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Chemo before or after RC for invasive BC
I am newly diagnosed with muscle invasive BC. Just had TUR but they were unable to remove all of 6 cm tumor. Also had severe hydronephrosis when diagnosed. I am now scheduled to start chemo with gemcitabine and cisplatin to be given for 3 months. I am unsure if I should have the chemo 1st or the RC. Apparently this is a very aggressive type of cancer. I am concerned if I wait and the chemo isn’t effective at all I will have wasted all those months and it could spread even further. Also that I will be so wiped out from the chemo I will have to wait even longer before I can have the surgery. It is very overwhelming!
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10 Replies
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I did not have cemo before or after my RC in 2004. They stopped with that procedure in the 80s my uro said.
I live in Oslo, Norway and had my surgery there.
I hope things work out well for you.
Sincerely,
Knut
Diagnozed first time April 1th 2004.
Muscle invasive, T3A.
Radical Cystectomy June 29th 2004.
Illeal conduit. Bag on my stommack.
Thank you. I made an appointment online today at Mayo for a second opinion. But I will go ahead with the recommended chemo, since it could be awhile before I could be seen. Thanks to everyone for their advice and comments. I went to the doctor last month thinking I had a UTI and found this instead! So of course like with everyone else, it is a shock. My husband has Non-Hodgkin’s lymphoma, he said we are very lucky he doesn’t need chemo now too. So that is something to be thankful for.
I had my surgery here in Ocala. I wasn’t offered chemo before and my nodes were clean so I didn’t need it after. I guess I was lucky or had a Dr that didn’t know what he was talking about. I also had an oncologist so I guess maybe he did the right thing. They always tell you on this site to get a second opinion, maybe that would make you feel better. Good luck
Barbara
Dx 4-28-08
pT3a no mo
Rc with Ileal Conduit on 6-09-08
2nd surgery on 6-27-09 for ureter leak
Renal failure on 7-01-09 nephy tube and then stent on 7-09-09
so far so good
Wherever you go, I would follow the doctors’ recommendations there about chemo. Having it before RC, if that is what is recommended, provides the opportunity for any small “seed” tumors to be killed before they have the chance to take hold. It would be quite a while after an RC before you would be strong enough for chemo.
What ever you do, go to a top place (and you seem to have a good choice)!
Best of luck to you.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
Forum Moderator
I am on the eastern coast. Where did you have your surgery? I am considering Shands, Mayo or Moffitt. They are all about a three hour drive from home. I am wondering now if I should just have the surgery before I do anything else, although I figure I may need chemo anyway.
where in Florida are you? I am in Ocala and had muscle invasive stage 3. I had my rc 4 and a half years ago and did not have any chemo before or after. I have an ileal conduit and I am very satisfied with it. Good luck to you and have positive thoughts.
Barbara
Dx 4-28-08
pT3a no mo
Rc with Ileal Conduit on 6-09-08
2nd surgery on 6-27-09 for ureter leak
Renal failure on 7-01-09 nephy tube and then stent on 7-09-09
so far so good
I am happy he is doing well. So that is a positive outcome at least. What type of diversion did he choose? I am weighing the options, but I don’t think I am a candidate for neobladder surgery. Guess I need to concentrate on one step at a time. I have had sensory overload this week!
Jim did not have chemo prior to his rc but after. We just saw his oncologist Friday and had this discussion. 2 1/2 yrs out Jim is dong well and cancer free until proven otherwise. The standard is chemo pre surgery. If you have any doubts a second opinion is always best. I wish you well in your journey.
I am in Florida, all the major hospitals with surgeons specializing in RC are about a three hour drive. Which is okay, I’ll make the drive, but I am concerned I won’t be able to get an appointment any time soon with one of them and I would like a second opinion before I start chemo.
My impression is that this is the usual protocol…chemo and then RC in cases such as yours. I think they want to hit that tumor just as soon as possible. If you are unsure about the approach, you might want to get a second opinion at a major center that treats LOTS of bladder cancer. Where are you located? Perhaps some of our members might have suggestions for such a place near where you live.
Sara Anne
Diagnosis 2-08 Small papillary TCC; CIS
BCG; BCG maintenance
Vice-President, American Bladder Cancer Society
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