Bladder Cancer: Causes, Symptoms and Complications, Drugs for the Treatment of Bladder Cancer

Medicines

Unlike many other tumors detected only in an advanced stage, bladder cancer is diagnosed in 80-90% of cases already in the initial stage, i.e. when the diseased cells remain limited to the bladder, and have not yet invaded the tonic muscles and the 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 recurrent – tumors in those individuals with a very high risk of relapse after surgery.
In recent years it has been observed that the use of anti-tumor drugs improves the survival of patients suffering from bladder cancer with invasion of malignant cells into the muscle tunic.

Below are the classes of anticancer drugs most used in 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 patient’s state of health and his response to the treatment:

Anti-Cancer Drugs:

• Cyclophosphamide (e.g. Endoxan Baxter , bottle or tablets): is an alkylating agent used in therapy for the treatment of bladder cancer. When used as monotherapy, it is recommended to administer the drug exclusively to patients without 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 orally at a dosage of 1-8 mg/kg per day. Consult your doctor for the most suitable dosage.
• Doxorubicin (e.g. 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 chemotherapeutics, 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 IV, every 21 days. Lower doses are recommended for patients with obvious marrow pathologies (mainly due to advanced age , previous therapy or previous neoplasms).
• Cisplatin (e.g. 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/m ² IV every 3-4 weeks for patients who have not previously been treated with radiotherapy or other chemotherapy drugs. Alternatively, take 50 mg/m ² IV ( 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 (e.g. 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 varying from 30-40 mg/m ² to 100-12,000 mg/m ² in association with other chemotherapy drugs (e.g. leucovorin).
• Thiotepa (e.g. 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 varies from 30 to 60 mg by intravesical instillation; this dosage is reserved for superficial bladder cancer patients.
• Mitomycin (e.g. Mitomycin C): another active ingredient belonging to the class of antibiotics-antineoplastics; it should be administered approximately at a dosage of 40 mg by intravesical instillation.

Alternative Treatment Options For Bladder Cancer Treatment:

1. Immunotherapy : Immunotherapy represents an innovative therapeutic strategy for the treatment of bladder tumors: the drugs carry out their therapeutic activity by stimulating the immune system to attack and destroy malignant cells. For this purpose, the Calmette-Guérin bacillus (live attenuated strain of Mycobacterium bovis: e.g. Oncotice, Immucyst) is used for the treatment of bladder cancer . If immunotherapy does not produce the hoped for therapeutic activity, the patient is generally treated with interferon (e.g. Betaferon , Rebif , Avonex , etc.).
2. Radiotherapy: indicated for the treatment of bladder cancer, characterized by local infiltration of malignant cells. For inoperable patients.
3. Radical cystectomy + removal of pelvic lymph nodes: Indicated for bladder cancer patients (multiple or recurrent lesions), in particular for forms in which there is infiltration of the diseased cells into the muscular layer.
4. Removal of the bladder

The procedure is clearly indicated for severe forms of cancer: the bladder is replaced by a special reservoir for urine. In men, this extreme surgical practice is often accompanied by resection of the proximal part of the urethra and seminal vesicles . In women with bladder cancer in the advanced stage, however, the uterus , urethra and the anterior wall of the vagina are generally removed .

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