My doctor has said I must have my bladder removed. Can we use BCG instead of cystectomy?
Dr. Lamm: Cystectomy is the treatment of choice for bladder cancer once it has invaded the muscular wall of the bladder (Stage T2 to T3). For patients who are not medically fit for cystectomy, radiation therapy is recommended, and the results of radiation when combined with chemotherapy are good, even similar to those of cystectomy. BCG is not recommended for muscle invasive bladder cancer, but it has been used as a last resort when other options are not acceptable. Surprisingly, when muscle tumors that invade muscle are again resected transurethrally (repeat TURBT, removing the tumor through a scope inserted through the urethra) and no tumor or non-muscle invasive tumor is found, studies show that survival is actually better (82% at 5 years) in those who are treated with intravesical treatment than those treated with cystectomy (65%). These patients were not randomized, so patients undergoing cystectomy may have had worse disease. Based on these data, however, it is hard to dogmatical
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- My doctor has said I must have my bladder removed. Can we use BCG instead of cystectomy?
