Reactions to Mitomycin Bladder Cancer Treatment: Key Questions

Q: Reactions to Mitomycin Bladder Cancer Treatment: Key Questions

Hello： 1. The biopsy of the bladder tumor confirmed renal cell carcinoma. Does this situation count as metastasis, or is it another condition? -- Since it is renal cell carcinoma, it should be classified as metastasis, but it has been surgically excised. 2. Aft

Regarding the reactions after intravesical instillation of Mitomycin for bladder cancer?

Hello, Doctor.
I have been diagnosed with renal pelvis cancer for 5 years, and my follow-ups have shown no issues during this time.
However, during my most recent endoscopic examination, a tumor was found in my bladder.
It is an early-stage tumor, and after a resection and biopsy, it was confirmed to be renal cell carcinoma.
I have started the process of intravesical chemotherapy with Mitomycin.
Since there is still some time before my next appointment, I have a few questions for you:
1.
The bladder tumor biopsy confirmed renal cell carcinoma.
Does this situation indicate metastasis, or could it be another condition?
2.
After the resection, I received my first Mitomycin instillation, and two days later, I began experiencing intermittent red rashes and itching all over my body, which have persisted for a week.
Five years ago, after my first surgery, I also received Mitomycin for bladder prophylaxis, but I did not experience this rash at that time.
Could you please let me know if Mitomycin can cause such side effects? Additionally, which specialist should I consult for this condition?
3.
Over the past six months, my weight has decreased from 75 kg to 68 kg, but I have not experienced any discomfort or loss of appetite.
In December, I was hospitalized for kidney checks, and a recent MRI of my lower body was normal.
Should I consider seeing another specialist regarding this weight loss?
I appreciate your clarification on these questions.
Thank you.

WU, 40~49 year old female. Ask Date: 2023/01/08

Dr. Jian Weihong reply Urology

Hello:
1.
The biopsy of the bladder tumor confirmed renal cell carcinoma.
Does this situation count as metastasis, or is it another condition? -- Since it is renal cell carcinoma, it should be classified as metastasis, but it has been surgically excised.
2.
After the resection, I underwent the first Mitomycin infusion, and two days later, I started experiencing red rashes and itching in various locations on my body, which have persisted for a week.
Five years ago, after my first surgery, I also had one Mitomycin infusion for bladder prophylaxis, and I did not experience this rash.
I would like to know if Mitomycin can have such side effects? Additionally, which specialty should I consult for this condition? -- Any medication can potentially cause side effects.
You should follow up with your physician and explain the situation; taking photos of the rash may be helpful.
3.
Additionally, over the past six months, my weight has decreased from 75 kg to 68 kg, and I have not experienced any discomfort or loss of appetite during this time.
In December, I was hospitalized, and a recent MRI of the lower body showed normal results for the kidneys.
Should I consult another specialty for this situation? -- You can discuss this with your current physician, as weight changes can be complex.
Further evaluation is necessary.
Wishing you good health.

Reply Date: 2023/01/08

More Info

Hello! Thank you for your questions regarding your recent diagnosis and treatment. I understand that you are navigating a complex situation with your health, and I will do my best to provide clarity on your concerns.

1. Regarding the bladder tumor biopsy confirming renal cell carcinoma: This situation is indeed concerning. The presence of renal cell carcinoma in the bladder could be indicative of metastasis from the kidney, especially given your history of renal pelvis cancer. It is essential to discuss this with your oncologist, as they can provide a more definitive diagnosis based on imaging studies and the pathology report. In some cases, tumors can also arise independently in the bladder, but given your history, the likelihood of it being metastatic is higher.

2. About the Mitomycin infusion and the rash: Mitomycin is a chemotherapeutic agent commonly used in bladder cancer treatment. While it is generally well-tolerated, it can cause side effects, including skin reactions. The rash you are experiencing could be a hypersensitivity reaction or an adverse effect of the drug. It is not typical for Mitomycin to cause widespread rashes, especially if you did not experience this during your previous treatment. It is crucial to report this reaction to your healthcare provider. They may recommend seeing a dermatologist or your oncologist for further evaluation and management of the rash. Documenting the rash with photographs can also be helpful for your medical team.

3. Regarding your weight loss: A drop from 75 kg to 68 kg over six months without any accompanying symptoms such as loss of appetite or discomfort can be concerning, especially in the context of your cancer history. Weight loss can be multifactorial, including metabolic changes due to cancer, stress, or other underlying conditions. It would be prudent to discuss this with your oncologist or a primary care physician. They may recommend further evaluations, including blood tests or imaging studies, to rule out any other potential causes for the weight loss.

In summary, it is essential to maintain open communication with your healthcare team regarding all these concerns. They are best equipped to provide personalized advice based on your medical history and current health status. Additionally, if you feel that your questions are not being adequately addressed, do not hesitate to seek a second opinion or consult with specialists in oncology or dermatology as needed. Your health and peace of mind are paramount, and it is important that you feel supported throughout your treatment journey.
Wishing you the best in your treatment and recovery!

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