Churging surgery for bladder cancer - is it necessary?
A member of my family has recently been diagnosed with a bladder cancer. Bladder excision surgery is planned. Is there any non-invasive therapy?
Answer: Unfortunately, the surgery, although very mutilating, is necessary and there is no alternative for it. After the surgery and the final stage of the disease (after the histopathological examination of the removed tumor), additional radiotherapy (for the pelvic area) and possibly chemotherapy may be used. Doing so should reduce the risk of local recurrence and distant metastases.
Is transurethral resection of a large bladder tumor satisfactory?
A cystoscopic examination revealed a tumor on the bladder. The tumor grew surface - reached the size of 6 cm - surrounding the bladder and blocking the mouth of the right ureter. Microscopic examination showed that this is a malignant tumor in the second stage, but it has not yet been able to penetrate the bladder. It was immediately removed by transurethral resection of the tumor. Tumor residues are treated with chemotherapy. Is such an operation enough? Is it enough to use chemotherapy and two-month cystoscopic control in further treatment? What do you think about the use of BCG vaccine?
Answer: Urologists in the treatment of bladder cancer currently apply international standards in the treatment of cancer in Poland. In the case of a minor stage of the disease, a local excision and subsequent chemotherapy are indicated. The use of such a complete procedure as bladder resection is simply not recommended. You can use the BCG vaccine, it certainly will not hurt and can help.
Bladder papilloma - chemotherapy and what next?
I was worried about one-off haematuria. Ultrasound examination revealed a diagnosis of papilloma (!) Of the bladder 20x20mm. Confirmation of the diagnosis by cystoscopic examination, (Transitional cell carcinoma papillare G1. The spine does not exceed the thickness of the mucous membrane), and then by tomography. I underwent transurethral resection of the tumor. After the tumor removal procedure I was additionally offered immunological treatment of BCG (Onco Tice drug), but only after obtaining the tuberculin test result - the swelling can not exceed 20 mm. Unfortunately, in my case the test showed a diameter of 30 mm edema. In this situation, BCG immunotherapy was abandoned and a cytostatism called Doxol was used. I am after the first ingot - without complications. Therefore, I have a few questions: 1) Does the use of such therapy as in my case cause any side effects and can they be prevented? 2) Is immunotherapy irreversible in my situation? 3) What are the other treatment options in case the current one turns out to be ineffective? 4) Is it possible to completely cure the disease at this stage? 5) Is any diet indicated during treatment? What drugs can be used and whether? 6) Do you use any supportive drugs (vitamins, herbs, etc.)? I will add that I am professionally active, without any (serious) discomfort so far. I am asking you for an answer.
Answer: 1). side effects of intravesical chemotherapy are relatively mild - they most often manifest themselves as irritation and inflammation of the bladder and urethra. There are no systemic side effects (eg cardiotoxicity, low white blood cell count, alopecia). There is no need to prevent them. 2. I am afraid that actually immunotherapy is not currently the best method of treatment for you. Perhaps in the future, after repeating the tuberculin test you will be able to think again about giving BCG. 3. You should discuss the possibilities of radical treatment with your urologist. The decision to choose treatment is not easy.The best effects (counted as a percentage of 5-year and 10-year survival), give a radical surgical treatment - that is, total or partial bladder resection (the choice of the method depends on the extent of neoplastic infiltration). At the same time, it is the most mutilating method and is burdened with the highest percentage of complications (depending on the center's experience, 6 to 38% of patients die from complications after surgery). Alternatively, chemotherapy combined with chemotherapy can be used, which gives a slightly lower percentage of cures, but is much safer. Blister intravesical injections from cytostatics are the method by which recurrences often occur. Therefore, after completing this treatment, you should very often carry out check-ups - cystoscopy at least every 2 months. 4. Complete cure is possible at this stage of the disease - the greatest chance is given by radical surgery (bladder removal), slightly worse results can be obtained with the use of radiotherapy. 5. There are no special recommendations for diet. Only cigarettes are contraindicated from stimulants - I do not see any contraindications for coffee and alcohol (of course in reasonable quantities). 6. Vitamins, especially in high doses, in cancer disease are generally contraindicated (cancer cells make them a better use than healthy tissues and cells). As for herbs, according to my knowledge, there is no herbal medicine with proven effectiveness in the treatment of cancer (vilcacora is a big scam).
Recurrences of bladder cancer
For several years I have had a constant recurrence and proliferation of papillomas in the bladder. 5 times papilloma removal procedures were performed transurethral resection of the primary tumor (TURT) and unfortunately they have not been removed because there was a problem with availability. In addition, one of the tumors blocks the ureter on the right side. After these surgeries, urine blocked in the right kidney, and later urine retention. I was offered cystoscopy of the bladder and removal of the right kidney. The kidney opening and removal of the tumor from the kidney and TUR procedure through the urethra were performed. Mitomycin ingots (4 ingots) were used. A cystoscopy was made later and a recurrence and even more recurrences of tumors were found. I asked the doctor to use ingots with BCG, but the doctor claims that it is best to perform cystoscopy, and perform a replacement intestinal bladder. I am aware of what problems I will have to deal with after such an operation. The problem of professional work, the length of sick leave and the possibility of losing a job or the necessity of moving to a sickness pension. I have 32 years of work and in 2006 I could have retired early. I have the impression that BCG ingots may help stop the development of this disease and prevent the tumor at the moment after G2 histopathology does not turn into G3.
Answer: From your description of the disease, it appears that you have bladder cancer, not papillomas. In this situation, and at the same stage of the disease, I do not think that the BCG ingots will do anything to help you. I advise you to listen to your doctor and undergo surgery before metastasis occurs, because then there will be no chance of healing. You can live with the intestinal bladder, although of course the quality of life deteriorates considerably. However, this is a better solution than leaving an untreated tumor - in such a situation you may simply not live to the retirement age. All issues related to losing your job, length of sick leave or sickness benefit should not really obscure your most important problem, which is cancer.
Advanced bladder cancer - stagnation of urine in the kidneys
Intensively treated patients with bladder cancer in old age can not urinate. Matomography showed stagnation of the kidneys, cauliflower at the mouth of the bladder. What does it mean?
Answer: A disturbing symptom in the cited study is the widening of the calf-pyelone system and urinary incontinence in the kidneys. This is evidently caused by a tumor in the bladder. Because this condition threatens to rapidly develop renal failure, the patient should urgently report to the urologist. Probably it will be necessary to put on renal pelvis catheters ("S" type catheters), or even nephrostomy, so as to ensure a free urinary outflow.
