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What Is The Best Treatment For Burning Sensation During Urination, Vomiting And Weakness?
Question: Hello doctor,
This is for my mom-in-law. She is diabetic for last 20 yrs. Her creatinine level is 5 now. She was having burning sensation while passing urine. Whatever she eats, she was vomiting and she was very weak. She had blood in the urine.Due to that, we have admitted her in the hospital. With MRI Scan, ultrasound we got to know that she was having a tumour in the Urinary bladder. So as per the doctor's advise we have done Cystoscopy TURBT and sent the tumour for investigation.I have attached her blood work, scan and Biopsy report. We are interested to know, what is the best treatment option available to proceed further. Please advise.Thanks in advance!
This is for my mom-in-law. She is diabetic for last 20 yrs. Her creatinine level is 5 now. She was having burning sensation while passing urine. Whatever she eats, she was vomiting and she was very weak. She had blood in the urine.Due to that, we have admitted her in the hospital. With MRI Scan, ultrasound we got to know that she was having a tumour in the Urinary bladder. So as per the doctor's advise we have done Cystoscopy TURBT and sent the tumour for investigation.I have attached her blood work, scan and Biopsy report. We are interested to know, what is the best treatment option available to proceed further. Please advise.Thanks in advance!
Brief Answer:
Hello dear. Best treatment is chemotherapy followed by surgery
Detailed Answer:
Hello dear. I have seen the reports. So she has an advanced tumor of urinary bladder. The ideal treatment in such a case is chemotherapy followed by surgical removal of urinary bladder. After that a new bladder can be created. She requires management in a cancer centre only.
Thanks and regards
Feel free to ask further
Hello dear. Best treatment is chemotherapy followed by surgery
Detailed Answer:
Hello dear. I have seen the reports. So she has an advanced tumor of urinary bladder. The ideal treatment in such a case is chemotherapy followed by surgical removal of urinary bladder. After that a new bladder can be created. She requires management in a cancer centre only.
Thanks and regards
Feel free to ask further
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
1)Her Creatinine is 5. Is it fine to treat her with Chemo? 2)Why we need to remove bladder after giving Chemo? 3)How do you create a new bladder?
4) At 60 yrs, diabetic with creatinine as 5 , all the treatment you have mentioned can be carried out without any risk?
5)Can this condition can be treated in any multi-speciality hospital or it needs to be treated only in the cancer center only?
6)This will be treated by oncologist or urologist?
7) Can't we remove partial bladder, what will be the recurrence rate? Or what will be the issue, why this treatment option has not been suggested?
8) Though we remove complete bladder, what will be the recurrence percent? Is she will be 100% free from cancer?
9)How long (maximum) we can wait to take any treatment further
4) At 60 yrs, diabetic with creatinine as 5 , all the treatment you have mentioned can be carried out without any risk?
5)Can this condition can be treated in any multi-speciality hospital or it needs to be treated only in the cancer center only?
6)This will be treated by oncologist or urologist?
7) Can't we remove partial bladder, what will be the recurrence rate? Or what will be the issue, why this treatment option has not been suggested?
8) Though we remove complete bladder, what will be the recurrence percent? Is she will be 100% free from cancer?
9)How long (maximum) we can wait to take any treatment further
Brief Answer:
Chemotherapy followed by surgery is standard treatment
Detailed Answer:
Hello dear. So it is a category 1 recommendation to treat such tumor by chemotherapy followed by surgery as this approach has maximum survival benefit.
We need to remove bladder after chemo so as to remove the residual remaining tumor cells also.
Obviously, we need to modify the chemo drugs as her kidney function is not good.
We create a new bladder from intestine
With high creatinine and diabetes, there will always be a little higher risk. Risk and benefit needs to be balanced.
This condition must be treated in a multimodality cancer centre only by oncologist and never by urologist.
Another treatment approach is to do radiation and chemotherapy in those patients who wish to preserve their bladder. However, results are inferior with higher chances of relapse.
There is always a chance of cancer relapse even if we remove the bladder, however, chances will be lesser as compared to chemoradiotherapy.
You must take treatment within 1 week.
Thanks and regards
Chemotherapy followed by surgery is standard treatment
Detailed Answer:
Hello dear. So it is a category 1 recommendation to treat such tumor by chemotherapy followed by surgery as this approach has maximum survival benefit.
We need to remove bladder after chemo so as to remove the residual remaining tumor cells also.
Obviously, we need to modify the chemo drugs as her kidney function is not good.
We create a new bladder from intestine
With high creatinine and diabetes, there will always be a little higher risk. Risk and benefit needs to be balanced.
This condition must be treated in a multimodality cancer centre only by oncologist and never by urologist.
Another treatment approach is to do radiation and chemotherapy in those patients who wish to preserve their bladder. However, results are inferior with higher chances of relapse.
There is always a chance of cancer relapse even if we remove the bladder, however, chances will be lesser as compared to chemoradiotherapy.
You must take treatment within 1 week.
Thanks and regards
Above answer was peer-reviewed by :
Dr. Kampana
Hello dr , Thanks for your reply.
Is there a possibility it will lead to continuous dialysis after bladder removal due to increase in creatinine level.
Is there a possibility to survive without bladder removal by doing only chemo and radiation therapy for next 5 years.
Please suggest the best solution consider in age, current creatine level and diabetes level.
Is there a possibility it will lead to continuous dialysis after bladder removal due to increase in creatinine level.
Is there a possibility to survive without bladder removal by doing only chemo and radiation therapy for next 5 years.
Please suggest the best solution consider in age, current creatine level and diabetes level.
Brief Answer:
Hello. Bladder removal doesnot lead to dialysis
Detailed Answer:
Hello. So bladder removal has nothing to do with dialysis as kidneys will continue their function.
Only chemotherapy and radiation is also a treatment option but nobody can tell when will the tumor relapse or not?
If patient is fit, XXXXXXX look for the causes of kidney dysfunction and correct them. Chemotherapy(modified as per kidney function report) followed by surgery is still the best option.
Thanks and regards
Hello. Bladder removal doesnot lead to dialysis
Detailed Answer:
Hello. So bladder removal has nothing to do with dialysis as kidneys will continue their function.
Only chemotherapy and radiation is also a treatment option but nobody can tell when will the tumor relapse or not?
If patient is fit, XXXXXXX look for the causes of kidney dysfunction and correct them. Chemotherapy(modified as per kidney function report) followed by surgery is still the best option.
Thanks and regards
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Above answer was peer-reviewed by :
Dr. Vaishalee Punj
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