July 12, 2002

Bladder-sparing procedure found effective for treating invasive bladder cancer

For patients with bladder cancer that has penetrated the organ's muscular layers, the standard of care has been to remove the bladder and adjacent structures completely. Now an MGH-developed strategy aimed at sparing the bladder has been shown to have long-term cure rates just as good as bladder removal. The findings, which appear in the July issue of Urology, could offer a better quality of life for many patients.

"Our first goal is to save the patient's life, but our second goal is to preserve the bladder if safely possible," says co-author William Shipley, MD, deputy head of clinical research for MGH Radiation Oncology. He and his colleagues used a three-pronged approach, combining surgery to remove the tumor with radiation and chemotherapy treatments. The MGH research team had developed this approach and reported a pilot study's results in 1993.

The current study enrolled 190 patients. Although one-third did eventually require bladder removal, the 10-year survival rate for all patients in the study was as good as that of radical bladder removal. Co-author Donald S. Kaufman, MD, director of the MGH Genitourinary Cancer Program, notes that chemotherapy is important to prevent tumor recurrence. "We are identifying better drugs that are both more effective and less toxic to the patient," he says.

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.