I have muscle invasive differential cell carcinoma that has not spread outside of my bladder. I am at the end of four cycles of MVAC chemo, and my urologist has recommended a radical cystectomy. The chemo has worked as planned in containing the tumor and shrinking it somewhat, and I have not had bad reactions from taking it. I have full bladder volume and I am not urinating blood. Are there any alternatives to surgery? I am open to traditional and alternative treatments. I just want to know if there is an approach that would leave my bladder and prostate intact. Thanks.
Cystectomy is the safest option. Bladder reconstruction may be possible. Radiation usually given with chemotherapy is a possible alternative depending on the location of the tumor and other factors. Radiation is less successful than surgery in controlling muscle invasive bladder cancer. Patients who have a complete response to chemotherapy can be followed. However, there is significant danger with this approach. Reliably assessing complete response is difficult, and chemotherapy only results in long term control in 15-20% of patients.