My husband had his first treatment for bladder cancer yesterday. This is his third primary cancer and, of course, he has asked, “Where next?”
Two biopsies were performed, but neither got enough muscle wall tissue to rule out the spread of the cancer there. It was a transitional papillary tumor at the top of the bladder which makes it more difficult to get a “good” muscle wall sample. Location, location, location.
His options were to assume that the cancer had not spread to the muscle wall or to assume that it had. After talking it over with his doctor, he chose to assume it had not. Removal of the bladder is still an option, but hopefully it won’t have to be done.
What is fascinating to me is the treatment when the assumption is that the tumor has not spread to the muscle wall. It consists not of chemotherapy, but of immunotherapy. In a nutshell, BCG (Bacille Calmette-Guerin), a tuberculosis vaccine is inserted into the bladder to “call” the immune system to battle the cancer.
Because the biopsies were inconclusive, my husband was faced with the choice of trying the immunotherapy or with surgical removal of his bladder. Surgical removal is sort of a guaranteed cure, but it is also a drastic cure. My husband chose the less drastic, but less certain treatment.
We shall see.