Comparing surgical approach and combination radiation/chemotherapy treatment for muscle invasive bladder cancer
Radical cystectomy, i.e. removal of whole bladder and adjacent organs such as prostate or uterus/ovaries is the standard of treatment for patients with muscle invasive bladder cancer. Chemoradiation, i.e. chemotherapy given with radiation, is typically reserved as treatment option for patients with muscle invasive or greater bladder cancer, who have extensive chronic conditions and poor performance status that might cause complications during or after undergoing surgery. Both treatment options are considered acceptable clinical practices. Although the disease-free survival at 5 years for those who had their whole bladder removed is greater than those who were treated with chemotherapy & radiation, patients who were treated with the surgical approach report poorer overall satisfaction, sexual function, urinary and bowel function, altered lifestyle, and health-related quality of life. The overall survival rate of chemoradation patients is comparable to those who have undergone radical cystectomy, with the majority of survivors undergoing chemoradiation treatment retaining their bladder and normal urinary function. This study will investigate if bladder preserving chemoradiation can be used as an alternative treatment option for patients who would typically be treated with the surgical approach. We also would like to explore if there are predictive markers in the blood and tissue of those patients who respond to the chemoradiation.