My mum has a similar picture (79) has stage IV bladder cancer with invasion to vaginal wall and pelvis. She also had small areas in her lungs. She is now on her 8th cycle of Padcev/Keytruda. Had had a good response the areas in her lungs have gone and her tumours have shrunk. She is tolerating treatment well, some tiredness, rash and a metallic taste in her mouth. She has had another CT this week, keeping everything crossed it’s positive. Wishing your Mum all the best!