Intravesical therapy with BCG is used for recurrent papillomas, mostly as a preventive agent. Other effective anticancer drugs include thiophosphoramide (Thiotepa), doxorubicin (Adriamycin), mitomycin-C and, in Europe, epodyl (Ethoglucid) and epirubicin . Complete tumor prevention succeeds in 20 to 45 percent of cases given cytotoxic drugs and 65 percent given BCG. More important, none of these drugs seem to be cross-resistant with each other or with immunological drugs.
Patients with diffuse recurrent Tis or who fail one or more trials of intravesical therapy should be considered for cystectomy.
In the United States, external radiotherapy , radiation seeds or needles and intra-operative radiation therapy have not yet been proven effective in controlling or in preventing Stage 0 disease.
Five-Year Survival Over 90 percent
Investigational
• New immunological drugs—interferon, interleukin-2, tumor necrosis factor , keyhole-limpet extract—are being
evaluated.
• New cytotoxic drugs such as epirubicin and mitoxantrone are being tested.
• Photodynamic laser therapy uses a photosensitizing material called hematoporphyrin that is similar to that
found in red blood cells . Hematoporphyrin is unique in that it goes into all cells but remains for a prolonged
