How can a 58-year-old male manage metastatic bladder cancer?

Question

Hello doctor,

I am a 58-year-old man with a history of bladder cancer treated two years ago, now presenting with severe back pain and weight loss of 20 pounds over three months. My CT scan revealed multiple bone metastases in my spine and pelvis, along with enlarged retroperitoneal lymph nodes, confirming metastatic urothelial carcinoma.

My PSA is normal, but my alkaline phosphatase is elevated at 320 U/L, indicating bone involvement. I am experiencing severe pain requiring opioid medications, and my performance status has declined significantly with fatigue and loss of appetite.

My oncologist mentioned immunotherapy options, but I am concerned about the prognosis.

Could these bone metastases cause spinal cord compression or fractures, and what is my life expectancy with metastatic bladder cancer?
Will I have months or years, and will the treatments help extend my life meaningfully?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query.

I completely understand and appreciate the amount of fear you felt as soon as you were diagnosed with metastatic bladder cancer (the cancer has spread from where it started in the bladder to another part of the body). Still, I would like to reassure you that everything has a treatment, and every day new medications emerge that are better than those that came before.

Initially, regarding bone metastases (when cancer cells from a primary tumor, like breast, lung, or prostate, spread to the bones), we prefer that you receive radiotherapy to the bone to reduce pain and decrease the amount of analgesics you will need to use. Secondly, we like to administer Denosumab by injection to increase bone strength and reduce bone metastases.

After that, we prefer to proceed with immunotherapy (a treatment that uses the body's own immune system to fight diseases). Immunotherapy in bladder cancer has shown very high effectiveness. It significantly reduces metastases, decreases the cancer burden, and markedly improves quality of life. It is better than chemotherapy at this stage.

It may be expensive, but you can participate in clinical trials that provide it free of charge, with excellent effectiveness and improved survival. I want to reassure you and encourage you not to worry. Everything has a treatment. There are many types of immunotherapy, and we will continue with the one that best suits you.

I hope I have answered your question.

Let me know if I can assist you further.