BOSTON -- July 8, 2002 -- People with the most serious form of bladder cancer, who elect to have bladder-sparing surgery, may live just as long as similar patients who undergo bladder removal to cure their cancer.
The report in the July issue of the journal Urology, offers patients with advanced bladder cancer hope of a better quality of life after cancer treatment.
The research team led by Dr. William Shipley of the Massachusetts General Hospital treated patients with a combination of surgery, radiation and chemotherapy in an effort to cure the disease and spare the patients’ bladders.
"Saving the bladder is a big event," says study co-author Shipley in a prepared statement. "Our first goal is to save the patient's life, but our second goal is to safely preserve the bladder if possible."
One-third of all bladder cancers are of the most serious invasive form, in which the tumor penetrates the organ’s muscular layers. The current standard treatment is to surgically remove the entire bladder and nearby organs and lymph nodes, which requires patients to wear a bag to take the place of the bladder for the rest of their lives.
At the time of study publication 190 patients had been treated first with surgery to remove the tumor from the bladder. Then, radiation and chemotherapy treatments were administered. Several weeks later, patients underwent tests to determine whether cancer remained. Overall, 66 patients (35%) did eventually require complete removal of their bladders, while the remaining two-thirds did not.
Of the entire 190 patients, 54 percent survived five years and 36 percent survived 10 years, which is comparable to the survival rates shown by other studies of patients treated with radical bladder removal.
The researchers note that current treatments for bladder cancer are effective in reducing recurrence of cancer in the pelvic area, but 50 percent of all invasive bladder cancer patients will eventually die from cancer that had spread or metastasized from its original location at the time of original diagnosis.
"That's why we include chemotherapy after surgery, as is used for patients with breast cancer and other high-risk cancers, to try and reach cancer cells throughout the body," says co-author Dr. Donald S. Kaufman, medical oncologist and director of the MGH Genitourinary Cancer Program.
Shipley adds that the new treatment strategy is gaining acceptance "As an alternative to radical surgery, it's now being offered to more patients, although it's not yet as common as are lumpectomies for breast cancer."
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