Bladder Cancer Treatment Algorithm

The Oncology Brothers, discuss how the definition of muscle-invasive bladder cancer is defined as when the cancer has invaded the muscle. They also highlight recommended treatment methods, including chemotherapy, immunotherapy, and aggressive surgery.

The Oncology Brothers, discuss recent clinical trials for early muscle-invasive bladder cancer that have shown promising results with neoadjuvant chemotherapy followed by radical cystectomy as standard of care, immunotherapy trials using checkpoint inhibitors that have demonstrated improved pathological complete response rates, and bladder-sparing approaches combining maximal TURBT with chemoradiation that have shown comparable outcomes to cystectomy in select patients.

The Oncology Brothers, discuss how advances in bladder cancer management have demonstrated significant clinical benefits by strategically combining chemotherapy and immunotherapy, which leverages cytotoxic agents to directly target malignant cells while simultaneously activating immune-mediated tumor recognition, as well as checkpoint inhibitors that have shown promise in maintaining disease control after initial chemotherapy response, especially in metastatic settings.

The Oncology Brothers, discuss how second-line treatment for bladder cancer typically involves immune checkpoint inhibitors (pembrolizumab, atezolizumab) after failure of platinum-based chemotherapy. For patients who are ineligible for immunotherapy, alternative chemotherapy regimens or targeted therapies may be used based on molecular profiling.

The Oncology Brothers, discuss how bladder cancer treatments commonly cause adverse effects, including frequent urination, painful urination, blood in urine, fatigue, nausea, hair loss, decreased immunity, diarrhea, skin irritation, and bladder inflammation. More severe effects may include organ damage, sexual dysfunction, and reduced fertility.