Getting a Leg Up On Bladder Cancer

Bladder cancer diagnosis and treatment advances reviewed

(RxWiki News) Even though it can be successfully treated, bladder cancer needs to be monitored in case it returns. The goal of researchers is to find better ways to detect and treat bladder tumors to make managing the disease easier. 

British researchers have reviewed the latest advances in diagnosing and treating bladder cancer. Several new techniques are proving to be effective.

"Quit smoking to help reduce the risk of bladder cancer."

Grace Cheung, a research fellow in bladder cancer/ robotics in the Urology Centre at Guy’s Hospital in London, led the study that reviewed recent advances in bladder cancer treatment.

About 72,500 Americans will find out they have bladder cancer this year. The vast majority (nearly 56,000) will be men who have smoked cigarettes at some point in their lives. Most patients – about 75 percent  will be diagnosed with cancer that has not yet invaded the muscles around the bladder – non-invasive bladder cancer.

Cystoscopy is the main diagnostic tool for bladder cancer. This instrument is a slender tube that is threaded through the urethra (which carries urine outside the body) to look inside the bladder. A tiny camera is attached for taking pictures and detecting lesions or tumors. Other tubes can be used to remove tissue.

The common treatment scenario for people who have bladder cancer that hasn’t invaded nearby tissue is to surgically remove the tumor. This surgery is called transurethral resection of bladder tumor (TURBT).

Depending on the nature of the bladder cancer, chemotherapy and immunotherapy (medicines that boost the immune system to fight cancer) are often given after surgery. This procedure - called intravesical therapy - involves delivering the medication into the bladder through a catheter. Various chemotherapy agents and delivery methods are used in this treatment.

The authors concluded that the most important advances in bladder cancer diagnosis and treatment include:

  • Photodynamic diagnosis/blue-light cystoscopy (PDD) has improved the detection rate of hard-to-spot cancer lesions. A dye is used before the procedure. Diseased tissue appears red, with normal tissue being seen as blue.
  • Narrow-band imaging (NBI) cystoscopy is very useful in detecting inconspicuous tumors without the use of dyes as is needed with the PDD.
  • Cytology is the most widely used urine sampling test for bladder cancer. While effective with high-grade tumors, cytology isn’t as good at seeing low-grade or early cancer. 
  • Urine biomarkers have also been identified. However, the researchers concluded these tests aren’t being widely used because they’re not very accurate.
  • In the past decade, a new surgical technique called “minimally invasive radical cystectomy” or “robotic assisted radical cystectomy” (RARC) has become popular for patients who have muscle-invasive bladder cancer. Robots are used to take out the entire bladder and surrounding lymph nodes, which is the standard for treating this aggressive bladder cancer.
  • Studies are currently underway to look at the long-term benefits of RARC. In the meantime, open radical cystectomy will remain the gold standard surgical treatment for advanced bladder cancers.
  • Patients wishing to preserve their bladder can opt for TURBT, followed by chemotherapy and radiation. Some patients will enjoy the same benefits from this therapy as removal of the whole bladder, according to the authors.

While bladder cancer continues to be a serious threat, improvements are being made in ways to find and treat it.

This review was published January 17 in BioMed Central. The work was supported by National Institute for Health Research (NIHR) comprehensive Biomedical Research Centre. No financial conflicts of interest were reported.

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Review Date: 
January 21, 2013