin (GC) or MVAC (methotrexate, vinblastine, doxorubicin, and cisplatin) is recommended 2) GC (gemcitabine-cisplatin) is generally the preferred regimen based upon its decreased toxicity compared to MVAC 3) MVAC (methotrexate, vinblastine, doxorubicin and cisplatin) is an acceptable alternative in selected patients. High-dose intensity MVAC, administered in 14 day cycles may be associated with a small increase in five year survival 4) There are many ongoing clinical trials and patients should be seek these out whenever possible as various regimens currently under evaluation (including the taxanes, ifosfamide, and trastuzumab) may hold promise Dr O. Posted on 09/18/07, 07:24 pm |
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Whoops
Where I wrote "Renal cell carcinoma" I meant to write "bladder cancer" Dr O. 
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When you write good kidney function how good do you mean. Would a creatinine level of 1.6 prevent using gemcitabine plus cisplatin?
My husband has mild renal insufficiency because of diabetes and he also has MDS 5q- which also contributes to his anemia.
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Creatinine of 1.6 would probably be good enough. They can also estimate a creatinine clearance and judge based on that...but 1.6 should be fine
Dr O.
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Dr Orr,
.My husband 69 young years old, he has been diagnosed with bladder cancer and many large/small tumor's , dr. indicate bladder removal after chemo, which he just started the chemo. Plans are to go with the neobladder, no stoma...I underststand it's a longer operation and if healthy person is an option for some. Have you heard of anyone been or going through chemo (before their bladder removal surgery) that is have or having frequent relentless urination, like every 20 minutes, during chemo? They advise you must drink alot of water to flush toxins from the chemo,so I'm assuming it's normal? I welcome any thoughts on this. Texrose "
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Dr Orr,
I forgot to mention their is still no proof thru cat scans that the cancer has metastaized outside bladder, but is it still a good idea to do chemo cisplatin & gemzar standard therapy anyway before surgery? He already has had 2 TURBT's ...Also if creatine levels within range, and they know their is a mild to moderate blockage in ureter exit, would that be a clearance to go ahead with Chemo? Any thoughts? Thanks Texrose
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