Chemo & Radiation May Prolong Survival Time for Persons with Bladder Cancer
Small-cell cancer of the urinary bladder is a rare cancer that is thought to behave much like small-cell cancer of the lung. For this reason, researchers have been studying the effects that treatments for lung cancer might have if used against small-cell bladder cancer. Recently, researchers in British Columbia reported that 1 such regimen—a chemotherapy combination with radiation therapy to the bladder area—produced a prolonged survival time in some persons with small-cell bladder cancer.
Cancer of the bladder is characterized by the presence of cancer cells in the bladder, the organ that is located in the lower abdomen and that serves to store urine. Treatment options, which depend on the stage of the cancer (extent of disease at diagnosis) and a number of other factors, may include surgery, radiation therapy, chemotherapy, and/or biologic therapy to help the immune system fight the cancer. Emerging evidence suggests that a rare type of bladder cancer called small-cell bladder cancer, also referred to as neuroendocrine bladder cancer, may behave much like small-cell cancer of the lung. For this reason, researchers have been studying the aggressive use of chemotherapy and radiation therapy combinations that are used to treat persons with small-cell lung cancer as potential treatments against small-cell bladder cancer. Two chemotherapy drugs that are most active against small-cell lung cancer are cisplatin and etoposide.
Researchers in British Columbia treated 14 persons with small-cell bladder cancer between 1985 and 1996. The researchers found that a multi-drug chemotherapy combination (including those drugs most active against small-cell lung cancer), along with radiation therapy to the bladder area, resulted in a 2-year survival rate of 70% and a 5-year survival rate of 44%. Eighty-two months after diagnosis, 5 patients are still alive and free of disease.
The researchers concluded that a multi-drug chemotherapy with radiation therapy regimen, similar to that given for small-cell lung cancer, appears to prolong survival time in some persons with small-cell bladder cancer. Persons with small-cell bladder cancer may wish to talk with their doctor about the risks and benefits of receiving this chemotherapy/radiation therapy combination or of participating in a clinical trial in which other promising new treatments are being studied. Sources of information on ongoing clinical trials that can be discussed with a doctor include a comprehensive, easy-to-use service provided by the National Cancer Institute (cancer.gov).
(Cancer, Vol 86, pp 2346-2352, 1999)