Chemo for high grade superficial BC

Yes, your right Wendy. I am not pushing to have it done, just curious as to why it does not seem to be considered. Your explanation sounds very plausable.

Since you are very young and are looking at long term survival as the goal, keep in mind that chemo comes with its own risks and long term side effects. For example the 'C' in MVAC, Cytoxan, has been shown to cause bladder cancer. This drug is used in breast cancer as well (my sister had it) and is given with a bladder-protectant drug Mesna. If a person survives long enough there's a big risk of bladder cancer down the road. If one is post-op and bladder-less I suppose it's not as risky (maybe).

That brings us to 'risk vs. benefit' and that's probably why chemo isn't given in your situation of early stage TCC, the numbers don't warrant it. There's also the Oath to "First do no harm". The newer drug combos for advanced bladder cancer are so new there are no long term data to call upon, so we can't be sure that it's a good thing for a person in your situation.

It's very hard for uro-oncs to know when exactly they are over-treating or under-treating. Nobody would want to give a man your age toxic drugs that might not even work...unless spread was near-definite and response could be tracked.

Early stage bladder cancer treatments, immunotherapy -which you are doing- is all about stimulating the immune system. Chemo does the opposite and might even be bad for your condition. It's not for nothing that it's reserved for high risk cases where spread is confirmed or at least highly suspected.

Wishing you all the best,
Wendy

Yes Wendy, there might be some science to it that makes it impractical... Maybe a 5-10% statistical chance isn't enought to warrant treatment or maybe the chemo still doesn't do such a good job at killing off any microscopic cancer cells floating around in our bloodstreams.

I know that chemo is common practice for many recieving neobladders/urinary diversions if any of the local lymph nodes have traces of cancer upon biopsy, but correct me if I am wrong, quite a few who don't have any infected lympth nodes don't proceed with chemo after the urinary diversion surgury.

I'm not sure why there are no pre-treatments for micro-metaststasis, maybe it is just overtreatment.

Hi Chris,

The only thing I can tell you is that in the 8 yrs I've been following bladder cancer treatments and thousands of people later, I've never heard of it being done.

Wendy

Well, I was wondering if anyone has taken this topic on with their doctors? I know that for grade 3 superficial (Stage 0 & 1) there is a slight risk of micro-metastasis.. somewhere between 0-10% (or higher?), especially for Stage T1G3 tumors.

I initially asked my doctor if we should put me on some sort of chemo treatments to try and kill off any rougue cancer cells that somehow spread before my tumor was removed... he indicated that it wasn't warranted and that I had the right to find some quack doctor who would pursue it for me if I wanted.

I have often wondered if a course of some type of chemo might be warranted for those at higher risk. I'm not talking about chemo instilled in the bladder, but chemo in the blood to try and kill off any micro-metastasis.

Anyone have any thoughts/experience in this matter?