Shift in Bladder Cancer Management

Bladder cancer likes to return after treatment. It also tends to get worse - going from what's called nonmuscle-invasive bladder cancer (NMIBC) to a form that invades surrounding tissue.

Researchers looked at this natural progression and have some new ideas.

Current surveillance and treatment methods for bladder cancer aren't working very well, according to a group of British researchers. They're suggesting it's time for a paradigm shift.

Quit smoking to eliminate the main risk factor for bladder cancer.

Bladder cancer will affect about 73,500 Americans this year, according to American Cancer Society estimates. Treatment typically includes surgery to remove either the primary tumor or the entire bladder. Surgery is usually followed therapy with a medicine known as Bacillus Calmette-Guerin, which is also a tuberculosis vaccine.  

For this study, researchers from the Academic Urology Unit and Institute for Cancer Studies at University of Sheffield in England reviewed information about all patients with primary, high-risk NMIBC at their institution from 1994 to 2010.

A total of 712 patients with high-risk NMIBC were included in the review. The median age of participants was nearly 74 years.

The cancer progressed to muscle invasion in 110 patients. Disease worsening was linked with age, changes in bladder tissue and cancer cells, as well as recurrence of the bladder cancer 

A total of 134 people died of bladder cancer at a median of 28 months, the researchers found. Mortality was associated with age, cancer stage, changes in bladder tissue and disease progression.

Disease progression and death were not associated with treatment Bacillus Calmette-Guerin, which is marketed under brand names TheraCys BCG and TICE BCG, 

As a result of these findings, the authors said, "Surveillance and bacillus Calmette-Guerin were ineffective in altering the natural history of this disease."

They concluded that it's now time to "rethink the paradigm of management of this disease."

This research was published April 27, 2012 in Cancer, the journal of the American Cancer Society.