Navigation Links
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 attack the bladder cancer. Imaging of the upper urinary tract with a CT scan, MRI scan or renal ultrasound is also recommended at diagnosis and every two years thereafter.

This would mean each patient receiving eight cystoscopy exams, eight urine tests, two upper urinary tract imaging exams, one chemotherapy shot and six BCG treatments in the two years after their diagnosis, according to the report.

Compliance with the guidelines had little to do with the patients' age, race or economic status. Instead, it was about the doctors who were treating them, the researchers said. The guidelines may not be reaching the urologists at community hospitals, which is where the majority of people are treated, they concluded.

Full adherence to the recommendations "only happened for one person in the study," Chamie said.

When researchers relaxed the standard to one cystoscopy, one cytology and one injection of BCG during the two-year follow-up, 37 percent of patients received the recommended treatment, and just 58 percent of doctors followed these less-strict guidelines on any one patient within two years.

Ongoing research suggests that following these comprehensive care guidelines may confer a survival edge for people with bladder cancer, he said.

Dr. H. Barton Grossman, professor and deputy chairman of the urology department at M.D. Anderson Cancer Center in Houston, said the guidelines described in the new study "are arbitrary and set the bar too high so it looks like everyone failed."

That said, even when the study authors relaxed the standards, they still were not met, Grossman said.

The authors' suggestions for boosting compliance rates included modifying reimbursement rates and conducting additional research to identify barriers to comprehensive treatment.

More information

For more information on bladder cancer and its treatments, visit the American Cancer Society.

SOURCES: Karim Chamie, M.D., postdoctoral fellow in urologic oncology and health services research, University of California, Los Angeles Jonsson Comprehensive Cancer Center; Barton Grossman, M.D., professor and deputy chairman, department of urology, M.D. Anderson Cancer Center, Houston; July 11, 2011, Cancer, online


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Bladder cancer patients rarely receive recommended care
2. Nearly all patients with high-grade bladder cancer do not receive guideline-recommended care
3. Diabetes Drug Actos May Raise Risk for Bladder Cancer: FDA
4. New made-in-Canada therapy for bladder cancer shows promising results
5. Digital imaging software to create a Google Earth view of the bladder
6. Vaginal Mesh Surgery Effective for Bladder Prolapse Repair: Report
7. Newer Versions of the Pill Pose No Added Risk to Gallbladder
8. Genetic variation linked to longer telomeres and lower risk of bladder cancer
9. Genetic variation cuts bladder cancer risk, protects chromosome tips
10. Gene test shows which bladder cancer patients may have cancer spread
11. Chemotherapy plus radiation prevents bladder cancer recurrences
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Bladder Cancer Patients Not Getting Recommended Care: Study
(Date:12/7/2016)... ... 07, 2016 , ... ODU, a worldwide leader in ... its advanced highly customizable contact technology solutions. , ODU Single Contact Technology portfolio ... ideal for a wide range of applications that require customization from industries like ...
(Date:12/7/2016)... ... December 07, 2016 , ... AlignLife clinics nationwide are giving ... are not fortunate enough to receive bountiful gifts wrapped tightly under a Christmas Tree. ... to the children of the world. , In exchange for generous donations, customers will ...
(Date:12/7/2016)... , ... December 07, 2016 , ... Facial plastic surgeon, ... holiday season by donating a portion of proceeds to two local organizations: North Chicago ... Animal Control & Friends is a team of authorized and trained volunteers who ...
(Date:12/7/2016)... , ... December 07, 2016 , ... "ProBrand Flip allows ... all media," said Christina Austin - CEO of Pixel Film Studios. , ProBrand Flip ... to use drop zones. Editors can select from a variety of flip book animations. ...
(Date:12/7/2016)... ... December 07, 2016 , ... “Tomorrow Trump Goes To Washington”: a ... to the presidency and to America. “Tomorrow Trump Goes To Washington” is the creation ... she can for this country. , Nancy attributes her patriotic nature to her WWII ...
Breaking Medicine News(10 mins):
(Date:12/6/2016)... Dec. 6, 2016 A new study released ... (AIR 340B) projects the 340B Drug Pricing Program will continue ... time it is expected to exceed $23 billion in total ... 340B purchases surpass current Medicare Part B drug reimbursement purchases ... study – based on analysis of data on total drug ...
(Date:12/6/2016)... , Dec. 6, 2016 /PRNewswire/ - InMed ... progress today on its R&D program in the ... obstructive pulmonary disease (COPD). In June, 2015 InMed ... tool to identify the targets and potential active ... of COPD. Subsequently, with in vitro assays using ...
(Date:12/6/2016)... Tenn , Dec. 6, 2016  In response ... dependent on opioids every 25 minutes, a respected group ... company that will provide a holistic suite of services ... Based on his own experience trying to ... social entrepreneur Justin Lanning launched 180 ...
Breaking Medicine Technology: