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Bladder Cancer Patients Not Getting Recommended Care: Study
Date:7/12/2011

By Denise Mann
HealthDay Reporter

TUESDAY, July 12 (HealthDay News) -- Most patients with a certain type of bladder cancer don't get the recommended treatments, which greatly increases their risk of experiencing a recurrence of their disease, researchers say.

New research published online July 11 in Cancer showed that just one of 4,545 people with high-grade, noninvasive bladder cancer was treated according to the comprehensive care guidelines set by the American Urological Association and the National Comprehensive Cancer Network.

All of the patients had primary bladder cancer that had not yet invaded their bladder muscle. These people have up to a 70 percent chance of their cancer returning after treatment, and as much as a 50 percent chance of the cancer becoming more aggressive and spreading to surrounding organs after initial treatment. Following the treatment guidelines in full may protect patients from potentially fatal cancer recurrences, the study authors said.

But the treatment guidelines are complex, and it's all or nothing, said study author Dr. Karim Chamie, a postdoctoral fellow in urologic oncology and health services research at the University of California, Los Angeles Jonsson Comprehensive Cancer Center.

"You have to do it all or you might as well not do anything," he said.

When a patient has a high-grade cancer, it means the cells show greater abnormality than cells from a low-grade tumor.

The guidelines for this grade of bladder cancer call for an initial injection of chemotherapy drugs directly into the bladder to kill cancer cells along with an intense follow-up surveillance schedule that involves using a scope to assess the bladder (cystoscopy) and urine testing (cytology) every three months. The chemotherapy shot should be followed by a six-week course of Bacillus Calmette-Guerin (BCG) treatment, which creates an inflammatory response and causes the body to a
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