Bladder-sparing procedure found effective
for treating invasive bladder cancer
BOSTON - July 8, 2002 - For patients with the most serious
form of bladder cancer, the standard of care has been to completely
remove the bladder and adjacent organs. Now scientists at Massachusetts
General Hospital (MGH) have shown that therapeutic strategies aimed
at sparing the bladder have long-term cure rates just as good as
does bladder removal. The findings, which appear in the July issue
of Urology, could offer a better quality of life for many patients.
"Saving the bladder is a big event," says co-author William
Shipley, MD, deputy head for clinical research of the MGH Department
of Radiation Oncology. "Our first goal is to save the patient's
life, but our second goal is to preserve the bladder if safely possible."
One-third of all bladder cancers are of the most serious invasive
form, in which the tumor penetrates the organ's muscular layers.
Shipley and his colleagues used a three-pronged or "tri-modality"
approach in their attempt to combat this often deadly condition.
Members of the MGH research team had developed this approach and
reported a pilot study's results in 1993.
One hundred ninety patients were treated in this study. First,
surgery was performed to remove the patient's tumor from the bladder.
Then, radiation and chemotherapy treatments were administered; chemotherapy
complements the cancer-killing effects of radiation, which is directed
at the bladder itself. One-third of patients enrolled in the study
did eventually require bladder removal, because tests conducted
several weeks after administering the tri-modality approach showed
that some cancer remained. However, the ten-year survival rate for
all patients in the study was as good as that of radical bladder
removal, which has been the standard of care for invasive tumors.
The researchers note that current treatments for bladder cancer
are effective in reducing recurrence of cancer in the pelvic area,
but 50 percent of all invasive bladder cancer patients will eventually
die from cancer that had spread or metastasized from its original
location at the time of original diagnosis. "That's why we
include adjuvant chemotherapy, as is used for patients with breast
cancer and other high-risk cancers, to try and reach cancer cells
throughout the body," says co-author Donald S. Kaufman, MD,
medical oncologist and director of the MGH Genitourinary Cancer
Program. "We are identifying newer and better drugs that are
both more effective and less toxic to the patient."
Shipley adds that the new treatment strategy is gaining acceptance
"As an alternative to radical surgery, it's now being offered
to more patients, although it's not yet as common as are lumpectomies
for breast cancer."
The other members of the MGH research team are Elizabeth Zehr,
Naill Heney, MD, Steven Lane, MD, H.K. Thakral, Alex Althausen,
MD, and Anthony Zietman, MD.
Massachusetts General Hospital, established in 1811, is the original
and largest teaching hospital of Harvard Medical School. The MGH
conducts the largest hospital-based research program in the United
States, with an annual research budget of more than $300 million
and major research centers in AIDS, cardiovascular research, cancer,
cutaneous biology, transplantation biology and photomedicine.
In 1994, the MGH joined with Brigham and Women's Hospital to form
Partners HealthCare System, an integrated health care delivery system
comprising the two academic medical centers, specialty and community
hospitals, a network of physician groups and nonacute and home health
Media Contact: Sue
McGreevey , MGH Public Affairs
Physician Referral Service: 1-800-388-4644
about Clinical Trials