Diagnosis and Treatment of Bladder Cancer

Management of metastatic bladder cancer

Metastatic bladder cancers include those tumors which have spread to the lymph nodes, bone, lungs or sites other than the bladder. Although metastatic deposits in the lung and lymph nodes may have good initial responses, patients with bone metastasis on average live for only one year survival. Randomized trials have demonstrated that M-VAC is the most effective chemotherapeutic regimen.10,15 Unfortunately, M-VAC has substantial side effects which frequently require decreasing the dose or eliminating some of the chemotherapeutic agents. Recently, two studies using paclitaxel alone and gallium nitrate with vinblastine and ifosfamide showed 42% and 67% objective response rates, respectively, which is very exciting given the limited alternatives currently available.17,18

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