Sunday, March 3, 2024

What Chemo Is Used For Bladder Cancer

Treatment Of Bladder Cancer By Stage

Treatment Talk | Explaining Chemotherapy for Bladder Cancer

Most of the time, treatment of bladder cancer is based on the tumors clinical stage when it’s first diagnosed. This includes how deep it’s thought to have grown into the bladder wall and whether it has spread beyond the bladder. Other factors, such as the size of the tumor, how fast the cancer cells are growing , and a persons overall health and preferences, also affect treatment options.

Lipid Metabolism And Mitochondria Function Alter In Cisplatin

The cellular mechanisms underlying the unique feature of PGCCs are still largely unknown. To get an overview of these cells, GC-mass analysis was performed to inspect these cells from a metabolic point of view. The metabolic profile of cisplatin-treated cells was compared to untreated cancer cells . Considerable changes in amino acids like aspartic acid, threonine, alanine, glycine, serine, and leucine were detected. Also, lactic acid and d-glucose which represent changes in cell metabolism were among the altered metabolites. In addition, lipid molecules including cholesterol, stearic acid, and palmitic acid were increased in cisplatin-treated cells.

Figure 3

Cisplatin-treated PGCC-enriched cells have a distinct metabolic profile. The metabolome of cisplatin-treated and untreated bladder cancer cells were assessed by gas chromatography-mass spectrometry .

Figure 4

PGCCs have augmented lipid metabolism. Oil Red O staining demonstrated the accumulation of lipid droplets in PGCCs surviving after cisplatin treatment which partly declined after ZA treatment. Nuclei are stained with haematoxylin. Quantification of the red signals in the images of Oil Red O-stained cells in three independent experiments confirmed the microscopic observations. Total cholesterol content of cancer cells increased after cisplatin treatment. * p-value< 0.05 error bars: mean±SEM.

What Are The Benefits And Side Effects Of Chemo

Chemotherapy medicines that are delivered through intravesical therapy tend to cause fewer side effects than systemic chemotherapy that affects the entire body.1,3 However, intravesical chemotherapy treatment can cause side effects such as bladder irritation or a burning sensation in the bladder. This is not an exhaustive list of all potential side effects of intravesical chemotherapy. Talk to your doctor for further information.

Patients receiving intravesical chemotherapy should talk to their doctor about any other medications , herbal remedies, and any supplements they are taking, as well as any other health conditions.

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Patients May Want To Think About Taking Part In A Clinical Trial

For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.

Many of todays standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.

Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.

Za Targets Pgccs Enriched After Cisplatin Administration

Two Chemo/RT Regimens Provide Bladder

PGCCs have common properties with osteoclasts, especially in terms of genome content and it is rational to assume that similar molecular mechanisms drive these mutual phenotypes. Hence, we were interested to assess if osteoclast inhibiting agents could be exploited to target PGCCs. The effect of different doses of ZA on the polyploid sub-population of 5637 bladder cancer cell line was investigated. A three-day treatment of these cells with ZA followed by 24 h recovery resulted in a drastic decline in the polyploid fraction . PGCCs are recognized as a main source of tumor relapse following initial response to chemotherapy. To simulate this situation, the PGCC-enriched population remaining after treatment with 6 M cisplatin was exposed to ZA. All examined doses of ZA ranging from 10 to 600 M could substantially eradicate PGCCs with the maximal effect observed with 50 M which resulted in the drop of PGCC fraction from 60±7.5 to 19±1.7% .

Figure 2

Zoledronic acid declines the population of PGCCs pre- and post-cisplatin administration. DNA content analysis of 5637 bladder cancer cells treated with different doses of ZA indicates the reduction of PGCCs post-treatment. Cisplatin administration enriches PGCCs and ZA at different doses from 10600 M declines the PGCC population with the most profound effect being observed at 50 M. *p-value< 0.05 ** p- value< 0.01 error bars: mean±SEM.

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Transurethral Resection Of The Bladder Cancer Tumor

This is when the tumor is removed from the urinary tract through the urethra using an electrical force. Transurethral resection is an endoscopic or scope procedure that does not involve making an incision in the body.

Drug therapy after TUR is commonly prescribed for patients with large, multiple or high-grade tumors.

How Is Chemotherapy Given

Most chemotherapy is given as an out-patient in an oncology unit. Thenurses are specially trained in talking to you about chemotherapy and in givingthe treatment.

Before you start your treatment you will need to have a blood test andbe seen by a doctor or nurse. Sometimesthis will be on the same day as your treatment, or some centres have a twoappointment system â a pre-chemotherapy assessment on one day and chemotherapydelivery on a different day.

The nurse will then insert a fine plastic tube into a vein in your arm. It may feel a little uncomfortable whilst it is beinginserted. Sometimes, chemotherapy is given through a vein in the crook of thearm or through a fine plastic tube inserted under theskin into a long vein near the collar bone. This is called a central line.

Before the chemotherapy is given, you will be given an anti-sicknessdrug which may be given though the cannula or as a tablet. If you are havingoutpatient treatment, you can go home after the chemotherapy. The cannula isremoved before you go home, unless you have a PICC or central line. If you haveeither a PICC or central line, you will be taught how to look after it whilstat home and how to shower etc with it in place.

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Before You Start A Course Of Chemotherapy

You need to have blood tests to make sure its safe to start treatment. You have these either a few days before or on the day you start treatment. You have blood tests before each round or cycle of treatment.

Before each treatment you need to stop drinking fluids. This stops the urine from diluting the drug in your bladder and will help you hold the urine more easily. Your hospital will tell you when to stop drinking.

Rule : Understand The Complex Biology Of Invasive Bladder Cancer When Designing Trials

Video: One-time chemotherapy treatment drops bladder cancer recurrence significantly

Invasive, clinically non-metastatic bladder cancer, representing about 20% of new cases, includes tumors that penetrate through lamina propria into muscle and beyond. Thus more than 17,000 new cases occur each year in the USA, and also some cases of non-invasive bladder cancer eventually become invasive, but are not reflected in national incidence figures for invasive disease. In the USA, a reasonable estimate is that more than 20,000 patients require treatment for invasive bladder cancer per year . Most bladder cancers are urothelial carcinomas , formerly termed transitional cell carcinomas , which is the focus of this review. Other cell types include squamous cell carcinoma, adenocarcinoma, small cell carcinoma and very rarely sarcoma, lymphoma, or melanoma . Invasive bladder tumors are usually moderately to poorly differentiated . Our xenograft studies suggested the existence of a stem cell tumor of origin in bladder cancer, explaining why urothelial carcinoma may coexist with (and perhaps give rise to squamous and glandular patterns ofcancer . We have also demonstrated in these models clonal heterogeneity, reflected in histology and ultrastructure, tumor growth kinetics, expression of growth factors and their receptors, and response to treatment .

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Other Treatments For Bladder Cancer

For many early-stage bladder cancers, BCG is the best option for treatment. Other treatments for bladder cancer include:

  • Surgery to remove the tumor: Early cancers can be removed with TURBT surgery. More advanced cancers may require more extensive surgery, like removal of part or all of the bladder .
  • Intravesical chemotherapy: This treats the inside of the bladder with chemotherapy drugs. Chemotherapy drugs commonly used for bladder cancer include Mutamycin , Gemzar , or Valstar .
  • Radiation therapy
  • Clinical trials

When Do You Have It

Your treatment plan depends on your risk of the bladder cancer spreading or coming back after treatment. Your doctor will tell you whether you have:

  • low risk non muscle invasive bladder cancer
  • intermediate risk non muscle invasive bladder cancer
  • high risk non muscle invasive bladder cancer

Single dose

You can have chemotherapy into your bladder as a one off treatment . You have it after a trans urethral resection of your bladder tumour . For low risk non muscle invasive bladder cancer, this is often all the treatment you need.

Course of chemotherapy

If you have a moderate risk of your cancer coming back, you have a course of treatment. You have chemotherapy into your bladder once a week for 6 weeks.

You might also have this treatment if your cancer comes back after the initial surgery and chemotherapy treatment.

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Radiation Therapy For Bladder Cancer

Radiation therapy uses high energy radiation to kill cancer cells or slow their growth. In bladder cancer, this type of treatment is given as external-beam radiation, which uses a machine to carefully direct the radiation at the cancer.

Radiation therapy may be used after surgery to remove any remaining cancer cells. Its also a potential option for people who cant have surgery or chemotherapy. Lastly, it may be used as a part of treatment for advanced bladder cancer.

Chemotherapy uses drugs that affect the growth and division of cells. Because cancer cells grow and divide more quickly than many other types of cells, chemotherapy can kill them or reduce their growth.

There are two types of chemotherapy for bladder cancer:

  • Intravesical:Intravesical chemotherapy is given directly into the bladder via a catheter. Its used for very early stage bladder cancers, typically after transurethral resection.
  • Systemic: Systemic chemotherapy for bladder cancer is given via IV. It may be used before surgery to help shrink a tumor or after surgery to get rid of any remaining cancer cells. Systemic chemotherapy is also used for advanced bladder cancers.

Cisplatin Induces Polyploidy In Cancer Cells

A Systematic Review of Neoadjuvant and Adjuvant Chemotherapy for Muscle ...

Figure 1

Cisplatin-induced polyploid cells demonstrate a dynamic polyploidization and depolyploidization characteristic. Cisplatin administration resulted in significant cell death and the enrichment of large polyploid cells. Representative images of cells treated with 3, 6, and 13 M cisplatin for 72 h are shown. In this panel, all pictures are captured with 20X objective lens except the third one which is taken with 10X. DNA content analysis of treated cells with different doses of cisplatin indicated that the 6 M cisplatin results in the highest rate of polyploidy. Assessment of different recovery periods following the three days of 6 M cisplatin administration revealed that polyploidy is maximal with a 7 days recovery time. Time-lapse imaging of cisplatin-treated PGCCs demonstrated considerable changes in the genome content and cytoplasm morphology. White arrowheads: fusion with a diploid cell orange arrowheads: fusion with another PGCC yellow arrowheads: budding of daughter cells. Nuclei and cell membrane are stained with DAPI and CM-Dil, respectively Cis: Cisplatin * p-value< 0.05 ** p-value< 0.01 error bars: mean±SEM.

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When Is Intravesical Therapy Used

Intravesical therapy is used mainly for some early-stage bladder cancers that are still only in the inner lining of the bladder . Drugs given directly into the bladder affect the cells lining the inside of the bladder and have little to no effect on cells elsewhere. This means that any cancer cells outside of the bladder lining, including those that have grown deeply into the bladder wall, arent treated by intravesical therapy. Drugs put into the bladder also cant reach any cancer cells in other parts of the body.

There Are Different Types Of Treatment For Patients With Bladder Cancer

Different types of treatment are available for patients with bladder cancer. Some treatments are standard , and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.

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Pgccs Have A High Mitochondrial Density

In line with the described active cytoplasm and nuclear morphological dynamism, the significant metabolic changes observed in PGCCs suggest that energy balance is essential for the functionality of these cells. In this regard, we were interested to assess the mitochondrial content of PGCCs. The mitochondria were stained with BioTracker 488 green and the mitochondrial content was evaluated by fluorescent microscopy and flow cytometry. It was found that cisplatin administration is associated with a considerable increase in the density of mitochondria. After treatment with ZA, a mild decline is observed in the content of mitochondria .

Figure 5

Cisplatin-surviving cells have high mitochondrial density and ROS content, both of which are reduced by ZA. Representative images of mitochondrial staining of cancer cells treated with cisplatin or cisplatin+ZA are demonstrated. Representative flow-cytometry graphs and quantification of four independent experiments demonstrated the augmentation of mitochondrial density after cisplatin and the partial declining effect of ZA. ROS content of cisplatin-survived cells is increased and is significantly diminished after ZA administration. The effect of ZA in declining ROS in cisplatin-treated cells is observed both in diploid and polyploid sub-populations. *p- value< 0.05 ** p- value< 0.01 error bars: mean±SEM.

Dietary Or Herbal Supplements And Chemotherapy

Chemotherapy for Muscle Invasive Bladder Cancer – Deborah Bradley, MD

Let your doctors know if you:

  • take any supplements
  • have been prescribed anything by alternative or complementary therapy practitioners

Its unclear how some nutritional or herbal supplements might interact with chemotherapy. They could be harmful.

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Side Effects Of Chemotherapy

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow , the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells are also likely to be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given and how long they are taken. When chemo and radiation are given at the same time, side effects tend to be worse. Common side effects of chemo include:

  • Nausea and vomiting
  • Increased risk of infections
  • Easy bleeding or bruising, even after minor cuts or injuries

These side effects usually go away over time after treatment ends. There are often ways to lessen these side effects, some can even be prevented. For instance, drugs can be used to help prevent or reduce nausea and vomiting. Ask your health care team about the side effects your chemo drugs may cause and what can be done to prevent and/or treat them.

Some chemo drugs can cause other, less common side effects. For example, drugs like cisplatin, docetaxel, and paclitaxel can damage nerves. This can sometimes lead to symptoms such as pain, burning or tingling, sensitivity to cold or heat, or weakness. This is called peripheral neuropathy.

What Is Intravesical Chemotherapy Treatment

In intravesical chemotherapy, the liquid medicine is delivered directly into the patients bladder through a catheter. A catheter is a small tube inserted into the bladder through the urethra, the tube-like organ that connects to the bladder so urine can pass out of the body. Systemic chemotherapy affects the entire body, but intravesical chemotherapy directly affects the cells in the lining of the bladder without affecting the entire body.

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How Can Chemotherapy Be Used To Treat Bladder Cancer

Systemic chemotherapy affects cancer cells located in the bladder as well as in different parts of the body, so it is most often used to treat patients with advanced bladder cancer.1,2 Bladder cancer typically starts growing in the thin layer of cells that line the bladder, but it can continue to grow into the muscle of the bladder wall and spread beyond the bladder to other parts of the body.

Possible Chemo Side Effects

Neoadjuvant Chemotherapy With Gemcitabine and Cisplatin for ...

Chemo drugs attack cells that are dividing quickly, which is why they work against cancer cells. But other cells in the body, such as those in the bone marrow , the lining of the mouth and intestines, and the hair follicles, also divide quickly. These cells can be affected by chemo, which can lead to side effects.

The side effects of chemo depend on the type and dose of drugs given and the length of time they are taken. Side effects can include:

  • Easy bruising or bleeding

These side effects are usually short-term and go away after treatment ends. There are often ways to lessen these side effects or even prevent them. For example, drugs can be given to help prevent or reduce nausea and vomiting. Be sure to ask your doctor or nurse about medicines to help reduce side effects.

Along with the possible side effects above, some drugs can have their own specific side effects. For example, cisplatin and oxaliplatin can damage nerves . This can cause numbness, tingling, weakness, and sensitivity to cold or heat, especially in the hands and feet. This goes away in most patients after treatment stops, but in some cases the effects can be long lasting.

Report any side effects you notice to your medical team so that they can be treated right away. Most side effects can be treated. In some cases, the doses of the chemo drugs may need to be reduced or treatment might need to be delayed or stopped to keep the effects from getting worse.

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