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Muscle-invasive transitional cell carcinoma of the bladder: Muscle-invasive transitional cell carcinoma of the bladder Expert commentary John Chester Expert commentary John Chester 

Muscle-invasive transitional cell carcinoma of the bladder: Muscle-invasive transitional cell carcinoma of the bladder Expert commentary John Chester Expert commentary John Chester
Chapter:
Muscle-invasive transitional cell carcinoma of the bladder: Expert commentary John Chester
Source:
Challenging Concepts in Oncology
Author(s):

Shanthini Crusz

DOI:
10.1093/med/9780199688883.003.0012

Transitional cell carcinoma (TCC) of the bladder is the commonest malignancy affecting the urothelium. Muscle-invasive TCC is a life-threatening, but potentially curable, cancer which presents significant challenges for the uro-oncological multidisciplinary team. Treatment options for localized muscle-invasive bladder cancer are evolving. There is solid trial-based evidence for the use of neoadjuvant systemic therapy, prior to radical treatment, with curative intent; the use of adjuvant chemotherapy is less well established. Systemic therapy treatment decisions are complicated by disease-related complications and co-morbidities, especially impaired renal function. This chapter explores a typical bladder cancer patient journey, from presentation with a new diagnosis of muscle-invasive disease to the failure of first-line palliative chemotherapy. The chapter illustrates potential problems that can arise in routine clinical practice, suggests some solutions to commonly encountered difficulties, and reviews the evidence base for the range of treatment approaches.

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