How to manage bladder cancer in my 67-year-old husband?

Question

Hello doctor,

My husband's age is 67, and he was recently told that his bladder cancer has spread to his liver and bones after the cystectomy that we believed would cure him. The urologist referred us to an oncologist, but the earliest appointment available is in three weeks, and it is noticeable that his condition is worsening daily.

He is having difficulty eating, has constant back pain, and yesterday he could barely get out of bed. We are frightened that this delay might be critical. Should we go to the emergency room?

I have been researching immunotherapy treatments, but I do not understand whether he is a suitable candidate. His brother died from liver cancer five years ago, and we are both terrified that this may be the end.

Are there any clinical trials available? Should we consider seeking treatment at a major cancer center instead of our local hospital? The entire situation feels overwhelming, and we do not know where to turn.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I am also sorry to hear that your husband's condition has progressed to metastatic bladder cancer. However, I would like to reassure you that there is no need to be afraid. Treatment options are available, and immunotherapy can be started.

In many cases, immunotherapy is better tolerated than chemotherapy. Chemotherapy can sometimes be difficult for patients to tolerate, whereas immunotherapy is generally easier to manage. There are several clinical trials available for immunotherapy, and enrollment in one of these trials may be possible.

I would suggest the following measures:

Immunotherapy.
Palliative radiotherapy.

Long hospital stays are usually not required, as immunotherapy is commonly given on an outpatient basis, meaning the treatment is administered, and the patient can go home the same day. It is typically given once a month, so living close to the hospital or changing the place of residence is usually not necessary.

Strong emotional support is very important, so staying close to him and supporting him emotionally will be helpful. This condition should not automatically be considered a terminal stage. Advances in cancer treatment are happening every day, and new options continue to emerge. Immunotherapy can significantly improve the quality of life and help in controlling the disease.

Regarding pain management, if abdominal or back pain is present, it can be managed effectively. Pain control is achievable. Treatment usually begins with non-steroidal anti-inflammatory drugs (NSAIDs), and if needed, medications can be gradually escalated to stronger pain relievers, including opioids. The goal is to keep him comfortable and pain-free throughout the day so that he can eat, drink, and carry out daily activities as normally as possible.

He should try to eat regular meals, drink adequate amounts of water, and maintain good hydration. As mentioned earlier, emotional support plays a vital role in overall well-being. I hope this explanation has helped reassure you and ease your concerns. Please remain calm and reassured. With appropriate treatment and care, improvement is possible.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.