Transitional cell carcinoma medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
==Treatment options== | ==Treatment options== | ||
=== | '''Immunotherapy''' | ||
*Chemotherapy may be given to patients with stage II and III disease either before or after surgery to help prevent the tumor from returning. | * [[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> | |||
'''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. | *For early disease (stages 0 and I), chemotherapy is usually given directly into the bladder. | ||
* Intravesical [[chemotherapy]]<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> | * Intravesical [[chemotherapy]]<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> | ||
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:* Systemic chemotherapy may be a treatment option for bladder cancer that has spread to other tissues near the bladder and bladder cancer that has spread to other parts of the body. | :* Systemic chemotherapy may be a treatment option for bladder cancer that has spread to other tissues near the bladder and bladder cancer that has spread to other parts of the body. | ||
:* Chemotherapy is recommended before a radical [[cystectomy]] (called neoadjuvant chemotherapy) for many people with bladder cancer that has grown into the muscle layer of the bladder wall. It is also often given after a radical cystectomy (called adjuvant chemotherapy) to people with high-risk features such as cancer that has spread to [[lymph nodes]]. | :* Chemotherapy is recommended before a radical [[cystectomy]] (called neoadjuvant chemotherapy) for many people with bladder cancer that has grown into the muscle layer of the bladder wall. It is also often given after a radical cystectomy (called adjuvant chemotherapy) to people with high-risk features such as cancer that has spread to [[lymph nodes]]. | ||
'''Radiation therapy''' | |||
* [[Radiation therapy]] may be the main treatment for people who can’t have surgery. | |||
* [[External beam radiation therapy]] is the type of radiation treatment that is most often used to treat bladder cancer. | |||
* Palliative radiation therapy may be given to relieve symptoms caused by advanced bladder cancer. | |||
==References== | ==References== | ||
Revision as of 20:53, 15 February 2016
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Transitional cell carcinoma Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Treatment options
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]
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.
- Intravesical chemotherapy[1]
- During intravesical chemotherapy, the drugs are placed into the bladder through a urinary catheter.
- Intravesical chemotherapy may be given instead of BCG or if the bladder cancer doesn’t respond to BCG.
- Mitomycin is the drug most often used in intravesical chemotherapy.
- Systemic chemotherapy
- During systemic chemotherapy, the drugs are given intravenously.
- Systemic chemotherapy may be a treatment option for bladder cancer that has spread to other tissues near the bladder and bladder cancer that has spread to other parts of the body.
- Chemotherapy is recommended before a radical cystectomy (called neoadjuvant chemotherapy) for many people with bladder cancer that has grown into the muscle layer of the bladder wall. It is also often given after a radical cystectomy (called adjuvant chemotherapy) to people with high-risk features such as cancer that has spread to lymph nodes.
Radiation therapy
- Radiation therapy may be the main treatment for people who can’t have surgery.
- External beam radiation therapy is the type of radiation treatment that is most often used to treat bladder cancer.
- Palliative radiation therapy may be given to relieve symptoms caused by advanced bladder cancer.
References
- ↑ 1.0 1.1 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