Hi,
I'm familiar with Dr. O'Donnell's protocols and never heard of these chemos in combination before, so I asked Dr. O'Donnell if he had any advice for your mother, and he replied:
"First, this is NOT my protocol at all. It may be someone's misinterpretation
of several combination chemotherapy protocols that I am working on (some
involving EITHER adriamycin OR mitomycin) but I never recommended the
combination of adriamycin and mitomycin. Both are known to cause cystitis
and the combination (although very active) has been reported to cause
substantial toxicity (severe cystitis) in over half of the patients treated.
The group that has been advocating this treatment is from Japan, Dr. Fukai.
He has reported about a 70% success rate. There are no 100% successful
treatments for bladder cancer.
I have found the best solution for the chemical cystitis caused by these
types of drugs is an oral prednisone taper taken over about 2 weeks (similar
to what physicians prescribe for a bad case of poison ivy or a severe
allergy). The dose starts with 40 milligrams a day for 3-4 days then cuts in
half to 20 mg for 3-4 days then 10 mg then 5mg then 2.5mg (each over 3-4
days) then done. It is also occassionly helpful to instill a steroid
medication directly into the bladder (solumedrol) plus an anesthetic
(marcaine) once a week for several weeks. You might also try some steroid
cream (not the weak hydrocortisone but stronger creams like aristocort) on
the involved skin then apply some diaper rash cream (like desitin) on top of
it - 3 times a day for about 2 weeks.
Ultimately, the best treatment for your mom may be bladder removal. The
disease that she has (based on your report below) is very very serious and
can lead to eventual life-threatening invasive disease in 50-80% of cases
once the patient fails BCG.
Anyway, I am very sorry to hear of your mom's distress and I hope the
suggestions above will be of some benefit. Of course, please discuss them
with your mom's doctor before going through with any of them as there are
some side effects that may also occur with the steroid medications."
Sincerely yours,
Michael O'Donnell, MD
Professor and Director of Urologic Oncology
University of Iowa Carver College of Medicine
D