Chemotherapy or radiotherapy and what would be the advantage of the choice? One doctor advised to start with chemotherapy and another advised to start with radiotherapy.
I assume that you mean high grade and invasive bladder cancer?
It depends on the stage. T1 tumor is considered invasive although it didn't reach the muscle layer yet,Iin this case the options are TURBT, , whichis removal of the tumor by endoscopy, plus intravesical immunotherapy, the other option is early cystectomy, that is removal of the bladder and perforning a suitable shunt for urin (can be a bladder substitute).
If the tumor reached the bladder muscle layer, it is called T2 and the standard treatment is cystectomy, although some bladder preservation protocols may be deployed.
If it is a stage T3 tumor, which means the tumor invaded beyond the bladder wall, the standard is to start with chemotherapy, that might downstage the tumr and deal with distant micromitastasis. ThisIis followed by cystectomy.
The first question maybe: 'What type of Cancer are we confronting, or what's the organ where it first originated?' Even after a response to this, the same type of tumor in the same organ can be treated in several different ways, medical consultations thru the web are dangerous, as you never know the kind of data you miss. I once hear somebody saying: 'Encounter visits give no money nor reputation'
Where is the cancer growing? Because for some cancers multimodal approaches have been developed.
Which organ? What is the histology? Then comes staging. Majority of solid tumors are best treated with surgical resection, if possible with negative margins. Frequently pre-operative treatment either chemotherapy, radiation therapy or both are employed to render it resectable or for organ sparing. Again even after complete resection, chemotherapy, radiation therapy or both may be used to improve survivals.
The same applied to Bladder cancer.
Dear Priscillar, it all depends on the type of cancer. For example advanced germ cell tumors have a high cure rate with chemotherapy and Melanoma is highly resistant to radio and chemotherapy.
Some say that the concept that Melanoma is a tumor resistant to Radiation Therapy comes from the times were some applied RT to Lentigo, that is different to Melanoma, RT to Lymph Node basins was used in some cases of Melanoma, and also sometimes, melanoma Brain metastasis do respond to different types or modulated and non-modulated Radiation Therapy
I would use any therapy that utilizes combinations of at least two or even three cancer drugs. Because cancer needs to be trea ted with a cocktail of compounds to prevent its reoccurrence.
Chemotherapy regimens come from randomized clinical trials. More is not necessarily better for cancer control but certainly increases toxicity. Multi-drug regimens of past have been prone to be inferior to modern two drug combination. In case of bladder cancer for example Gemcitabine and cisplatin are superior to MVAC.
As indicated elsewhere in this site, an article by Zuanel Diaz et al in 'Modern Pathology' is about Bio-banking as a way to study the molecular profile of metastasis, it can be applied to select an individualized therapy, the CIOCC research Institute in Madrid has experience in this. PubMed reference N is 23743930
Pelvic mass turned cancerous and a long loop seen crossing the left ovary. Pelvic mass pressing the bladder and displacing it.
So, we have a Tumor presenting in the lower part of abdomen, some kind of Hystologic material is needed, just to start the assessment of what is confronted, and considering the appropiate choices for therapy, but with these data, very little what can be done, if you want to stay within the limits of Good Medical Practice rules, as an hepatologist said about Liver Biopsies, you can make a blind biopsy, but not a deaf one, please tell us more!
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