What are the next steps after stage 2 cancer tumor removal surgery?

It's completely natural to feel overwhelmed while waiting for next steps after surgery - this is such a big moment in your journey. Your medical team will likely discuss options like additional treatments or monitoring plans based on your specific situation, and many people find it helpful to prepare questions ahead of Friday's appointment. The community here understands this waiting period well, so feel free to share any concerns or ask about others' experiences as you navigate what comes next.

Doctor meeting today. He is recommending a round of chemotherapy then bladder removal. I’m 57 and in good health otherwise. I’m at a loss

Yes, it can be overwhelming. I also have been diagnosed with stage 2 muscle invasive bladder cancer. My doctor also recommended chemotherapy and bladder removal. I elected not to have the surgery, did not want to deal with the ostomy bag. Now I am considerably older than you at 78, so maybe at your age I may have decided differently. It’s been a year and a half since and my quarterly cystoscopies have been clean as well as my CT scans. I know this could all change at my next checkup but I am willing to take that chance. I am comfortable with my decision.

Thanks Richard. Had a CT scan done with contrast and it didn’t show anything in the lymph nodes or surrounding organs, which is good. Today had CT scan of chest/lungs and all was clear with that. They did do surgery this morning to put in a port. They are recommending cis/gem plus immunotherapy once a week for 2 weeks then 1 week off. Do that 4 times. They didn’t offer any idea besides that even though there is TMT option with bladder preservation. Just really struggling with the idea of radical cystectomy if it’s possible to save the bladder. Maybe the radiation would do considerable damage… don’t know. Thank you again for responding.

I have also had the cis/gem therapy for four cycles and am now receiving immunotherapy every four weeks for eight cycles along with BCG treatments. I am willing to do any kind medicinal treatment but no bladder removal for me. Everyone’s situation is different. Make the decision that feels right for you.

Any tips on how to handle the cis/gem treatments? I appreciate being able to talk to you.

It is no problem to talk with you anytime. The only side effect I had was extreme fatigue. I had been trying to exercise during these cancer treatments to try to keep my spirits up but with the cis/gem treatments even a short walk was difficult. So be prepared to pace yourself. The worse part was the first week after each infusion and then I would start to feel better until the next treatment. The good news is when the treatments were finished I quickly rebounded to my old self. I had my treatments last summer and I feel good. Quarterly CT scans and cystoscopy exams and so far no new tumors.

So glad to hear you are doing so well! My first treatment is in 2 days so i have been trying to prepare for the unknown. You sharing your experience is very helpful. I know everyone is different on their responses but had read about fatigue being very real. Hopefully when i get the one week off i can recover a little bit in preparation for going again. Thanks again and I’ll share on here how it goes after the first treatment.

Had an appointment yesterday at IU med center and was told I should go with keytruda/padcev combo instead of cis/gem in an effort to try bladder preservation. Follow those rounds with maximal TURBT then continue with monthly infusions along with monitoring every 3 months with scans and scope. Decided to give this a try. Start them next Tuesday. One day at a time.

Good luck with your treatments.