Bladder cancer - European Society for Medical Oncology

psychological advice may be valuable, and some patients may find support in patient groups or
patient‐targeted information media. Dieticians may provide advice on adequate nutrition. Social
workers may help in finding resources to ensure successful rehabilitation.
What if the cancer comes back?
If the cancer returns, it is called recurrence*. The extent of the recurrence will direct the treatment
decision, and this should be carefully determined for each individual patient.
In patients treated with organ preservation therapy*, residual tumor can be detected in 20% of cases
during restaging. An additional 20‐30% of patients with initial complete responses will develop new
or recurrent disease in the preserved bladder. Up to 70% of patients are free of tumors after the first
cystoscopy* control. A quarter of them develop a new lesion in the later course that requires
additional treatment (cystectomy when possible).
For patients with metastatic* disease who experience progression* after completing a first‐line
platinum‐containing regimen, a second‐line chemotherapy regimen with vinflunine* is
recommended.
Bladder cancer: a guide for patients‐ Information based on ESMO Clinical Practice Guidelines ‐v.2012.1 Page 20
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