Final answer:
The treatment of choice for nonmuscle invasive urothelial bladder cancer often starts with transurethral resection of the bladder tumor (TURBT) followed by intravesical therapy using chemotherapeutic agents or immunotherapy with BCG. The treatment plan can vary and may include repeat TURBT or radical cystectomy based on the tumor's characteristics and response to initial therapies.
Step-by-step explanation:
The treatment of choice for nonmuscle invasive urothelial bladder cancer typically involves a multi-faceted approach. The most common initial treatment is transurethral resection of the bladder tumor (TURBT), often followed by intravesical therapy. The intravesical therapy may involve the administration of a chemotherapeutic agent such as mitomycin C or, more commonly, the use of immunotherapy with Bacillus Calmette-Guérin (BCG), especially in cases of high risk or recurrent tumors. For certain low-grade tumors, TURBT alone may suffice, while other cases may require additional treatments including repeat TURBT, enhanced surveillance, or radical cystectomy depending on the progression and stage of the cancer.
In the context of metastatic cancers, like metastasized testicular cancer, systemic chemotherapy with drugs like cisplatin has shown significant success, as was the case with Lance Armstrong's treatment. However, for nonmuscle invasive bladder cancer, systemic chemotherapy is generally not the primary treatment. Treatments for other forms of cancer often include modalities like surgery, chemotherapy, radiation therapy, targeted therapy, or a combination thereof, tailored to the type and stage of cancer. It's important for patients to discuss the risks and benefits of different treatments with their healthcare provider to decide on the most appropriate options for their specific case.