Radical cystectomy after age 80?

I'd be interested in this too. My husband is undergoing EVP treatment for MIBC. He will be done soon with his initial treatments. Most everything I've read is that his bladder will likely need to be removed. He is 84 and in otherwise good health.

Greetings,
I had a radical cystectomy in 2015 at age 70. Now I am 80 and thriving.
I opted for a urostomy bag for my bladder alternative, and I have never
regretted it. I find it to be my new best friend. It is so easy to travel with.
I don't think as I get older I could handle emptying another type of
diversion. With this there are no leaks, it is sanitary, and it doesn't get in the way of intimate relations as there are modesty panels you can wear.
When I was first diagnose I was a member of the BCAN support group
there I met Pat B Fit, and another woman, Pat was a cyclist, swimmer
hiker. Her friend was a scuba diver. I learned from those women that
it is best to have a device that you do not have to fiddle with. Yes the
surgery is a long one. I had mine operation at UCSF, I think the side
effects of the chemo has been the most difficult to deal with as it was
before the docs brought patients back to clinic to rehydrate them after
chemo. It was impossible for me to drink or eat anything after chemo.
I am doing great at this time, other than kidney disease due to chemo.
GO WITH THE BAG

Hi @walpi1945 -
Your response was certainly a welcomed one and to hear how successfully you have managed your situation is heartening, for sure.

I don't understand something - did you have MIBC or wide-spread? If so, is this why you must have had chemotherapy after your radical cystectomy? For those with NIMBC, I would suppose the chemo would not be necessary?

Although you were older when you had you RC, you still were not above 80 so this surely factors in. Again, as I mentioned -- it seems there is a greater risk to those over this age since it is a very lengthy surgery and might impact one's cognition to some degree if one is under anesthesia for too long a period of time. I am certainly not a medical professional but from what I have read, this may pose a problem.

It is certainly uplifting to hear of your experience and I hope others who have chosen this path share a similar experience.

Best wishes.

Hi. I second @walpi1945's endorsement of the urostomy bag. I had my RC last year at UTSW Medical Center in Dallas; I was 77. My oncologist strongly urged me to choose the external bag, given my age, and I agree that it is relatively foolproof once you master a few things (you'll note there are virtually no posts on the Mayo site from people having trouble with their stomas or bags). For what it's worth, surgery did not impact me cognitively.

It is a long surgery. While the risk of prolonged time under anesthesia increases with age, I'd question whether 80 is a hugely greater risk than say, 70 or 77; there are probably a number of other factors at play. You might want to discuss your concerns with your surgeon and anesthesiologist. Bladder cancer can kill you, so opting out of surgery because of cognitive concerns isn't a great solution, assuming they've clearly recommended surgery. Does a neobladder require substantially more surgery time? If so, that would help convince me to go with the external solution.

Hi Again,

My Bladder Cancer was contained in a tumor in the bladder. Unfortunately
the docs took a sonogram in the pelvis area, and they found one cancerous
cell. That necessitated chemo, MVAC. It really made me sick sick sick.
Since I had my RC the medical practice now requests patients to come
back to the hospital or infusion center after chemo several days to rehydrate. I found it impossible to drink fluids or eat anything. This was not the practice
when I had chemo. In fact, a year later my kidneys function went way
down due to chemo.

I can understand the age factor. if I was to have an RC now, I would have
similar concerns. I consider myself as having a strong body, only because
I have been quite active until the kidney disease progressed. However I
try to walk a mile a day several times a week, and go to the gym. I have
only been to the gym twice in the last two week, so not an avid exerciser.I would definitely talk with your doc about the possibilities of having brain damage due to then length of time you are under anesthesia.

As far as recovery, i came home 3 days after the surgery. Within two weeks
I was in Santa Cruz, attending my nieces baby shower, She had twins
two weeks later, and I spent a lot of time in Santa Cruz, helping with
the twins.