Hi,
I'm sorry to hear about your father's diagnosis. Until recently not much had been published about small cell of the bladder but MDAnderson Cancer Center in Houston has published a review and developed a clinical trial using combination chemo:
"MD Anderson Cancer This trial is for patients with a rare and aggressive variant of bladder cancer. " Center in Houston is conducting a clinical trial for small cell carcinoma of the bladder: Phase 2 Trial of Ifosfamide and Doxorubicin Alternating with VP-16 & Cisplatin for Small Cell Carcinoma of the Urothelium:
There is more info and links here:
blcwebcafe.org/raretypes.asp#scc
Maybe you father's doctor could consult with the experts there.
I'm afraid that almost every cancer is fatal once it has spread. Chemo can put someone into remission or shrink tumors but I suppose you've already heard that is no guarantee for lasting cure. The most important goal is quality of life. There are risks vs. benefits to be considered. Chemo could increase quality of life or it could lower it, there is no way to tell in advance.
I know that people do better when they have a good relationship with their doctor and faith in the chosen path of treatments.
Here's info from our 'metastatic' section:
"Benefits from treatments include control of symptoms and possible prolongation of life. The most important concerns are:
Will further treatments improve my quality of life?
Will benefits outweigh risk and discomfort?
Will further treatments add to survival?
What feels most comfortable to me?
Do I feel I can manage the side effects of each treatment option? What kind of support will I have from family or friends? Outside agencies?
Many studies cite the addition of 2-3 months to a person's life as justification enough for aggressive chemotherapy. Ask your doctor how many patients he's treated with the same therapy and how the patients did. Palliation of symptoms alone is still a valid goal in metastatic cancer.
Because the needs of metastatic patients are highly individual and many of the treatments are still experimental, there are no standard guidelines available to either the patient or the doctor. In some cases the decision is determined by whose opinion you seek — a surgeon will recommend surgery, an oncologist chemotherapy or a radiation oncologist radiation therapy. Often, the patient and family must decide on the course of treatment. .
When faced with two different opinions about treatment, consider seeking a third opinion from a nationally recognized cancer center. Although it can be very difficult to focus in the face of metastases, it's important to take the time needed to investigate available options before coming to a decision.
New treatment modalities are being investigated in clinical trials for advanced bladder cancer; given that existing therapies are often inadequate, participation in clinical trials is often recommended for those with a stage IV bladder cancer diagnosis.
blcwebcafe.org/metatcc.asp