Chemotherapy after Surgery Reduces Risk of Bladder Cancer Recurrence

A large US study has found that treating bladder cancer patients with a common chemotherapy agent after surgically removing their tumor, can significantly help prevent the cancer from coming back. The clinical trial confirmed the findings of other studies of bladder cancer recurrence conducted in Canada and Europe.

The study investigators found that immediately flushing the bladder with the chemotherapy drug gemcitabine after removal of a cancerous tumor, can reduce the risk of cancer recurrence. The Phase III clinical trial was conducted by researchers with the Southwest Oncology Group (SWOG), and the results were presented at this year’s American Urological Association (AUA) annual meeting.

“This one extra step, using a drug that’s fairly inexpensive, has impressive results,” said Dr. Edward Messing, an investigator with SWOG and Chairman of Urology at the University of Rochester. “Urologists in Europe and Canada have been doing this procedure for more than 20 years with other chemotherapy drugs, with the research to prove it. Even the AUA recommends it.”

The clinical trial – dubbed, S0337 – included 406 patients with non-muscle invading bladder cancer. Around 50 percent of patients with bladder cancer are diagnosed with the non-muscle invasive form of the disease, which is currently treated using a transurethral resection for bladder tumor (TURBT).

Patients were randomly assigned to receive a single infusion of gemcitabine, or a saline solution, after undergoing a TURBT procedure. After being followed up with for a four-year period, patients who received the dose of chemotherapy showed a 34 percent reduction in the risk of bladder cancer recurrence. More of these patients did report moderate pain following surgery compared to the control group, however no other side effects of the chemotherapy treatment were observed.

“Now that we’ve got results from an American study, using a readily available drug that is very well-tolerated, maybe American urologists will start using gemcitabine this way,” continued Messing. “I certainly hope this finally changes our standard of care.”

Bladder cancer presents one of the top three most common cancer types in men, and is the sixth most common cancer in the US. According to estimates made by the National Cancer Institute, over 79,000 new cases of bladder cancer will be diagnosed in 2017, with over 16,000 patients dying as a result.

“The big deal here is that cancer recurrence is common for people diagnosed with this less aggressive form of bladder cancer,” said Messing. “I know some patients who undergo four TURBT procedures a year. If we can cut down on these recurrences, we will save a lot of people a lot of pain, money, and time lost to recovery.”