Patient Power®
Get Email Alerts!
Health Topics
Bladder Cancer Health Center
Health Center Home Audio Programs Videos
Search by Keyword:
Search by Health Topic:
View all Health Topics >
Spring Survey Results 2012

Treatments

Program: Advances in the Treatment of Bladder Cancer
<< Previous   1   2   3   4   5   6   7   8   9   10   11   12   13   Next >>

Andrew Schorr:

You are back listening to Patient Power as we discuss bladder cancer with Dr. Colin Dinney, chairman of the department of urology at M. D. Anderson, and also his patient Tom Touzel, who coincidentally are both joining us tonight live from different parts of Canada. Tom lives in Canada some of the time, sometimes comes down to Texas for his work with M. D. Anderson and helping other patients and helping related to the support of research as well. And Dr. Dinney is up at a bladder cancer think tank near Quebec or in Quebec province.

Dr. Dinney, let me ask you about this. Just before the break you were mentioning about injecting something into the bladder to try to lower the risk of tumors. Again what do you inject? And then let's learn more about these various approaches you use like that.

Dr. Dinney:

Okay. Well, I think that we are talking about non muscle invasive tumors that really our goals of treatment are to prevent the cancer from recurring, and we also want to prevent progression of the cancer. Now, we also want to make this as less morbid a therapy as possible. So generally after somebody has a tumor that's removed we will often give a single course of chemotherapy into the bladder in the recovery room after the procedure because that's been shown to delay the frequency of recurrences. It delays the frequency of recurrences by about 10 percent, but it's been shown to be effective in individuals. And so we do offer that to individuals who have small tumors that we think will be amenable to it.

Now, if individuals have higher risk disease, if their cancer looks angry under a microscope, we call that high grade cancer, if they have carcinoma in situ, which is a form of very aggressive cancer which is confined to the lining, a tumor which is minimally invasive into the bladder wall, that is it is starting to invade but not into the muscle, in those individuals we will actually go back and rebiopsy the bladder to make sure that we are not understaging it because understaging of these tumors is a very, very frequent problem and can be quite deleterious and dangerous. Also people who have large tumors or recurrent tumors or multiple tumors when we diagnose them will all be candidates for more aggressive intravesical or therapy put into the bladder.

Now, there have been a number of agents that have been studied in this scenario including a number of chemotherapeutic agents including thiotepa, mitomycin which we commonly use, and others, and then some of the other immune stimulants, the most prominent which is called BCG which is actually the attenuated form of a tuberculosis vaccine. Now, BCG is given into the bladder, and we generally give it once a week for six weeks. It's reasonably well tolerated. It does cause individuals to complain of frequency of urination, sometimes some burning and some pain and sometimes blood in the urine. But BCG has been shown to be the most effective agent for reducing recurrence and reducing progression. And in fact about 80 percent of individuals who are candidates would be expected to respond to BCG.

<< Previous   1   2   3   4   5   6   7   8   9   10   11   12   13   Next >>