Bladder Cancer Treatment: Targeted Therapy, Immunotherapy, and Concerns

Bladder cancer D1

Hello Doctor, I would like to ask the following questions:
1.
My mother has bladder cancer and has undergone a radical cystectomy.
During the surgery, two lymph nodes in the groin were found.
The attending physician mentioned that she needs to undergo chemotherapy.
Are there any targeted therapies or immunotherapies available for her condition?
2.
Recently, I have noticed my mother coughing, and I am concerned that there may be metastasis to the lungs.
Should we get an X-ray to confirm whether there is any metastasis?
3.
I came across information online stating that ginsenosides have the potential to inhibit cancer cell proliferation.
What is the validity of this claim? (http://www.snoopygo.com/disease/detail-1979.html) Thank you!

Xiao Mei, 30~39 year old female. Ask Date: 2015/10/16

Dr. Chen Sirong reply Oncology

1.
My mother has bladder cancer and has undergone a total cystectomy.
During the surgery, two lymph nodes in the groin were found, and the attending physician mentioned that she needs to undergo chemotherapy.
Are there any targeted therapies or immunotherapies available? The combination of radiation therapy and chemotherapy is currently the primary treatment option with the highest success rate according to Western medicine.
It is not advisable to choose a treatment with a lower success rate, even if it is the latest option, as it may not necessarily be the best or most suitable for the patient.
2.
Recently, my mother has been coughing, and we are concerned about the possibility of metastasis to the lungs.
Should we get an X-ray to confirm if there is any metastasis? Both the patient and family members often have such concerns.
It is advisable to follow a regular schedule for check-ups, and you can ask your attending physician about the appropriate timing.
If the cough persists, it is certainly reasonable to consult the physician about the need for an earlier examination.
3.
I have seen online that ginsenosides may inhibit the proliferation of cancer cells, but I am unsure of its validity.
Was this research conducted specifically on bladder cancer? Laboratory success must be confirmed through human trials, and those trials need to demonstrate a significant success rate.
There is no definitive success rate for bladder cancer treatments available, but you may consider trying it as a dietary supplement.
Thank you! - Chen Si-Rong, Taoyuan Hospital.

Reply Date: 2015/10/16

More Info

Bladder cancer treatment has evolved significantly over the years, with various options available depending on the stage and characteristics of the disease. In your mother's case, where she has undergone a radical cystectomy (bladder removal) and has lymph node involvement, the treatment plan will likely involve a combination of chemotherapy and possibly additional therapies such as targeted therapy or immunotherapy.

1. Targeted Therapy and Immunotherapy: After a radical cystectomy, especially with lymph node involvement, adjuvant chemotherapy is often recommended to reduce the risk of recurrence. The standard chemotherapy regimen typically includes a combination of cisplatin and gemcitabine. However, there are also targeted therapies and immunotherapies available for bladder cancer. For instance, immune checkpoint inhibitors such as pembrolizumab (Keytruda) and atezolizumab (Tecentriq) have shown efficacy in treating advanced bladder cancer, particularly in patients who are not candidates for cisplatin-based chemotherapy. These therapies work by enhancing the body's immune response against cancer cells. It is essential to discuss with your mother's oncologist whether she qualifies for these treatments based on her specific medical condition and cancer characteristics.

2. Concerns About Coughing and Potential Metastasis: The presence of a persistent cough in your mother raises valid concerns about possible metastasis to the lungs. It is advisable to follow up with her healthcare provider regarding this symptom. A chest X-ray or CT scan can help determine if there are any signs of metastatic disease. Early detection of metastasis is crucial for effective management, so it is essential to address these symptoms promptly.

3. Ginseng Saponins and Cancer Cell Proliferation: Regarding the claims about ginseng saponins inhibiting cancer cell proliferation, while some laboratory studies suggest that ginseng may have anti-cancer properties, the evidence is not conclusive. Most of the research has been conducted in vitro (in the lab) or in animal models, and there is limited clinical evidence to support its effectiveness in humans, particularly for bladder cancer. Therefore, while ginseng may have some health benefits, it should not be considered a substitute for conventional cancer treatments. It is always best to consult with a healthcare professional before adding any supplements to your mother's treatment regimen.

In summary, your mother's treatment plan should be tailored to her specific situation, considering her cancer stage and overall health. Engaging in open discussions with her oncologist about the best treatment options, including chemotherapy, targeted therapy, and immunotherapy, is crucial. Additionally, addressing any new symptoms, such as coughing, with appropriate imaging studies will help ensure that any potential complications are managed promptly. Lastly, while exploring complementary therapies like ginseng can be beneficial, they should not replace standard medical treatments.

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