Details determine your best treatment options<\/p>\n
Which type of bladder cancer do you have? Is it the most common \u2014 urothelial carcinoma<\/a> \u2014 or something more unusual<\/a>?<\/p>\n Depending on the type, grade and stage of the bladder cancer, your treatment options here at UT MD Anderson could range from something as simple as intravesical therapy<\/a> (in which the walls of the bladder are repeatedly bathed in cancer-fighting drugs) to something as complex as a radical cystectomy, or the complete surgical removal of your bladder.<\/p>\n Bladder-preserving options are sometimes available, but not every patient is eligible for them.<\/p>\n \u201cMore patients are realizing the opportunity to keep their bladders as we develop better treatment strategies,\u201d Campbell says. \u201cBut some are better candidates than others. If you\u2019re having to urinate every hour on the hour, for instance, or waking up at night and having to urinate frequently, the chances of that improving with a bladder preservation strategy are quite low.\u201d<\/p>\n \u201cSometimes, radiation therapy<\/a> is also an option for bladder cancer,\u201d adds Kamat, \u201cbut it is not appropriate for every patient. That\u2019s why personalizing cancer care is extremely important.\u201d<\/p>\n New treatment strategies are yielding better results<\/p>\n The standard of care for bladder cancer used to be a cisplatin-based regimen of chemotherapy<\/a>, followed by surgery. Unfortunately, only about half of all bladder cancer patients were eligible to receive that drug, because it\u2019s so hard on the kidneys, nerves and ears (hearing). Of those who could receive it, only about 30% to 40% saw a complete pathologic response (pCR) \u2014 or the total absence of living cancer cells \u2014 by the time they had surgery.<\/p>\n \u201cBut this has dramatically shifted in just the last year,\u201d notes Campbell. \u201cThere\u2019s a treatment now combining an antibody drug conjugate<\/a> called enfortumab vedotin with an immune checkpoint inhibitor<\/a> called pembrolizumab that has dramatically increased the chances of eradicating cancer by the time of surgery. Those pCR numbers are now pushing closer to the mid-50% and even the mid-60% range, depending on how you do your calculations. And, that includes patients who were historically cisplatin-ineligible. So, this has been a huge game-changer for the bladder cancer patients we treat here at UT MD Anderson.\u201d<\/p>\n To hear the full conversation between Campbell and Kamat, listen to UT MD Anderson’s Cancerwise podcast<\/a>.<\/p>\n