My Bladder Cancer Fight

What is a bladder Oncologist?

Oncology (on-KOL-uh-jee) - An area of medicine that deals with the study and treatment of cancer.

An Oncologist is a Medical Doctor trained in the use of Chemotherapy drugs to kill cancer cells.

A Bladder Oncologist is specially trained to treat cancer of the bladder.

The following paragraphs have been quoted and or paraphrased. The original website is given below.

Chemotherapy is the use of drugs to kill cancer cells. For bladder cancer, doctors may decide to use one of two types of chemotherapy:

intravesical (local)

or

systemic (whole body) treatment.

In general, earlier-stage cancers are more likely to be treated with local chemotherapy and more advanced cancers with systemic chemotherapy.

Intravesical therapy.

In this type of therapy, drugs are placed into the bladder through a catheter inserted in the bladder through the urethra. Local treatment kills only noninvasive tumor cells. It cannot reach tumor cells in the bladder wall or that have spread to other organs. The most common drug that is given in intravesical treatment is an immunotherapy drug called BCG (see above), other times, chemotherapy agents are used. The most common chemotherapy used is mitomycin C (Mitomycin, Mutamycin); thiotepa (Thioplex) and doxorubicin (Adriamycin, Rubex) have also been used. Intravesical therapy can cause bladder irritation, bladder infections, temporary inability to urinate, or blood in the urine. Rarely, patients experience fevers or chills.

Systemic chemotherapy.

In this type of chemotherapy, patients receive drugs orally (by mouth) or intravenously (given through an IV). Intravenous chemotherapy is either injected directly into a vein or through a catheter. The drugs enter the bloodstream and travel to all parts of the body. Since most chemotherapy kills some healthy cells as well as cancer cells, side effects are common. Most side effects can be treated with medications and go away after treatment is over. Side effects of systemic chemotherapy can include nausea and vomiting, loss of appetite, hair loss, mouth sores, anemia (low blood cell count), fatigue, bleeding or bruising after minor injuries, and increased chance of infection.

In bladder cancer, many of the available chemotherapy regimens are still being tested in clinical trials to help determine which drugs, or which drug combinations, work the best in treating bladder cancer. Of the known drugs, usually a combination of drugs works better than one drug alone. The question of whether and in what situations is it best to give chemotherapy before or after surgery is also being tested in clinical trials.

A combination of drugs, called MVAC, has been used as the standard treatment for bladder cancer for many years, based on the results of clinical trials from the 1990s. MVAC has been useful in bladder cancer in delaying recurrence, extending life and sometimes achieving cure, but it has severe side effects. Other drugs are now in clinical trials to determine if there is a combination of drugs that works better and has fewer side effects. MVAC uses four drugs: methotrexate (MTX, Amethopterin, Rheumatrex, Trexall), vinblastine (Velban), doxorubicin (Adriamycin, Rubex), and cisplatin (Platinol). More recent clinical trials have shown that the combination of a newer drug gemcitabine (Gemzar), plus cisplatin, gives similar anticancer effects to the MVAC combination but with fewer side effects. Clinical trials are currently studying this new combination with the addition of other chemotherapy agents, such as paclitaxel (Taxol), docetaxel (Taxotere), and ifosfamide (Ifex).

Chemotherapy for locally advanced bladder cancer

Locally advanced bladder cancer refers to invasive bladder cancer that has spread beyond the boundaries of the bladder to surrounding organs or to the pelvic lymph nodes. Researchers are studying new combinations of chemotherapy that are more effective in managing bladder cancer. Treatments may include:

* Combinations of different drugs

* Known drugs tested in different doses

* Drugs or drug combinations given before or after surgery

* Drugs or drug combinations given along with radiation therapy. If radiation therapy is combined with chemotherapy, it may make chemotherapy more effective through an effect called radiosensitizing.

Metastatic bladder cancer

Metastatic bladder cancer refers to cancer that is diagnosed after it has spread beyond the lymph nodes. The term advanced bladder cancer may be used; this can also refer to a cancer that has recurred after all local treatments (such as a cystectomy or radiation therapy) have failed and which poses a serious threat to the patient’s survival.

There are no methods to permanently cure metastatic bladder cancer in most people. In these cases, the goal of treatment switches to slowing the spread of cancer, achieving shrinkage of tumor (temporary remission), relieving symptoms, and extending life as long as possible. With advances in treatment, most patients with advanced bladder cancer can expect to live many months or even years-longer than they could just a few years ago. As outlined above, the MVAC and gemcitabine-cisplatin regimens are the current standard approaches in treatment; clinical trials are studying whether modifications of these regimens or the use of novel treatment regimens will improve survival rates, quality of life, and duration of life. Since there are relatively few treatment options for metastatic bladder cancer, clinical trials are often the best option for treatment. Clinical trials compare the best treatments available (standard treatments) with newer treatments that may be more effective. Investigating new treatments involves careful monitoring using scientific methods and all participants are followed closely to track progress.

To read the source of the above, go to Oncology for the full text.

Posted on March 14th, 2008 by Neil
Filed under: Bladder Cancer - Background, My Cancer