How to Treat Bladder Cancer

Invasive bladder cancer treatment best results with chemotherapy before surgery

(RxWiki News) Patients with bladder cancer have several options, but the recent trend towards combination therapies can be confusing even for professionals.

Two urologists recently gave a presentation on the big picture when it comes to invasive bladder cancer, citing several studies from the past decade to support their treatment recommendations.

"Ask your urologist about neoadjuvant therapy for bladder cancer."

Filling the need for a good comparison, Bernard Bochner, MD, vice chairman of the Department of Surgery at Memorial Sloan-Kettering Cancer Center and Andrew Feifer, MD, urologic oncology fellow at Memorial Sloan-Kettering Cancer Center, compiled several studies.

They found that the data shows a course of cisplatin before surgery is the best option for long term survival in cases of invasive bladder cancer.

Currently most treatment centers do not follow this guideline, and the team of urologists urged conference attendees to implement similar treatment programs in their institutions.

The paper cited Dr. Feifer's 2011 study, presented last year at the American Society for Cancer Research's annual meeting.

The study shows that over a five year period in a sample of 4,541 patients, only 12 percent were given the best current standard of care for invasive bladder cancer, giving three doses of chemotherapy before surgery, a procedure known as neoadjuvant chemotherapy.

While difficult to detect until late in the disease, bladder cancer usually does not metastasize, making treatment easier.

While no cancer is without risk, the authors of the paper stated their belief that if urologists began to follow the current pre-surgery chemotherapy guidelines, large improvements in the survival of patients with invasive bladder cancer could be made with a minimum of risk.

The doctors also cited a case report from the Journal of Clinical Gynecology and Obstetrics where a slightly modified course of chemotherapy prior to surgery was successfully used in a bladder cancer patient who was 22 weeks pregnant at the time, showing the belief of doctors in the safety of chemotherapy.

The baby was delivered safely and in good health.

The authors concluded their presentation by emphasizing again the importance of switching to the new standard of care, and the fact that not enough urologists had switched over.

"Bladder cancer is known to be chemosensitive, and the most current level-one evidence available suggests that neoadjuvant administration of cisplatin-based chemotherapy combined with high-quality surgery prolongs survival. Although academic centers lead the way in therapy integration, many patients are still not benefiting from multidisciplinary care."

Research presented at conferences is considered preliminary until publication in a peer-reviewed journal.

Authors of the paper did not disclose any relevant financial interests.

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Review Date: 
May 30, 2012