Investigational Treatment for this stage is becoming controversial. Since most patients do not do well with cystectomy alone, many investigators are entering patients into clinical trials that will answer the important question of how effective neoadjuvant therapy is in increasing survival.
• Two national protocols under investigation are: chemotherapy with M-VAC versus no chemotherapy before
cystectomy; and MCV chemotherapy followed by combined radical (doses of 7,000 cGy) radiation therapy
plus cisplatin .
Preliminary results suggest that patients downstaged from a T3 to a much lower stage tumor fare better.
Patients are urged to participate in these studies so that correct answers to the true value of neoadjuvant
