Bladder Cancer and Gemcitabine
About Bladder Cancer
A cancerous growth in the urinary bladder, the organ that stores urine, is known as bladder cancer. The technical term for this disease is transitional cell carcinoma of the bladder. Based on its growth pattern, bladder cancers are classified as either papillary cancer or a non-papillary invasive cancer. Though symptoms are many, it would be recommended to get oneself evaluated if there is blood in the urine or painful urination along with weight loss, lethargy and urinary urgency.
Chemotherapy is the mainstay of bladder cancer. It may be given as single drug or combinations, with cisplatin, doxorubicin and gemcitabine being preferred drugs. Combination of cisplatin and gemcitabine is reported to have far fewer side effects than other therapies.
Gemcitabine Properties and Uses
Gemcitabine is a nucleoside(pyramidine) analogue, which shows anti-cancer activity. It is a white solid, water soluble, and insoluble in ethanol or polar organic solvents. It is available as injections of strengths of 200mg and 1000mg, under the trade name Gemzar.
Gemcitabine has been indicated for use in the following disease conditions
1. Ovarian cancer – in combination with carboplatin
2. Breast cancer – in combination with paclitaxel
3. Non-Small Cell Lung cancer – in combination with cisplatin
4. Pancreatic cancer – first line treatment
The recommended vehicle for reconsitituting gemcitabine is 0.9% sodium chloride injection without any preservatives. Once the powder has fully dissolved, administration should be by intravenous infusion, once weekly for 7 weeks followed by 1 week of rest.
Warnings, Side Effects, and Drug Interactions
Gemcitabine is contraindicated in patients known to have a hypersensitivity (allergy) to the drug.
The main side effect is myelosuppression.Other side effects include nausea and vomiting, blood in urine, fever and rashes, dyspnea, flu-like symptoms.
When used with anticoagulant warfarin, its potency may increase, and hence warfarin dose may be reduced.
Toxicity is increased of the infusion time of longer than 1 hour and a dosage frequency of more than weekly is used. Toxicity signs and symptoms include the following:
1. Suppression of bone marrow function
2. Lung toxicity
3. Renal failure with hemolysis
4. Liver failure has been reported rarely.
Gemcitabine is known to cause fetal harm, and hence not to be administered to a pregnant woman.