A member asked:

Cytoxan (cyclophosphamide) related t1 g3 bladder cancer. not candidate for cystectomy, or chemo due to previous chemo, any studies that radx is worthwhile alone.

6 doctors weighed in across 2 answers
Dr. John Tillett answered

Specializes in Urology

See below: Please clarify a few things for me - you said t1, high grade disease? Chemo is not needed. The standard of care is still intravesical immunotherapy with bcg. Intravesical Mitomycin c, bcg with interferon, or gemcitabine are also used. Cystectomy for t1 disease is typically reserved for bcg-refractory cases. Most radiation data is from europe and involves >t2 tumors.

Answered 10/9/2017

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Dr. Jeffrey Buchsbaum answered

Specializes in Radiation Oncology

Extending ...: Agree, for t1 bcg is the standard. In my experience, we have also used Mitomycin c for this sort of case cautiously (the medonc i worked with did this). I personally have a lot of respect for this agent based on anal carcinoma experience - but it worked. In theory if it was not working, a restaging would be indicated as it is unlikely to still be t1. Good luck.

Answered 11/27/2017

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