Video

On Cancer: Watch Experts Discuss Bladder Cancer Diagnosis and Treatment

By Jim Stallard, MA, Writer/Editor  |  Tuesday, February 5, 2013
Pictured: Bernard Bochner
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Memorial Sloan Kettering experts discuss their multidisciplinary approach to identifying and treating bladder cancer.

(83:00)

In a recent discussion as part of Memorial Sloan Kettering’s CancerSmart lecture series, bladder cancer experts spoke at a public event about symptoms and risk factors, various disease stages, and the latest treatment options available for bladder cancer.

Given the complexity of the disease, the experts emphasized the advantages of receiving treatment at a highly experienced facility such as Memorial Sloan Kettering, where hundreds of patients are cared for each year.

“It certainly is a team approach to managing people with bladder cancer,” says medical oncologist Dean F. Bajorin. “I think one of the major advantages to this type of center is directly related to the individual expertise of everybody involved, from pathologists making sure your slides have been correctly read, to nurses that help you get through various procedures, to the doctors who are working together to optimally manage the different stages of the disease.”

Watch the talk, or explore specific videos on understanding the disease, diagnosis, risk factors, treatment approaches, and minimally invasive surgery and reconstruction.

Comments

what does mean when the doctor says you have 80% cancer in the blood/urine.

Irene, thank you for your comment. Unfortunately we are not able to answer personal medical questions on our blog. We recommend that you follow up with your doctor.

please respond thank you.

It sounds like advanced bladder cancers are treated with surgical removal. Given cancer has not metastasized to bone or distant organs, are there situations where radical cystectomy is not recommended?

Brian, thank you for your comment. We consulted with Dr. Bochner, who responded:

Radical cystectomy is used for disease that is localized to the pelvis. Even in the face of regional lymph node involvement, radical cystectomy could still be helpful. It remains the preferred treatment for this type of disease.

Dr. Bajorin's notes NEJM article demonstrated chemotherapy combined with surgery survival is superior to surgery alone. He also states that MSKCC uses chemo prior to surgery. The NEJM article research used surgery prior to chemo. Drugs were fluorouracil & mitomycin, with radiation. It is unclear from Dr. Bajorin's statements whether MSKCC follows any of these treatments. Specifically: chemotherapy before or after surgery? Fluorouracil and mitomycin? Is radiation routinely used with chemotherapy

Hi Brian, we consulted with one of our physicians and this is his response to your questions:

The first question depends on the stage at which the bladder cancer is diagnosed. With muscle-invasive disease (stage II) and higher, we would strongly recommend using chemotherapy before surgery if the patient is a candidate for chemotherapy and for surgery.

In certain cases, we will recommend chemotherapy plus radiation instead of chemotherapy followed by surgery as definitive treatment for stage II bladder cancer.

One recent clinical trial comparing radiation alone to radiation with chemotherapy (Fluorouracil and mitomycin) in muscle-invasive bladder cancer showed that patients who received radiation plus chemotherapy had fewer recurrences of their bladder cancer than with radiation alone. Based on this data, we would offer radiation plus chemotherapy consisting of fluorouracil and mitomycin in certain situations.

The decision on whether we would choose chemotherapy followed by surgery vs. chemotherapy plus radiation alone is a personalized one and would require a long discussion with the patient regarding risks/benefits.

Thank you for your response to my first comment. Can you please clarify the issues I raised in my second comment? I look forward to the next response.

Hi Brian, we have forwarded your second question to one of our experts and are hoping for a response today.

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