Adding Chemo to Cancer Surgery

Bladder cancer treatment adding chemotherapy to surgery

/ Author:  / Reviewed by: Robert Carlson, M.D

(RxWiki News) Chemotherapy, surgery, radiation. The choice used to be simple, but doctors are taking a closer look at combination therapy, using elements of several treatments for the best outcome.

For patients with small cell urothelial cancer, a rare type of bladder cancer, dramatic differences in long term survival were observed when chemotherapy was given before the surgery, a technique called neoadjuvant therapy.

"Ask your oncologist about neoadjuvant therapy."

A group of doctors from MD Anderson investigated the role of chemotherapy for small cell urothelial cancer. When a round of chemotherapy was included in the treatment before surgery, the median survival jumped from 18.3 months to 159.5 months.

While bladder cancer is generally curative by surgery, small cell urothelial cancer in the bladder is notable for having metastasis early on, and chemotherapy plays an important role in wiping out these smaller tumors.

Patients given chemotherapy alone had a median survival of 18.1 months. Records from the MD Anderson Cancer Center from the years 1985-2010 were examined, with 172 patients of this cancer type treated overall.

Relevant data from the records was statistically evaluated, taking into considering the grade of each tumor. Overall, a substantial reduction in the seriousness of the tumor was noted in 62 percent of patients given the chemotherapy in addition to the surgery.

A statement from the study stated that the best level of chemotherapy isn't known, but the topic should be explored in further research.

The authors concluded that administering chemotherapy before surgery, a processed referred to as neoadjuvant chemotherapy, should be considered in all surgical candidates with small cell urothelial cancer as the difference in long term survival is pronounced.

The study was published online 18 April 2012 in the journal European Urology.

Researchers stated that no conflicts of interest were involved in the publication of the study.

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Review Date: 
April 25, 2012
Last Updated:
April 27, 2012