Treatment strategies using transurethral surgery, chemotherapy, and radiation therapy with selection that safely allows bladder conservation for invasive bladder cancer

Abstract

Combined modality therapy with the goal of effecting cure and achieving organ preservation has become the standard oncological approach in many malignancies. Although radical cystectomy has been considered the standard treatment for invasive carcinoma of the bladder, equivalent results have been achieved using combined modality treatment in selected patients, particularly those with T2 and T3a disease without obstructed ureters. Effective combined modality treatment consists of three treatment modalities: (1) transurethral resection of the bladder tumor (TURBT), followed by concurrent (2) chemotherapy, and (3) radiation. Following induction therapy, histologic response is evaluated by cystoscopy and biopsy. Clinical complete responders continue with concurrent chemotherapy and irradiation. Those patients not achieving a clinical complete response are advised to undergo cystectomy. Individually the local monotherapies of radiation, TURBT, or systemic chemotherapy each achieve a local control rate of 20% to 40%. When they are combined, complete response rates of 70–80% are achieved and 85% of these will remain free of invasive recurrence in the bladder. Bladder preservation trials using combined modality treatment approaches with selection for organ conservation by response to initial treatment report an overall 5‐year survival rate of approximately 50%, and they have achieved a 40% to 45% 5‐year survival rate with the bladder intact. Modern multi‐modality bladder preservation approaches offer survival rates similar to radical cystectomy, for patients of similar clinical stage and age, and an improved quality of life by allowing a majority of patients to retain their own fully functional bladder. Bladder conservation therapy may be offered to selected patients with bladder cancer as one alternative to radical cystectomy, and its use should be by experienced multi‐modality teams of urologic oncologists. Semin. Surg. Oncol. 13:359‐364, 1997. © 1997 Wiley‐Liss, Inc.

Antibiotics for cancer treatment: A double-edged sword

“…Nowadays, weapons to fight cancers include surgery, radiotherapy, chemotherapy, immunotherapy and targeted therapy [2]. Surgery alone has been offering a cure for cancers for centuries.…”

“…Surgery alone has been offering a cure for cancers for centuries. With advancement in modern therapy, approximately 50% of all cancer patients are treated with radiotherapy because of the relative light damage to the body [2]. However, surgery and radiation therapy can only be used to treat malignant cancers, which are confined locally to a particular organ [2].…”

“…With advancement in modern therapy, approximately 50% of all cancer patients are treated with radiotherapy because of the relative light damage to the body [2]. However, surgery and radiation therapy can only be used to treat malignant cancers, which are confined locally to a particular organ [2]. With the paradigm shift in our understanding of cancer as a systemic disease, chemotherapy and targeted therapy, which are used to kill cancer cells that have metastasized to distant sites in the body, have assumed increasingly larger role in cancer treatment and the challenges to patient care poised by acquired resistance and/or the the genotoxic nature of such treatments have started to come more sharply into focus [3].…”

<p>Long Noncoding RNA <em>ADAMTS9-AS2</em> Inhibits the Proliferation, Migration, and Invasion in Bladder Tumor Cells</p>

“…2 Common treatment options are recommended, including surgery, chemotherapy, or combined with radiation therapy, but patients often end up with a relatively poor prognosis. 3 Moreover, non-muscle-invasive bladder tumor constitutes the majority of patients, more often than not, which incurs a high cost and inconvenience due to frequent recurrence. 4 Therefore, exploring more prognostic biomarkers that participate in the bladder tumor cell growth, migration, and invasion are necessary for the improvement of the patients’ prognosis and life quality.…”

Common themes in antimicrobial and anticancer drug resistance

“…Antimicrobial and anticancer drug resistance: The dimension of the challenge for the public health accounting for the highest mortality rates are, in alphabetical order, breast, colorectal, liver, lung, prostate, skin, and stomach cancers (Ferlay et al, 2021). The current therapeutic approaches in cancer include surgery and chemotherapy as first options, followed by radiotherapy, immunotherapy, and targeted therapy (Kanady et al, 1997). Based on experimental tumor induction and propagation models, it is estimated that in neoplasms containing 10 3 -10 6 cells, the chemotherapeutic treatment can select at least one clone of resistant cells, which can survive and continue to proliferate, leading to tumor recurrence or metastasis formation.…”