Moderate therapy OK for some bladder cancers

Once bladder cancer invades surrounding muscles, surgical removal of the bladder - radical cystectomy - is usually deemed necessary. However, if the disease has not spread to other areas of the body, this can sometimes be avoided, according to Italian researchers.

They say an option is to cut out just the diseased area of the bladder, and follow this with extended chemotherapy and radiation.

As Dr. Donatella Tirindelli Danesi told AMN Health, "Even though urologists consider radical cystectomy as standard treatment for this kind of tumor, patients who refuse such mutilating intervention could find a valuable alternative with this combined treatment" - without adversely affecting their chances of surviving.

In the medical journal Cancer, Danesi, from ENEA Research Center Casaccia, and colleagues at other facilities in Rome report on long-term outcomes for 77 such patients treated with this organ-sparing approach.

Of the 72 patients who could be evaluated, 65 had a complete response and 7 had a partial response. After an average of nearly seven years, 44 of the complete responders (57 percent) were still alive, and 33 had no sign of bladder cancer.

The overall five-year survival rate was 58 percent.

"Our study has demonstrated that in selected cases it is possible to preserve the bladder with radiochemotherapy with an overall survival comparable to that obtained with radical cystectomy," Danesi said.

"Furthermore," she added, "it is important to underline that the bladder, due to the improvement of radiation therapy techniques, retains its normal capacity and functionality in the large majority of cases."

SOURCE: Cancer, December 1, 2004.