What Comes After Surgery?

Bladder cancer chemotherapy practices vary widely

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Cancer that appears in the bladder – the organ that holds urine – is most often treated with surgery to remove the tumor. Sometimes, though, surgery isn’t enough and some kind of chemotherapy is needed.

A recent review looked at physician practices relating to bladder cancer chemotherapy.

The use of what’s called intravesical postoperative therapy (IPT) – chemotherapy that’s placed inside the bladder – varies widely around the United States.

This method is only sometimes used after surgery in patients who have non-muscle-invasive bladder cancer.

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A team of scientists from the Department of Surgery at Vanderbilt University looked at IPT practice patterns across the United States.

Surveys were sent to 259 urologists (doctors who specialize in diseases of the urinary tract), asking them if or how often the use IPT in patients with non-muscle invasive bladder cancer.

IPT involves placing drugs in the bladder through a tube that goes through the urethra, the opening from where urine exits.

This treatment kills only the non-muscle-invasive tumor cells. The most common treatment is drug called BCG (Bacillus Calmette-Guerin).

The urologists reviewed the records of the last four patients they’d had with this type of bladder cancer. A total of 1,010 patient records were examined.

Study researchers found that the doctors used IPT to treat about 17 percent of initial cases of non-muscle-invasive bladder cancer. The therapy was most often used in low-risk patients, about 90 percent of whom started the treatment within 12 hours of surgery.

Interestingly, 66 percent of the urologists surveyed had never used IPT; 17 percent used it for about half of their cases and 2 percent used IPT for everyone diagnosed with this type of bladder cancer.

“The reason for the great diversity in the use of intravesical postoperative chemotherapy is speculative. However, physician awareness, physician bias, recurrence risk, and local pharmacy and hospital practice factors are all likely contributing factors,” the authors concluded.

This study appeared in the May issue of the Journal of Urology.

No funding information or financial disclosures were available.


 

Reviewed by: 
Review Date: 
September 7, 2012
Last Updated:
September 8, 2012