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gatorsmom

gatorsmom

Total Messages 1

Subject:Neoadjuvant chemo before cystectomy or not?

Hi,

My father, Alan C.,  is 70years old and was diagnosed with bladder cancer in late September 2009.  One week ago, Oct. 13, he underwent TURBT to remove the tumor.  The pathology results gave a diagnosis of, "high grade papillary urothelial carcinoma with extensive invasion of muscularis propria.  Prostetic urethra negative for malignancy."  He had a CT scan done yesterday which showed no metastasis and no enlargement of the lymph nodes.  His cancer was graded as T2 by his urologist.

His urologist recommended a radical cystectomy within 40 days of his TURBT (although the soonest his office could schedule the procedure is November 18th   confused).  The doctor said that they would remove the bladder, prostate and do extensive lymph node dissection to search for minute cancer cells that may not have shown up on the CTscan.   So far, we haven't questioned this.  It sounds like a logical treatment.  However, the urologist did not recommend neoadjuvant chemotherapy and his reasoning was simply that with the results of the CTscan it wasn't necessary.  However, since we met with that doctor, I've read in at least 3 different places that recently an important clinical trial has shown that the use of chemo before radical cystectomy improves survival for patients with invasive bladder cancer because it may kill small metastic deposits of disease that have spread beyond the bladder.  I'm concerned that if we wait til November for the cystectomy and add in recovery time after that, this fast-growing carcinoma will have had time to spread in his body.  If we do chemo first, it may prevent the cancer from gaining a foothold elsewhere in his body. 

My dad has asked me to look into this for him as he is a bit shell-shocked right now from being hit with so many big decisions.  Also, he is not at all computer-literate and relies on me to do his online research.  He is being treated at Gundersen Lutheran hospital system in LaCrosse, Wisconsin.  

Thank you for any help, recommendations, or referrals you can give me!

Lisa


Posted: 22 Oct 2009 10:10 PM
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LWalther

LWalther

Total Messages 69

Subject:Neoadjuvant chemo before cystectomy or not?

Hi Gatorsmom-

So sorry you and your dad have to go through this ordeal!  You seem to have lots of questions related to medical issues.  The best place to go for answers is your dad's medical team, as they know all of the details of his case.  That being said, MD Anderson has a web page that might be somewhat helpful to you:

http://www.mdanderson.org/patient-and-cancer-information/cancer-information/cancer-types/bladder-cancer/index.html

You also mentioned that your dad seems a bit "shell shocked" with his diagnosis and decisions.  He can be matched via telephone with a bladder cancer survivor through Anderson Network:

800-345-6324 or http://www.mdanderson.org/patient-and-cancer-information/guide-to-md-anderson/patient-and-family-support/anderson-network/index.html

Hope this helps and keep us up with your progress,

Laura Walther-Broussard, Social Work Counselor


Posted: 30 Oct 2009 03:26 PM
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