Chemotherapy prior to bladder surgery greatly improves the surgery outcomes

Studies have shown improved cancer control when patients receive chemotherapy prior to radical cystectomy (complete bladder removal). A recent study compared two popular chemotherapy regimens: dose dense MVAC versus Gemcitabine/Cisplatin. Both had impressive results, but in term of cancer control, ddMVAC seemed to have the edge. Complete tumor response was seen in 42% of the dd MVAC group compared to 36% of the GC group. Additionally the tumor pulled back completely out of the bladder muscle in 63% of the ddMVAC patients versus 49% of the GC patients. Although ddMVAC did better, it did come with a higher rate of side effects, which could limit the ability to give the full regimen of chemotherapy. This information is useful for patient counseling and helps us choose the chemotherapy regimen on an individual basis.