Page 226 - Urological Health

News about clinical trials for radiation therapy
• Further bladder preservation trials are ongoing with newer agents.

• Right now, these newer agents are saved for patients that are not suitable surgical candidates or are
highly motivated to keep their bladder and are accepting of the risks and long-term side effects.
• This treatment with multiple therapies requires the close coordination of urologists, radiation and
medical oncologists.

Follow-up

With any form of treatment for muscle invasive bladder cancer, close follow-up is important because
of the high rate of recurrence and complications following treatment.

At the very least, you should be followed closely for five years. However, urothelial cancer carries
alife-long risk of recurrence especiallyif the bladder is notremoved. The chance of developing cancer
in the upper tract (ureter and kidney) is low (5%), however there is risk of developing metabolic
complications when the bowel is placed in the urinary tract and stricturing of the ureters where they
join the bowel.
UNDER REVIEW
The follow-up regimen is usually driven by the stage (T,N,M), modality of treatment and associated
carcinoma in-situ (CIS).

1. The first follow-up includes a physical exam, liver function tests, renal function tests, and
ultrasonography at three months.

2. At six months, these investigations are sometimes repeated with a CT scan to look more
closely for recurrent disease.

3. These investigations are repeated again at one year and then yearly depending on
disease risk.
4. If you have a neobladder, the urethra needs to be monitored for recurrence of disease,
especially if you’ve had a cystectomy for CIS.

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