The “good” thing about the most common type of bladder cancer is that it rarely develops into a life-threating disease. On the downside, even after successful treatment, this cancer returns in half the people who had it, and they then have to have surgical treatment all over again—more pain, more recovery time and more expense.
So here’s some good news for bladder cancer patients with no apparent downside: A new, surprisingly simple advance in treatment can significantly reduce the odds of this bladder cancer coming back.
The form of bladder cancer we’re talking about is called low-grade non-muscle-invasive urothelial cancer—this is a cancer in which the tumor or tumors are along the inner lining of the bladder and do not extend down into the bladder muscle. The usual treatment is to surgically remove tumors with a procedure called TURBT, or transurethral resection of bladder tumor.
That’s the procedure after which half of patients eventually get the cancer again. But an additional step has been gaining traction in other countries: Flushing out the bladder with a cancer drug immediately after TURBT. Though prior studies of chemotherapy flush have shown that it reduces recurrence, very few American patients are being offered this treatment—only approximately 17%. With the publication of new research done in the US, that should change.
Led by scientists at the University of Rochester, the research included 406 patients with low-grade non-muscle invasive bladder cancer from a total of 23 cancer centers in the US. The patients all underwent TURBT. Then half of them were also treated with an internal bladder flush of gemcitabine, a common cancer drug (a catheter delivers the drug within the bladder)…while the other half were given just a saline flush. The goal was to document the extent to which the gemcitabine chemotherapy would reduce recurrence of the cancer.
The results: All the patients were followed for four years after treatment. In that time, 47% of the patients in the saline group had a recurrence…but only 35% of those in the chemo flush group did. Another important finding was that having the chemo flush did not add to any side effects of the TURBT treatment.
While this advance doesn’t prevent needing regular follow-up exams after your initial TURBT, not having to go through the procedure again is significant for patients because it involves general anesthesia, often having a catheter for several days, and then managing urinary symptoms like burning and seeing blood in the urine. And that’s all in addition to the psychological stress of having cancer again.
Bottom line: If you’re diagnosed with low-grade non-muscle-invasive bladder cancer, be sure to ask your cancer team whether this treatment is a wise choice for you.