What is the best treatment for my high-grade bladder cancer?

Question

Hello doctor,

I was diagnosed with high-grade urothelial cancer of the bladder recently. I am reading about immunotherapy options like Avelumab, and I wonder how effective they are when surgery is not ideal.

Can these therapies be used long-term?
How often should imaging be done to track recurrence?
Is it possible to still preserve bladder function with some of these newer treatments?
Are there any new targeted therapy options for this kind of bladder cancer?
What about genetic testing can it guide treatment in my case?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand and appreciate the fear and pain you feel after being diagnosed with bladder cancer. I want to tell you that the situation is manageable and does not need to overwhelm you. We have various treatment options.

The choice depends on the exact stage of the disease. If the cancer has not yet penetrated the bladder wall, meaning it is a very early stage, we can treat it with transurethral resection of bladder tumor and bacillus calmette guerin therapy, localized therapy, and that usually resolves the issue.

If the cancer has penetrated the bladder wall, we do not necessarily need to remove the bladder. We can use another approach called the bladder-preserving strategy, which involves giving chemotherapy, performing extensive TUBRT (transurethral resection of bladder tumor), possibly adding hormones, and then radiation therapy. This is applicable when the disease is localized.

As for treatments like immunotherapy or laser therapy, these are generally used when the disease has spread to other parts of the body. We hope it has not reached that stage.

You will be able to choose the appropriate treatment based on your stage and condition.

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

Thank you.