Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Bladder-sparing treatment shows promise against cancer, maintains quality of life

21.07.2004


For patients with invasive bladder cancer, treatment has typically meant an operation to remove the bladder and nearby organs. This requires up to a week in the hospital and leaves patients with a reconstructed bladder or urostomy bag.



Minimally invasive surgery combined with chemotherapy and radiation therapy has potential in some patients to cure the cancer but preserve the bladder. A new pilot study by University of Michigan Health System researchers found combining radiation therapy and a chemotherapy drug that is used successfully with other forms of cancer may effectively treat bladder cancer without toxic reactions, while allowing many patients to preserve their bladder.

Results of the study appeared in two papers published this month. The first paper, published in the Journal of Clinical Oncology, tested appropriate doses of the chemotherapy drug gemcitabine. The second paper, published in Urology, looked at quality of life.


Instead of cystectomy, surgery that removes the entire bladder, 24 patients with muscle invasive cancer confined to the bladder underwent transurethral surgery, a procedure that involves no incision, to remove the tumor cells. Patients then received low doses of gemcitabine along with radiation therapy for six weeks. The radiation was given once daily, five days a week; chemotherapy was given twice each week throughout the six weeks.

By monitoring toxic reactions such as low blood counts, the researchers were able to determine the dose at which patients could tolerate combined gemcitabine and radiation therapy. All but two patients showed no signs of cancer at their first follow-up screening. About four years later, 65 percent of the patients were still cancer-free – similar to results with more aggressive surgery – and they still had intact bladders.

"The exciting part of this study is we were able to use gemcitabine at a dose that increases the effectiveness of radiation without causing significant toxicities – and 16 of 24 patients kept their bladder," says study author David C. Smith, M.D., associate professor of internal medicine and urology at U-M Medical School and medical director of the Multidisciplinary Urologic Oncology Clinic at the U-M Comprehensive Cancer Center.

Smith emphasizes that this approach, which is still experimental, will likely work best on certain types of patients, namely those whose disease has not spread outside the bladder and who do not have a condition called carcinoma in situ. It may also be an option for patients who cannot have surgery because of a large tumor or other medical conditions.

Previous studies have looked at radiation alone to treat bladder cancer, but results were not promising. Other chemotherapy drugs in combination with radiation therapy have been used, but the chemotherapy regimen is too difficult for many patients to finish. When radiation and chemotherapy are administered ineffectively, patients end up needing surgery to remove their bladders anyway.

The U-M team chose gemcitabine because it has been shown to make radiation more effective at killing cancer cells and generally does not cause severe side effects. Few study participants had toxic reactions, including bladder inflammation, low blood counts and liver damage, and most were able to receive full doses of chemotherapy throughout their radiation therapy. Gemcitabine has been used along with radiation therapy to treat pancreatic cancer and head and neck cancers.

Study participants completed questionnaires about quality of life before treatment began, during their six weeks of treatment and after they completed treatment. Questionnaires asked about physical, emotional, social and functional well-being and included questions specific to bladder cancer patients about urinary and bowel control. The researchers found no statistically significant differences in responses before, during or after treatment.

"Patients were able to finish the entire treatment regimen and the majority reported few changes in urinary urgency, bowel control and erectile function. Our results suggest gemcitabine with radiation therapy may be an effective way to treat bladder cancer in selected patients," says study author Howard Sandler, M.D., professor of radiation oncology at U-M Medical School.

Bladder preservation using gemcitabine and radiation is not currently offered to patients outside of clinical trials, and radical cystectomy remains the standard approach for most bladder cancer patients. Researchers are planning a larger, multicenter phase II study to further determine whether gemcitabine with radiation is a good option for treating bladder cancer.

Nicole Fawcett | EurekAlert!
Further information:
http://www.umich.edu

More articles from Studies and Analyses:

nachricht Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland

nachricht Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Giant Magnetic Fields in the Universe

Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.

The results will be published on March 22 in the journal „Astronomy & Astrophysics“.

Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...

Im Focus: Tracing down linear ubiquitination

Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.

Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...

Im Focus: Perovskite edges can be tuned for optoelectronic performance

Layered 2D material improves efficiency for solar cells and LEDs

In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...

Im Focus: Polymer-coated silicon nanosheets as alternative to graphene: A perfect team for nanoelectronics

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.

Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...

Im Focus: Researchers Imitate Molecular Crowding in Cells

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.

Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

International Land Use Symposium ILUS 2017: Call for Abstracts and Registration open

20.03.2017 | Event News

CONNECT 2017: International congress on connective tissue

14.03.2017 | Event News

ICTM Conference: Turbine Construction between Big Data and Additive Manufacturing

07.03.2017 | Event News

 
Latest News

When Air is in Short Supply - Shedding light on plant stress reactions when oxygen runs short

23.03.2017 | Life Sciences

Researchers use light to remotely control curvature of plastics

23.03.2017 | Power and Electrical Engineering

Sea ice extent sinks to record lows at both poles

23.03.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>