ZocdocAnswersWhat are the alternatives to a radical cystectomy?

Question

What are the alternatives to a radical cystectomy?

Large transitional cell carcinoma (3.0 x 6.5 cm) Right Bladder Wall. Successful TUR-Bladder. Tumor completely removed. Clinical Stage II. PET Scan Negative for metastatic disease. 45 year old, healthy male. Completed neoadjuvant chemotherapy (Cisplatin and gemzar).

Answer

It sounds like you have had excellent treatment so far for your condition. As you probably know, radical cystectomy (completely removing the bladder) gives the best chance of completely removing the tumor. However, it is a major surgery, obviously, and also has significant impact on quality of life afterwards. Therefore, in many cases, attempts are made to conserve the bladder. In your case, it sounds like you had a transurethral resection of the tumor, with complete removal an no evidence of metastatic disease. Furthermore, you had chemotherapy to further prevent recurrence of the tumor. At this point, you will need very close followup with your urologist and cancer doctors. They will give you advice on how frequently they will want to monitor for any recurrence of the tumor, as you will continue to be at risk of having the tumor come back. In fact, up to half of all people who have their tumors removed in the fashion you did may be at risk of recurrence, which underscores the need for close followup. I recommend setting up a visit with your cancer doctors to discuss your care so far and your plan of care going forward, as they know your situation better than anyone else.

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