Bladder Cancer

Medicaid on CT surveillance of bladder cancer after radical cystectomy – pro

CMS requires that the CT scan be reasonable and necessary based on the literature and opinion.  Reasonableness and opinion is expressed by guidelines, After radical cystectomy, NCCN recommends: Urine cytology, liver function tests, creatinine, and electrolytes every 3 to 6 mo for 2 y and then as clinically indicated Imaging of the chest, upper tracts, abdomen, and pelvis every 3 to 6 mo for 2 y based on risk of recurrence and then as clinically

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NMP-22 urine assays for bladder cancer – pro

   NMP-22 urine assays for bladder cancer  detect nuclear mitotic apparatus protein 1 (NUMA-1) using monoclonal antibodies. NMP-22 protein provides structural support for the nucleus and ensures the correct separation of genetic material during mitosis into the respective daughter cells through mitotic spindle stabilization. It is not a particularly specific tests, with many described non-cancer  factors that elevate its values,  and there

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Intravesicular interferon after transurethral resection of non-muscle invasive bladder cancer – pro

Standard adjuvant therapy for non muscle invasive cancer can reduce the risk of recurrence. Patients at high risk for cancer recurrence receive bacillus Calmette-Guérin (BCG) therapy after surgery. One study that compared mitomycin with interferon alfa-2b showed an improved outcome with mitomycin, although interferon was better tolerated. Intravesical interferon therapy  with BCGT or by itself can significantly lower the recurrence rate in superficial

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Metastatic bladder cancer – pro

Lay Summary: Chemotherapy agents that have shown activity in metastatic bladder cancer include paclitaxel, docetaxel, ifosfamide, gallium nitrate, and gemcitabine. A prospective, randomized trial of methotrexate, vinblastine, doxorubicin, and cisplatin (M-VAC) compared with cisplatin, cyclophosphamide, and doxorubicin demonstrated improved response and median survival rates (48 weeks vs. 36 weeks, P = .0003) with the former regimen. Results from

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Gecitabine/docetaxel for bladder cancer – pro

Although advanced urothelial carcinoma is a common and relatively chemosensitive neoplasm, it still remains a fatal disease. Over the last 10 years or so chemotherapy of advanced urothelial tumours has focused on cisplatin-based combinations such as cisplatin-methotrexate-vinblastine (CMV), or methotrexate-vinblastine-adriamycin-cisplatin (M-VAC). Response rates with standard cisplatin-based combination chemotherapy range from 40 to 70%; however,

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Chemo for bladder cancer – pro

A variety of therapeutic options are available to vital, elderly patients with invasive bladder cancer, including radical cystectomy and treatments that preserve the bladder. Radical cystectomy remains the gold standard for treatment of muscle-invasive bladder cancer, but has traditionally been avoided in elderly patients because this population was thought to be at higher risk of morbidity and mortality. A growing body of evidence, however, indicates

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Gemcitabine carboplatin for bladder cancer – pro

The standard treatment for advanced bladder cancer is the chemotherapy combination consisting of cisplatin (Platinol®), methotrexate, Velban® (vinblastine) and doxorubicin (Adriamycin®), referred to as M-VAC. However, M-VAC is associated with side effects and are particularly difficult to tolerate for patients who have impaired renal function and/or are elderly. Researchers have been evaluating different chemotherapy combinations for the treatment

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MVAC for bladder cancer – pro

Systemic chemotherapy is the only modality that has been shown in phase 3 trials to improve survival in responding patients with advanced bladder cancer).The M-VAC regimen, first reported in 1985 by investigators from Memorial Sloan-Kettering Cancer Center, revealed that urothelial carcinoma was sensitive to chemotherapy. Patients with measurable lesions were found to have a remarkably high response rate of 72%, and 36% attained complete response.

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PET for bladder cancer – pro

Conventional PET using FDG is unsuitable for imaging bladder tumors because of its high urinary excretion. However, it is 67% sensitive, 86% specific and 80% accurate in detecting pathologic lymph nodes in patients with bladder cancer, which exceeds both CT and MRI. Although PET scans are being used as part of research projects in bladder cancer, it is not yet certain how valuable they are in helping to manage the care of patients with bladder cancer.

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Taxotere and gemcitabine for bladder cancer – pro

A variety of therapeutic options are available to patients with metastatic bladder cancer.  More recently, gemcitabine and cisplatin was found to be as effective and less toxic than MIAD, but the cisplatin still produces much toxicity. Gemcitabin and docetaxel has been studied in an attempt to minimize toxicity; it showed response rates of 40%–60%.  In a phase ii trial of the same regimen in a weekly schedule, a cr of 42% (mds: 11.9 months) was

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