Benefits of Neoadjuvant Chemo

And lucky me day 15 of my chemo I broke out in a rash on my shins and forearms and here it turned out I was allergic to the Gemzar first time I had an allergy to anything and of all things a friggin chemo drug. So they switched me over to the high intensity MVAC chemo which I did fine with. Joe

Yes, the guidelines are saying this, in Europe too, that there appears to be an added benefit to pre-op chemo, and Gemzar-Cisplatin is surely moving quickly up the ladder as first line approach.

The last article I read about this up and coming new standard of treatment was that the trouble with it is...only 3% of doctors polled actually do it! Something about implementation of guidelines being very slow to take hold in uro-oncology.

Which says to me this is just another good reason for patients themselves to take part in the new field of "participatory medicine" - meaning people just like us learning all we can so we can choose along with our doctors, and learn about the many treatment options. There are many variations on the theme, depending on where you go and who you speak to. It's good to be convinced, and to believe you've made the right choice with your doctor. Even if it is not the gold standard...but tailored to your personal preferences and needs (like bladder sparing for example).

I'm glad to see that behemoths like UPenn and MDAnderson are setting the examples re:neoadjuvant chemo, a lot of research comes from these places that most uros will read sooner or later.

Take care,
Wendy

Interesting article Joe. In fact my Oncologist at MD Anderson told me Neoadjuvant Chemo..........Gemzar/Cisplatin is now their gold standard for invasive bladder cancer.

Dr's have been debating rather doing the chemo before the surgery or doing the chemo after the surgery for years and it is still going on today. When I went to see my surgeon Dr' Malkowicz I thought I was getting the surgery and then the chemo. Then he explained how he had a better success rate doing the chemo first especially if the cancer was contained in the bladder in his words "If it is contained then let's keep it that way" Well I had to think about this and the more I did the more sense it made to me so I told him I would go ahead with the chemo first. Now here is an article to back up what he was talking about. What is different is the year thing when I was in his office he told me he got a thank you card from a guy celebrating his 10th year and some folks even had more then that and some didn't. I don't play the statistic game as all that does is give you somewhat of an idea and cancer doesn't play numbers it does what it is going to do. Joe

www.nci.nih.gov/clinicaltrials/results/pre-surgical-chemo0501