Chemo after Bladder Removal

Sorry, can't let that slip by! There is plenty of research going on & some radical new treatments. It's an utter myth that pharma companies are suppressing better treatments. 

There are some new immunotherapies possible for some BC Px - worth asking about that. Even the chemo options have improved immensely in some respects. 

Otherwise, I didn't have chemo myself, before or after RC, so can't advise on that. Hope it goes well for you.

Thanks! I am glad that you didn't let it slip by!

I decided to take the stoma route which does not include Chemo and that is one of the many reasons why I took this step

This of course is a personal decision and I wish you well

Inanna x 

Have a read about pembrolizumab and atezolizumab immunotherapy treatments. A patient I know had BC with mets to liver, lungs and bones, atezolizumab treatment worked so well she is now free of cancer.

CB

A standard protocol for cystectomy is to have pre-operative (neoadjuvant) chemotherapy before the surgery.  The data shows that the survival rate increases with neoadjuvant chemotherapy.  In some cases, such as when removing the cancerous bladder is considered urgent, post-operative (adjuvant) chemotherapy is given.  Because the patients are very tired from the major surgery, some patients opt not to get adjuvant chemotherapy.   It is noted that because neoadjuvant chemotherapy tends to understage cancer and sometimes no cancer is found, some patients choose not to remove the bladder when they find no cancers in their body by CT scan.  

I will call rather the discovery of chemotherapy is a miracle.  The most often used chemotherapy is platinum-based chemotherapy such as Cisplatin, which was discovered in 1965. Cisplatin was approved in 1978 for cancer treatment.  A scientist was studying E. coli.  When the scientist used platinum-based electrodes, E-coli bacteria cells stopped dividing though they kept growing. When the power was cut, the bacteria cells began dividing again.  The scientist's accidental discovery led to cisplatin, which has extended the lives of so many cancer patients.  Cisplatin is a small molecule, which consists of two chlorine atoms, 6 hydrogen atoms, two nitrogen atoms, and one platinum atom.  It is small enough which enables cisplatin molecules to go into our cell.  In the end, the platinum of the cisplatin molecule attaches to a pair of guanine of DNA and prevents it from replicating, and leads to the death of the cancer cell.   Yes, because cisplatin does not know which cells are cancer cells, it will kill normal cells too.  But, the cancer cells divide much faster than the normal cell. So, cisplatin will kill more cancer cells than normal cells in a given time.  Also, our body has the ability to regenerate new cells.  The hair loss due to chemotherapy usually comes back when the treatment is stopped.  Why I say the miracle is because the angle of the arms of a platinum atom in cisplatin makes it possible for the platinum atom to hold onto those guanines in DNA. The proof is that Transplatin, which has exactly the same chemical composition as cisplatin yet has does not kill cancer cells just because the arms of the platinum atom of Transplain extend horizontally.  I am not a scientist but from an engineer's view, we just cannot invent such a drug.   

You are correct that T-cells, especially T-killer cells can kill cancer cells.  But, many types of cancer cells, including bladder cancer cells have evolved to be able to hide from T-killer cells.  Even if our innate immune system like dendritic cells get signals (some sort of proteins) from the cancer cells and help activate T-killer cells specific to the cancer cell when a T-killer cell gets near a cancer cell, the T-killer cannot see the cancer cell, so it does not attack.   The drugs to expose the cancer cells which are hiding from T-killer cells are called immunotherapy.  Immunotherapy is called the fourth pillar for cancer treatments, which include surgery, radiation therapy, chemotherapy, and now immunotherapy.  Your suggestion of enhancing T-cells has been used in clinical practice, not as effective as we thought it would. One type of T-cell-based therapy is called Chimeric Antigen Receptor T-cells therapy or CAR T-cell therapy.  Get antigen ( some protein identifier) of a cancer cell, attach it to T-cells of a patient, grow and multiply them in vast quantity in a lab, and put it back to the patient into the blood vessel.  Because artificially created T-cells with the antigen of the cancer cell,  The T-killer cells recognize and attack the cancer cells.  I think CAR T-cell therapy has been approved for Lymphoma and melanoma, but not for solid tumor-like bladder cancers. The CAR T-cell therapy has shown good efficacy for Non-Hodgkin Lymphoma such that 39% response at the median of 27.1 months.  39% response at 2.5 years is considered very good for any cancer treatment.  

I do not know much about diet, except we need to take enough protein to produce  20 amino acids, of which 9 essential amino acids must be obtained from food.  Meat happens to have a high concentration of amino acids. Our body uses those amino acids to produce proteins in our body, including immune cells such as T-cells. I also take a vitamin supplement pill.  I was told vitamins are important catalysts for metabolism in our body.  One way to check how our diet is correct is to compare to what the health authority says about diet. https://www.nhs.uk/live-well/eat-well/

best

Thanks, Joe72, I appreciate you taking the time to write. On a completely different topic I have posted a blog in Cancer blogs "The Demon that makes a Stay in Hospital Hell"