After 3 surgeries and 10 rounds of chemotherapy, early-stage bladder cancer frequently recurred. How can it be terminated?

时间：2026-04-16　人气：

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The National Cancer Center released the disease burden of malignant tumors in China in 2022. As of 2022, there were 92,400 new cases of bladder cancer in China, showing an upward trend compared to previous years. It is estimated that by 2040, the number of new cases of bladder cancer will increase to 150,000, posing a serious threat to people's health.

More than 80% of patients initially present with painless hematuria as a common clinical manifestation. About 10% of bladder cancer patients will first exhibit bladder irritation symptoms, including urinary frequency, urgency, dysuria, and difficulty in urination, without obvious gross hematuria. Some patients may experience flank and rib pain, lower limb edema due to tumor-induced ureteral obstruction, while some advanced bladder cancer patients may present with symptoms such as fever, anemia, rapid weight loss, renal dysfunction, and abdominal pain.

The conventional treatment for bladder cancer primarily involves surgery, combined with other treatment modalities such as intravesical drug instillation therapy, systemic chemotherapy, and systemic immunotherapy. Radiotherapy can serve as an adjuvant treatment for bladder cancer. However, despite adopting personalized treatment plans, bladder cancer, as a common malignant tumor of the urinary system, has an unsatisfactory prognosis with a high overall metastatic recurrence rate. According to authoritative statistics, approximately 70% of bladder cancer patients will experience recurrence within 3 years after surgery. Faced with this reality of high metastatic recurrence rates, how should we handle it? Let's take a look at what insights Mr. Xi's experience can offer us.

Disease Overview
Overview of the illness

In April 2016, Mr. Xi experienced painless gross hematuria and was subsequently diagnosed with bladder cancer. He underwent immediate transurethral resection of bladder cancer, and postoperative pathology revealed high-grade urothelial carcinoma with invasion of the lamina propria (no muscular layer involvement) and visible vascular thrombi. Fortunately, the stage was T1N0M0, and he was treated with pirarubicin bladder instillation chemotherapy.

But even for early-stage cancer that has undergone conventional treatment, it does not mean that patients can rest easy, as residual cancer cells still lurk nearby.

Just six months after the surgery, Mr. Xi experienced a recurrence. Nine months later, he had a second recurrence! Mr. Xi had to undergo multiple cystoscopic electroresection procedures. However, frequent surgeries could not completely solve the problem of tumor "resurgence".

Three months later, in early 2018, Mr. Xi's follow-up examination revealed iliac vascular metastasis again! He was treated with four cycles of gemcitabine + cisplatin chemotherapy.

Facing the frequent and recurring troubles of illness, Mr. Xi suffered greatly.

The follow-up examination in 2019 once again dashed Mr. Xi's hopes - revealing an increase in the number and size of retroperitoneal, iliac lymph node, and parasternal nodules compared to previous findings, suggesting metastasis. Subsequently, he underwent six cycles of chemotherapy with albumin paclitaxel and carboplatin.

We can observe the cyclic treatment mode of surgery + chemotherapy. Mr. Xi's tumor has not been suppressed, indicating that it is not sensitive to most current chemotherapy drugs and may even have developed resistance, posing a significant burden on his body. Mr. Xi felt physically and mentally exhausted, and when he was at a loss regarding treatment, he learned about the treatment cases of vNKT cell immunotherapy in inhibiting recurrence and metastasis.

Tips

What are vNKT cells?

The vNKT immune cell subpopulation discovered by Zhang Minghui's team at Tsinghua University possesses both the nonspecific recognition function of NK cells and the specific recognition function of CD8+ T cells. Therefore, the dual anti-tumor effect of vNKT cells can rapidly kill tumor cells. It not only directly kills cancer cells but also kills inhibitory immune cells (Myeloid-derived suppressor cells, MDSCs are a heterogeneous group of cells derived from the bone marrow, which have the ability to significantly negatively regulate immune responses. ), regulate the microenvironment within cancer tissues, and provide new hope for the treatment of solid tumors. At the same time, vNKT cells are obtained by collecting immune cells from healthy individuals, culturing and expanding them, and then infusing them back into patients' bodies, making treatment more feasible.

Mr. Xi contacted Professor Zhang Minghui's Lehexin Medical team at Tsinghua University School of Medicine. After reviewing Mr. Xi's medical records and fully understanding his condition, Professor Zhang Minghui, after comprehensive evaluation by the Lehexin Medical team, provided a second diagnosis and treatment suggestion:

1. The patient promptly discovered the bladder tumor and underwent radical surgery, followed by routine postoperative chemotherapy. Fortunately, the clinical stage was early.

2. However, there were high-risk factors in the pathological results: firstly, the "high-grade tumor" had low differentiation, with more primitive tumor cells, higher atypia, and higher malignancy. Secondly, "vascular thrombi" indicated that cancer cells had infiltrated deep blood vessels, and tumor cells precisely used this method to leave the primary lesion and metastasize to other sites, thus posing a greater risk of recurrence in the future.

3. The traditional surgery + chemotherapy regimen did not effectively solve the problem of recurrence and metastasis. Mr. Xi experienced recurrence after only six months, and despite undergoing three surgeries and two rounds of chemotherapy within two years, the disease remained uncontrolled. This was further evidenced by the recurrence of iliac vascular metastasis. Multiple treatments also brought significant side effects to the body.

4. Therefore, the most important thing for Mr. Xi at this moment is to contain the active cancer cells and prevent recurrence or metastasis. vNKT cell immunotherapy has unique advantages in this regard, as it can kill residual tumor cells, prevent the aggregation of free cancer cells, and effectively reduce the risk of metastasis and recurrence. Furthermore, it has no significant side effects and is patient-friendly.

Conclusion and Comments

Conclusion and Commentary

Mr. Xi underwent vNKT cell immunotherapy in May 2020 and has completed 34 courses so far. During this period, multiple follow-up examinations have shown no significant signs of tumor progression. Mr. Xi's physical condition has improved significantly, with a weight gain of 1-3kg. He reports that he has fewer colds and fever episodes in spring and winter than before, and his quality of life is excellent. Overall, his condition is stable!

03

Imaging changes

Cystoscopy: No significant recurrence was observed during follow-up examinations from January 19, 2021, to March 12, 2024.

The Power of Innovative Treatment Strategies
Innovative treatment strategies

Currently, the treatment of bladder cancer primarily focuses on surgical intervention, especially for muscle-invasive bladder tumors. Clinically, radical cystectomy combined with pelvic lymph node dissection is commonly employed, supplemented by various treatment options such as radiotherapy and chemotherapy. This approach can effectively reduce the recurrence risk of bladder cancer patients and subsequently improve long-term survival rates. However, studies have indicated that 50% to 70% of patients still experience recurrence within 5 years after surgical treatment[1].

From Mr. Xi's case, it can be observed that although his tumor was clinically classified as early stage, due to the presence of multiple high-risk factors for recurrence such as "high-grade tumor" and "vascular thrombus," it indeed recurred only six months after the initial surgery. This suggests that even early-stage tumors cannot be taken lightly, as tumor seeds may have already quietly metastasized to other parts of the body and established a foothold before the tumor is removed, plotting a comeback. Fortunately, as a wise patient, Mr. Xi, after multiple recurrences and unsatisfactory results from current treatment regimens, sought out new treatment methods and firmly chose vNKT cell therapy, which has been maintained for over four years without any tumor recurrence or metastasis! He is now on the verge of meeting the five-year clinical cure standard. vNKT therapy provides a new strategy for the prevention and treatment of recurrence and metastasis in patients with early-stage tumors but high recurrence risk.

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References:

[1] Zhang Jinying. Prognostic factors affecting patients with bladder cancer after surgery [J]. Chinese Journal of Geriatrics, 2022, 42(04):830-833.

Written by: Zhao Tuantuan
Reviewed by: Qiao Jiacheng, Wang Ying, Gao Chen
Edited/typeset by Zhang Jiao

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