Navigation Links
AUA releases new guidelines on non-muscle invasive bladder cancer
Date:11/9/2007

LINTHICUM, MD. The AUA is pleased to announce their new Guideline on the Management of Nonmuscle Invasive Bladder Cancer. Each year, more than 60,000 people are diagnosed with bladder cancer, which has been linked to a number of risk factors, including cigarette smoking and exposure to hazardous chemicals. The AUA originally published its guideline in 1999 and the report issued today is an update to that document.

The Guideline focuses on current treatment impacts on outcomes of interest to the patient, such as efficacy outcomes and occurrence of complications and side effects in treated patients. Unfortunately, new evidence on treatment modalities is scant and advances in treatment and physician education regarding treatment are limited.

The Guideline reviews a number of current treatments, including transurethral resection of bladder tumors (TURBT) and the use of chemotherapeutic agents (such as mitomycin C) and immunotherapeutic agents (such as bacillus Calmette-Guerin) in conjunction with TURBT. The panel also reviewed the efficacy of chemotherapy vs. immunotherapy in treating these non-invasive tumors, and the use of these agents in single induction courses compared to use as maintenance therapies.

The Guideline comes to the following conclusions based on current literature:

  • Accurate clinical staging upon which to base treatment decisions is critically important. The panel recommends performing a repeat TURBT prior to intravesical therapy in situations where there is high grade T1 disease without muscularis propria in the specimen and in select cases even when there is muscle present.

  • A single, post-operative instillation of a chemotherapeutic agent may decrease recurrence risk in patients with superficial disease who have undergone uncomplicated resection of the tumor(s).

  • There is no clear superiority of immunotherapy over chemotherapy for low risk disease. Induction courses of either intravesical chemotherapy or immunotherapy (BCG) should be administered in patients with an increased risk of tumor recurrence but low risk of progression.

  • An induction course of mitomycin C in conjunction with maintenance therapy enhances the effectiveness of the drug in preventing recurrence, however, no determinations have been made in regard to optimal maintenance dose, schedule or duration.

  • An induction course of BCG in conjunction with maintenance BCG therapy decreases recurrence and possibly progression in patients with higher risk tumors. Though no determinations on optimal schedule and duration have been made, data is available that supports the SWOG regimen.

Treatment algorithms are available both in the full document and the Executive Summary. However, many accepted studies used to develop these algorithms did not provide stratified outcomes data, and little data were available in regard to progression and survival. As a result, the panel felt the paucity of data needs to be addressed and corrected; the Guideline includes a discussion of future research needs and the optimal reporting of bladder cancer data. Most available studies focus primarily on recurrence and less on progression to muscle invasion a more important outcome with lethal implications.

Bladder cancer affects thousands of people each year and as the incidence of the disease rises, it is increasingly important that clinicians better understand how this disease progresses and how to stop it, said Craig Hall, M.D., chair of the panel that developed the Guideline. We may know more than ever about the diseases clinical behavior and molecular biology, but we need a larger body of strong research in order to educate physicians and make treatment recommendations.


'/>"/>

Contact: Wendy Isett
wisett@auanet.org
410-689-3789
American Urological Association
Source:Eurekalert

Related medicine news :

1. Cleveland Clinic Press Releases Journal-Writing Book Write for Life: Healing Body, Mind, and Spirit Through Journal Writing by Sheppard B. Kominars, Ph.D.
2. Leading Child Abuse Center Releases Back to School Tips to Protect Children From Internet Predators
3. JHA Releases 2007 U.S. Group Disability Mid-Year Market Survey Results
4. Verdict One Releases Directory of Board Certified Attorneys for Consumers
5. Academy releases emergency preparedness tools to enable millions more people to shelter in place
6. Provectus Pharmaceuticals, Inc. releases summary results of phase 1 metastatic melanoma study
7. MITEM Releases Blue Iris eLaborate 8.6
8. Produce for Better Health Foundation Releases Statement on Study Saying Fruit & Vegetable Consumption Not Strongly Associated With Colon Cancer Risk
9. Patient Safety Authority Releases Advisory Focusing on Common Causes of Medication Errors
10. URAC Releases Issue Briefs Examining Stakeholders Views of Care Coordination Along the Healthcare Continuum
11. Cardiac Science Releases New Cardiac Rehabilitation System
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/13/2017)... ... October 13, 2017 , ... ... that offers insurance and financial preparation services, is providing an update on a ... organization. , Rock City Rescue is a locally recognized nonprofit that provides shelter ...
(Date:10/13/2017)... ... 13, 2017 , ... The International Association of Eating Disorders ... for the field of eating disorders, announces the opening of early registration for ... Florida at the Omni Resort at ChampionsGate. , The annual iaedp™ ...
(Date:10/13/2017)... Shelton, CT (PRWEB) , ... October 13, 2017 , ... ... and long-term care services, staged a mock evacuation of the facility as part of ... Department, Shelton Fire Department, Echo Hose EMS and Shelton City Emergency Manager, as well ...
(Date:10/13/2017)... ... October 13, 2017 , ... Global Healthcare Management’s 4th Annual Kids Fun ... NJ. This free event, sponsored by Global Healthcare Management’s CEO, Jon Letko, is ... is geared towards children of all ages; it is a non-competitive, non-timed event, which ...
(Date:10/13/2017)... ... , ... “The Journey: From the Mountains to the Mission Field”: the story ... the Philippines. “The Journey: From the Mountains to the Mission Field” is the creation ... has taught all ages and currently teaches a class of ladies at her church, ...
Breaking Medicine News(10 mins):
(Date:10/7/2017)... --  Provista, a proven leader in the supply ... power, today announced a new resource area on Provistaco.com ... is the online home for case studies, articles on ... releases, slideshows and events. ... at their fingertips, viewers can also watch short videos ...
(Date:10/2/2017)... Oct. 2, 2017 Diplomat Pharmacy, Inc. (NYSE: ... Software and Consulting, LLC , and named its founder ... based in Tennessee , will operate ... expands EnvoyHealth,s service offerings for health care partners to ... "In an interoperable world, technology ...
(Date:9/28/2017)... , Sept. 28, 2017 Hill-Rom Holdings, ... 2017 earnings conference call and webcast on Friday, November ... a.m. (EDT) and ending at approximately 8:30 a.m. (CDT) ... discussing the company,s 2017 financial performance and guidance for ... opportunities, initiatives to enhance operational performance, and long-range financial ...
Breaking Medicine Technology: