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.
UCLA’s Jonsson Comprehensive Cancer Center has more than 240 researchers and clinicians engaged in disease research, prevention, detection, control, treatment and education. One of the nation’s largest comprehensive cancer centers, the Jonsson center is dedicated to promoting research and translating basic science into leading-edge clinical studies. In July 2012, the Jonsson Cancer Center was once again named among the nation’s top 10 cancer centers by U.S. News & World Report, a ranking it has held for 12 of the last 13 years. For more information on the Jonsson Cancer Center, visit our website at http://www.cancer.ucla.edu.