Medicines to Treat Bladder Cancer
Bladder cancer is the result of the abnormal and pathological development of some bladder cells: by proliferating in a completely uncontrolled way, the insane cells give rise to a neoplasm, which can be malignant or benign, of variable size. Transitional bladder cancer (ie at the level of the transitional epithelia, which cover the inner surface of the bladder), constitutes its absolute prevalence; squamous cell carcinomas and adenocarcinomas, on the other hand, represent the smallest part.
The etiological factor triggering bladder cancer is still the subject of study and research today; among the risk factors, we mention: chemotherapy (prolonged intake of cyclophosphamide), exposure to chemical agents during work, cigarette smoking, bladder infections , radiotherapy Hypothesis: Some artificial sweeteners appear to increase the risk of bladder cancer (there is no uniquely demonstrated evidence).
The pain during the secretion of urine and the emission of blood mixed in the urine should induce the patient to run for cover for an immediate medical check-up; among the symptoms - however highly nonspecific - associated with bladder cancer, we cannot forget: difficulty in urinating , abdominal pain, lower back pain, tendency to urinate often, rectal tenesmus.
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Unlike many other cancers found only in an advanced stage, bladder cancer is diagnosed in 80-90% of cases already in the initial stage, that is when the diseased cells remain confined to the bladder, and have not yet invaded the muscle tonic and other neighboring areas. In this case, surgical resection represents the most suitable therapeutic option to resolve the disease.
The use of drugs is generally aimed at the treatment of multiple - or in any case relapsing - tumors in those individuals presenting a very high risk of relapse after surgery.
In recent years it has been observed that the use of anticancer drugs improves the survival of patients with bladder cancer with invasion of malignant cells in the muscle layer.
The following are the classes of anticancer drugs most used in the therapy against bladder cancer, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
- Cyclophosphamide (eg Endoxan Baxter, bottle or tablet): is an alkylating agent used in therapy for bladder cancer. When used alone, it is recommended to administer the drug only to patients who do not have haematological abnormalities: 40-50 mg / kg divided into small doses over 2-5 days; alternatively, take 10-15 mg / kg every 7-10 days, or 3-5 mg / kg twice a week. Furthermore, the drug can also be taken by mouth at a dosage of 1-8 mg / kg per day. Consult your doctor for the most suitable dosage.
- Doxorubicin (eg Myocet, Caelyx, Adriblastina) belongs to the class of antibiotics and antineoplastics; when used in therapy for the treatment of bladder cancer in combination with other chemotherapy drugs, it is recommended to take the drug at a dosage of 40-60 mg per square meter of body surface, intravenously, every 3-4 weeks. Alternatively, take 60-75 mg of active ingredient per square meter i.v., every 21 days. Lower dosages are recommended for patients with obvious bone marrow disorders (mainly due to old age, previous therapy or previous malignancies).
- Cisplatin (eg. Cisplatin ACC, Platamine, Pronto Platamine): the drug (alkylating agent) is widely used in therapy for the treatment of bladder cancer. It is recommended to take 50-70 mg / m2 i.v. every 3-4 weeks for patients who have not previously been treated with radiotherapy or other chemotherapy drugs. Alternatively, take 50 mg / m2 i.v. (slow infusion over 6-8 hours) every 4 weeks; the latter dosage can also be used in patients with previous chemotherapy or radiotherapy treatments.
- Methotrexate (eg Reumaflex, Methotrexate HSP, Securact) the drug is an antagonist of folic acid synthesis, capable of heavily influencing the body's immune response. It is administered at a dosage ranging from 30-40 mg / m2 to 100-12,000 mg / m2 in combination with other chemotherapy drugs (eg leucovorin).
- Thiotepa (eg Tepadina): the drug is an alkylating agent used in therapy for the treatment of bladder cancer: it is used, in particular, for instillations (insertion of the drug drop by drop) into the bladder. The recommended dose ranges from 30 to 60 mg for intravesical instillation; this dosage is reserved for patients with superficial bladder cancer.
- Mitomycin (eg Mitomycin C): another active ingredient belonging to the class of antibiotics-antineoplastic; it should be administered at a dose of 40 mg by intravesical instillation.
Alternative Therapy Options for Bladder Cancer Treatment:
- Immunotherapy: Immunotherapy represents an innovative therapeutic strategy for the treatment of bladder cancer: drugs carry out their therapeutic activity by stimulating the immune system to attack and destroy malignant cells. For this purpose, for the treatment of bladder cancer, it is employed the bacillus of Calmette-Guérin (attenuated live strain of Mycobacterium bovis: eg. Oncotice, Immucyst). If immunotherapy does not perform the hoped-for therapeutic activity, the patient is generally treated with interferon (eg Betaferon, Rebif, Avonex, etc.).
- Radiotherapy: indicated for the treatment of bladder cancer, characterized by local infiltration of malignant cells. For inoperable patients.
- Radical cystectomy + removal of the pelvic lymph nodes: Indicated for bladder cancer patients (multiple or recurrent lesions), in particular for the forms in which there is an "infiltration of the diseased cells in the muscular layer.
- Removal of the bladder
The procedure is clearly indicated for severe cancers: the bladder is replaced by a dedicated urine reservoir. In men, this extreme surgical practice is often accompanied by resection of the proximal part of the urethra and seminal vesicles. In women with advanced bladder cancer, however, the uterus, urethra and anterior wall of the vagina are usually removed.
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