Bladder Cancer-Mitomycin-C and Cellcept Lowering the Bodies Immune System

Hi there. For complicated situations like your husband's it is best that he is to be managed by a multidisciplinary team, meaning the combination of subspecialty doctors relevant to his case. I believe that a urologist alone will not be the best option for him, and I suggest that a collaboration between the urologist, the medical oncologist, and the neurologist be made. Cellcept affects predominantly the lymphocytes (a kind of white blood cells) while the Mitomycin will ultimately affect the neutrophils (the other kind of white blood cell). Affecting both will really compromise the immune system. However, not giving the former or the latter may cause either flare or worsening of the CIDP or decreased local control from the bladder cancer respectively. So a delicate balance should be agreed upon by your doctors. For example, there can be permissible dose reductions of either two drugs so as not to compromise benefit. Or there can be more active and more frequent surveillance of the blood tests during the treatment course to detect signs of immunosuppression. I suggest that you get an oncologist involved in the team. This multidisciplinary strategy is what is currently being advocated by majority of top cancer centers in the US and Europe. I hope your husband's treatment will be uneventful. Take care and God bless.

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