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Ask Dr. D. Love Your Own Question
Dr. D. Love
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 18673
Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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My mother, 71, was recently diagnosed with high grade muscle

Customer Question

My mother, 71, was recently diagnosed with high grade muscle invasive bladder cancer with possible spots on her lungs. It has been two weeks since the tumour inside the bladder was removed and now we are waiting on an appointment with the oncologist. She is not a candidate for radical cystectomy despite very good health, it will probably be radiotherapy. What is the prognosis for this type of cancer and will the wait time on an oncologist and start of treatment affect this. Thank you so much!
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. D. Love replied 3 years ago.
Hello from JustAnswer.

I'm sorry that your mother is having to deal with this. My mother also has had to deal with bladder cancer this past fall.

When we speak of prognosis for cancers, we typically measure the 5 year survival rate. In her case, you state that there are possibly spots in the lung, but whether these spots represent metastases of the cancer will make a significant difference in the prognosis. There also would be a difference in the degree of local invasion by the primary tumour.

The 5 year survival for people with bladder cancer that has invaded into the muscle layer is 63%. If the local tumour has invaded through the muscle layer and into the fatty tissue surrounding the bladder, then the 5 year survival drops to 46%. However, if there are metastases outside the bladder, such as to lymph nodes, liver, or the lung, then the 5 year survival is only 15%.

One of the issues whenever a patient or family asked for prognosis is that it is important to realize that the best that can be said is statistical averages for populations of patients. It is impossible to predict how a specific individual will respond.

Regardless of the extent of the tumour, a delay of a couple weeks typically will not adversely affect prognosis, and there is a reason to allow some amount of healing of the surgery site before treating metastases, so that the wounds will heal properly.

If I can provide any further information, please let me know.











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Customer: replied 3 years ago.
I am sorry that you and your family have had to go through this as well. Can you tell me why radical cystectomy would not be an option for my mother, is it because the cancer is too advanced for this procedure or do they prefer radiotherapy as a treatment for aged patients in good health. Your expertise in this is much appreciated, thank you!
Expert:  Dr. D. Love replied 3 years ago.
If it has spread beyond the bladder, then there is no benefit from performing a radical cystectomy. It is also true that performing a radical cystectomy carries significant risks and difficulties that is greater in older persons, but it is more likely in her case that the more aggressive surgery does not offer benefit when the tumour has already started to spread.

Customer: replied 3 years ago.
Is radiotherapy treatment successful in these cases? And What affect does it have on the tumour? Thank you for your time
Expert:  Dr. D. Love replied 3 years ago.
Both radiotherapy or chemotherapy may be used, depending the evaluation to ascertain whether these lung spots are metastatic disease. The prognosis statistics that I noted above are in people in whom these treatments are used. So the success rate is essentially the 5 year survival rates. Both modalities work by killing the cancer cells and shrinking the remaining tumours in the body. Chemotherapy is better at total body killing of the cancer cells, whereas radiotherapy is better for specific treatment of a particular tumour or treatment of the local area to prevent local recurrence.

Customer: replied 3 years ago.
Thank you so much, I am extremely grateful to you as you have eased my concerns. Kindest regards Jacqui
Expert:  Dr. D. Love replied 3 years ago.
You're welcome. I hope that everything goew well.