Researchers at UCLA’s Jonsson Comprehensive Cancer Center led by Dr. Karim Chamie, assistant professor-in-residence in the Department of Urology, have found that the burden of bladder cancer on the population is very high, and that more intense surveillance and treatment in the first two years after diagnosis could reduce the number of patients whose cancer returns after treatment and lower the death rate from this disease. The study was published online ahead of press today in the journal Cancer.
Based on their previous research showing underutilization of care for patients with bladder cancer, this is the first study to examine the natural history of the disease from a population standpoint. To date no one has examined the morbidity of recurrence of disease in the U.S. Chamie and colleagues found that nearly three quarters of patients with high-grade, non-muscle-invasive bladder cancer will suffer return of the disease (recurrence) within 10 years, while 33 percent of patients will have their cancers progress to a more advanced form requiring removal of their bladder, radiation therapy or systemic chemotherapy. An additional 41 percent will recur without further spread of the disease (progression).
“Even though 80 percent of bladder cancer patients don’t die of their disease within five years, most patients will either die of other causes or bladder cancer, require aggressive treatment (removal of the bladder, radiation and/or chemotherapy), or have recurrence of their disease," said Chamie. "What this study hopes to do is highlight the need to comply with treatment guidelines—prevent recurrences by instilling anticancer agents inside the bladder (intravesical) and follow patients more closely within the first two years of diagnosis."
The study was based on a nationwide sample of Medicare beneficiaries who had high-grade, non-muscle-invasive bladder cancer.
“We have level-one evidence that demonstrates that a single instillation of chemotherapy into the bladder can minimize recurrences, and that six instillations can minimize recurrence and progression,” Chamie stated. “Efforts should be increased to offer patients intravesical therapy with the goal of minimizing the burden of this disease.”
The researchers also found that the elderly, women and African-American patients had higher likelihood of dying of bladder cancer than younger patients, men and whites, respectively.
This study was supported by the American Cancer Society, Ruth L. Kirschstein National Research Service Award Extramural, Jonsson Comprehensive Cancer Center, National Institutes of Health, and National Institute of Diabetes and Digestive and Kidney Diseases.
The Jonsson Cancer Center Foundation, founded in 1945, is the single most important vehicle for raising private funds for cancer research at UCLA. Through activities such as Taste for a Cure and Lifeline Connection, the foundation supports high-priority cancer research efforts aimed at translating laboratory discoveries into more effective and less toxic therapies for cancer patients. UCLA's JCCC has more than 240 researchers and clinicians who are internationally renowned for finding new and better ways to prevent, detect and treat cancer. One of the nation's largest comprehensive cancer centers, the JCCC is ranked among the nation’s top 12 cancer centers by U.S. News & World Report. For more information on the Jonsson Cancer Center, visit our website at http://www.cancer.ucla.edu.