Actos Cancer Updates
Actos Cancer : Radiation therapy for bladder cancer is commonly delivered with a machine that focuses an invisible external beam on die area that requires treatment. The procedure is painless and similar to having an ordinary X-ray done. In the usual approach, your doctors will use your CT scan as a road map of your abdomen and pelvis to pinpoint your tumor and aim the beam at it. In another type of radiotherapy, doctors implant a small pellet or needle of radioactive material directly into your cancer. (This is rarely used for bladder cancer these days.)
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When radiation is used alone or with chemotherapy, there is an increased likelihood that your other organs, such as the prostate and uterus, will remain functional, as does your ability to void urine normally and have sex. The intention when chemotherapy ^¿radiotherapy are given is usually to improve the chances of curing the cancer while preserving the bladder and avoiding the need to remove it surgically. This area is still somewhat controversial; some physicians believe that this approach is nearly as effective as surgical removal of the bladder, but others feel that cystectomy is the best treatment. The decision of which treatment to pursue depends in part upon the physical fitness of the patient as well as upon the patients personal preferences.
Radiotherapy is not without side effects. Radiation can scar bladder tissue, and the scarring can reduce the amount of urine your bladder can hold as the bladder wall becomes less distensible. As a result you may experience an increase in the number of times you have to urinate, which can be irritating, especially at night. You also may experience an increase in bouts of cystitis.
There has been much discussion in the medical community about whether the results achieved by radiotherapy are the same as those from cystectomy with respect to achieving cure. We think that when one considers all types of bladder cancer, in the hands of a highly experienced urologist who specializes in this operation, cystectomy gives better results than radiotherapy. However, there are some patients, particularly those with other significant medical conditions, who will benefit from radiotherapy, despite the possibility of a lower chance of permanent cure. In some centers, such as Massachusetts General Hospital, where the techniques of chemo radio therapy and bladder preservation have been piloted, a urologist will perform a cystoscopy about halfway through the planned course of radiotherapy. If the tumor is shrinking well, radiotherapy will be completed. However, if it appears that the cancer is not responding to radiotherapy, the plan will be abandoned and replaced with a radical cystectomy.
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There are no absolute guidelines for follow-up after cystectomy. What is right for you will depend on your situation: the type of urinary diversion system you have, whether you received chemotherapy and/or radiotherapy, and what, if any, side effects you are dealing with. A reasonable guide for follow-up, however, is to expect a physical exam, chest X-ray, urine test, and blood work every three months for the first year, every four months for the next two years, and then twice a year for life. We usually recommend an annual CT or MRI for the first five years at least.
As with superficial cancer, if you have any of the symptoms discussed in chapter 1, check in with your doctor. Call your doctor if you have blood in your urine or an increase in the urge or frequency of urination. It might be an infection, but the best thing to do is to make contact without unnecessary delay.
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