Is Surgery Needed for Muscle-Invasive Bladder Cancer?

6 years 11 months ago #53083 by Jack R
The subject, Tri Modal Therapy (TMT) is not a new subject, it has been around for years. There may well be individuals, in specific circumstances, for whom it may offer a plausible option.

I remain unconvinced that it "should be considered for most".

I find that articles promoting a wider use of TMT gloss over three issues:
1) The concept of "mostly non-invasive tumor" or "minimally invasive", and
2) The follow-up plan in case TMT fails to provide the claimed benefit, and
3) Uncertainties in the staging of tumors.

Again, TMT may be applicable to an individual, but until it can be shown to equal or surpass "the gold standard" of RC, it is likely to remain NOT considered when choices are made for most BC patients.

My opinion, based on my reading and understanding of the subject. I agree, the thought of keeping one's bladder is seductive.

6/2015 HG Papillary & CIS
3 Years and 30 BCG/BCG+Inf
Tis CIS comes back.
BC clear as of 5/17 !
RCC found in my one & only kidney 10/17
Begin Chemo; Cisplatin and Gemzar
8/18 begin Chemo# 3
Begin year 4 with cis
2/19 Chemo #4
9/19 NED again :)
1/2020 CIS is back
Tried Keytruda, stopped by side effects
Workin on a new plan for 2021
The following user(s) said Thank You: lotech35

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6 years 11 months ago #53072 by dtat60
I'm not sure if this has been discussed before (Article dated May 2016)?

Should urologists rethink radical cystectomy (RC) as the best choice for most patients with muscle-invasive bladder cancer (MBIC)?

Yes, says radiation oncologist Timur Mitin, MD, PhD, Oregon Health and Science University, in Portland, who is a staunch proponent of bladder-preserving trimodality therapy (TMT) as an alternative to the gold-standard RC.

No, say Peter Black, MD, and Edmund Chedgy, MBBS, Vancouver Prostate Center, University of British Columbia, Canada, who argue in favor of the gold-standard RC. Both viewpoints were published online May 5 in JAMA Oncology.

www.medscape.com/viewarticle/863338#vp_1

08/16 Blood in Urine;09/16 CT Scan, RPG, Cysto;10/16 TURBT;12/08 BL TURBT;01/17 6X BCG;05/17 NED, 3X BCG, 9/17 NED, 3X BCG,1/18 NED, 3X BCG,7/18 NED, 3X BCG

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