Transitional cell carcinoma medical therapy: Difference between revisions
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*For more advanced stages (II-IV), chemotherapy is usually given by vein (intravenously). | *For more advanced stages (II-IV), chemotherapy is usually given by vein (intravenously). | ||
=== | ===Immunotherapy=== | ||
Bladder | * [[Immunotherapy]] is a type of biological therapy that uses the immune system to help destroy cancer cells.<ref name=Canada>Bladder Cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/bladder/treatment/?region=ab Accessed on October, 7 2015 </ref> | ||
* Bacillus Calmette–Guérin (BCG) | |||
:* [[Immunotherapy]] by intravesicular delivery of Bacillus Calmette–Guérin (BCG) is often used to treat and prevent the recurrence of superficial [[tumors]].<ref>{{Cite journal|author=Alexandroff AB, Jackson AM, O'Donnell MA, James K |title=BCG immunotherapy of bladder cancer: 20 years on |journal=Lancet |volume=353 |issue=9165 |pages=1689–94 |date=May 1999 |pmid=10335805 |doi=10.1016/S0140-6736(98)07422-4}}</ref> | |||
:* BCG is a [[vaccine]] against [[tuberculosis]] that is prepared from attenuated live ''[[Mycobacterium bovis]]'', that has lost its virulence in humans. BCG immunotherapy is effective in up to 2/3 of the cases at this stage, and in randomized trials has been shown to be superior to standard [[chemotherapy]].<ref>{{Cite journal|doi=10.1056/NEJM199110243251703|title=A Randomized Trial of Intravesical Doxorubicin and Immunotherapy with Bacille Calmette–Guérin for Transitional-Cell Carcinoma of the Bladder|year=1991|last1=Lamm|first1=Donald L.|last2=Blumenstein|first2=Brent A.|last3=Crawford|first3=E. David|last4=Montie|first4=James E.|last5=Scardino|first5=Peter|last6=Grossman|first6=H. Barton|last7=Stanisic|first7=Thomas H.|last8=Smith Jr|first8=Joseph A.|last9=Sullivan|first9=Jerry|last10=Sarosdy|first10=Michael F.|last11=Crissman|first11=John D.|last12=Coltman|first12=Charles A.|journal=New England Journal of Medicine|volume=325|issue=17|pages=1205–9|pmid=1922207|pmc=1164610}}</ref> | |||
:* The mechanism by which BCG prevents recurrence is unknown, but the presence of bacteria in the bladder may trigger a localized immune reaction which clears residual cancer cells.<ref>[http://www.webmd.com/cancer/bladder-cancer/bacillus-calmette-guerin-bcg-for-bladder-cancer Bacillus Calmette-Guerin (BCG) for Bladder Cancer]</ref> | |||
Immunotherapy for bladder cancer is usually performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). It is given through a Foley catheter directly into the bladder. If BCG does not work, patients may receive interferon. | |||
As with all treatments, side effects are possible. Ask your doctor what side effects you might expect, and what to do if they occur. | As with all treatments, side effects are possible. Ask your doctor what side effects you might expect, and what to do if they occur. | ||
Revision as of 20:28, 15 February 2016
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Transitional cell carcinoma Microchapters |
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Differentiating Transitional cell carcinoma from other Diseases |
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Treatment |
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Transitional cell carcinoma medical therapy On the Web |
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Directions to Hospitals Treating Transitional cell carcinoma |
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Risk calculators and risk factors for Transitional cell carcinoma medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment options
Treatment depends on the stage of the cancer, the severity of your symptoms, and your overall health.
- Stage 0 and I treatments:
- Surgery to remove the tumor without removing the rest of the bladder
Chemotherapy or immunotherapy directly into the bladder
- Stage II and III treatments:
- Surgery to remove the entire bladder (radical cystectomy)
- Surgery to remove only part of the bladder, followed by radiation and chemotherapy
- Chemotherapy to shrink the tumor before surgery
- A combination of chemotherapy and radiation (in patients who choose not to have surgery or who cannot have surgery)
Most patients with stage IV tumors cannot be cured and surgery is not appropriate. In these patients, chemotherapy is often considered.
CHEMOTHERAPY
- Chemotherapy may be given to patients with stage II and III disease either before or after surgery to help prevent the tumor from returning.
- For early disease (stages 0 and I), chemotherapy is usually given directly into the bladder.
- A Foley catheter can be used to deliver the medication into the bladder.
- For more advanced stages (II-IV), chemotherapy is usually given by vein (intravenously).
Immunotherapy
- Immunotherapy is a type of biological therapy that uses the immune system to help destroy cancer cells.[1]
- Bacillus Calmette–Guérin (BCG)
- Immunotherapy by intravesicular delivery of Bacillus Calmette–Guérin (BCG) is often used to treat and prevent the recurrence of superficial tumors.[2]
- BCG is a vaccine against tuberculosis that is prepared from attenuated live Mycobacterium bovis, that has lost its virulence in humans. BCG immunotherapy is effective in up to 2/3 of the cases at this stage, and in randomized trials has been shown to be superior to standard chemotherapy.[3]
- The mechanism by which BCG prevents recurrence is unknown, but the presence of bacteria in the bladder may trigger a localized immune reaction which clears residual cancer cells.[4]
Immunotherapy for bladder cancer is usually performed using the Bacille Calmette-Guerin vaccine (commonly known as BCG). It is given through a Foley catheter directly into the bladder. If BCG does not work, patients may receive interferon.
As with all treatments, side effects are possible. Ask your doctor what side effects you might expect, and what to do if they occur.
References
- ↑ Bladder Cancer. Canadian Cancer Society 2015. http://www.cancer.ca/en/cancer-information/cancer-type/bladder/treatment/?region=ab Accessed on October, 7 2015
- ↑ Alexandroff AB, Jackson AM, O'Donnell MA, James K (May 1999). "BCG immunotherapy of bladder cancer: 20 years on". Lancet. 353 (9165): 1689–94. doi:10.1016/S0140-6736(98)07422-4. PMID 10335805.
- ↑ Lamm, Donald L.; Blumenstein, Brent A.; Crawford, E. David; Montie, James E.; Scardino, Peter; Grossman, H. Barton; Stanisic, Thomas H.; Smith Jr, Joseph A.; Sullivan, Jerry; Sarosdy, Michael F.; Crissman, John D.; Coltman, Charles A. (1991). "A Randomized Trial of Intravesical Doxorubicin and Immunotherapy with Bacille Calmette–Guérin for Transitional-Cell Carcinoma of the Bladder". New England Journal of Medicine. 325 (17): 1205–9. doi:10.1056/NEJM199110243251703. PMC 1164610. PMID 1922207.
- ↑ Bacillus Calmette-Guerin (BCG) for Bladder Cancer