Bladder Cancer

Transurethral resection remains the standard for first-line treatment of transitional cell carcinoma of the bladder. This technique clearly defines the pathologic grade and is essential in determining the clinical stage of

The fastest growing segment of the US population is the group over the age of 65 years. In the next 30 years, this group will comprise over 20% of the population. Because 60% of all cancers occur in this age group, there will be an expected rise in the total cancer burden.

Researchers who conducted a large, randomized clinical trial across Europe, Great Britain, and Canada found that in order to improve safety and reduce toxicity, advanced bladder cancer patients can be treated with a combination of gemcitabine (Gemzar) and cisplatin (Platinol). This combination (known as GC) did not extend survival, but it was much less toxic than the currently used combination, MVAC (methotrexate, vinblastine, doxorubicin [Adriamycin], and cisplatin).

COPENHAGEN-For patients with locally advanced or metastatic bladder cancer (transitional cell carcinoma of the urothelium), the combination of gemcitabine (Gemzar) and cisplatin (Platinol) may offer a less toxic regimen, according to a presentation at the ASCO meeting.

Despite being one of the more common genitourinary neo plasms, superficial transitional cell carcinoma involving the urinary bladder can be a confusing entity for the treating physician. This confusion stems, in large part, from the binary classification

Baselli and Greenberg have presented a comprehensive overview of intravesical strategies for the management of superficial urothelial malignancies of the bladder, both past and present. A number of points made in the article deserve further

Approximately 54,400 new cases of transitional cell carcinoma of the bladder were reported in the United States in 1999, with an estimated 12,500 deaths attributable to this cancer. Close to 75% of all bladder tumors are confined

The intravesical instillation of therapeutic agents for the treatment of localized bladder cancer began in 1903 when Herring[1] summarized his experience with silver nitrate. Since then, intravesical chemotherapy and immunotherapy have emerged as

BALTIMORE-Physicians should consider using intravesical chemotherapy or immunotherapy as adjuvant therapy following surgery for non-muscle-invasive bladder cancer, according to new treatment guidelines released by the American Urological Association (AUA). “The fact that the peer-reviewed published data show that the use of intravesical agents after surgery lowers the probability of recurrence but not progression is the most important finding that we made,” panel chair Joseph A. Smith, Jr., MD, of the Vanderbilt University Medical Center, said in a news release.

CHICAGO-Despite recent excitement about therapy involving ifosfamide (Ifex) and other new chemotherapy drug combinations, MVAC-methotrexate, vinblastine, Adriamycin (doxorubicin), and cisplatin-remains the standard of care for advanced bladder cancer, Derek Raghavan, MD, said at the Chicago Prostate Cancer Shootout III Plus Bladder Conference, sponsored by the Chicago Urological Society, Chicago Radiological Society, and Chicago Medical Society

Often overshadowed by more common genitourinary cancers, such as prostate, testicular, and kidney cancers, penile and urethral cancers nonetheless represent difficult treatment challenges for the clinician. The management of these cancers is slowly evolving. In the past, surgery, often extensive, was the treatment of choice. Recently, however, radiation and chemotherapy have begun to play larger roles as initial therapies, with surgery being reserved for salvage. With these modalities in their treatment armamentarium, oncologists may now be able to spare patients some of the physical and psychological sequelae that often follow surgical intervention without compromising local control and survival. Part 1 of this two-part article, published in last month’s issue, dealt with cancer of the penis. This second part focuses on cancer of the urethra in both females and males. [ONCOLOGY 13(11):1511-1520, 1999]

CHICAGO-Systemic chemotherapy would seem to be a reasonable option to reduce the number of deaths from metastatic transitional cell bladder carcinoma. To date, however, systemic neoadjuvant chemotherapy has failed to show an effect on survival, and the jury is still out on the issue of chemotherapy following definitive therapy, said Derek Raghavan, MD, chief of medical oncology, University of Southern California Norris Cancer Center.

UFT, a compound containing uracil and tegafur (a prodrug of 5-fluorouracil) in a 4:1 molar ratio, has been used in Japan for the treatment of and as adjuvant chemotherapy for bladder cancer. In phase II studies, 300 to 600

Superficial transitional cell carcinoma of the bladder comprises an extremely heterogeneous group of tumors, both in terms of morphology and, even more importantly, in terms of tumor biology and clinical behavior. Drs. deVere White and Stapp provide a succinct overview of the challenges encountered clinically because of tumor heterogeneity and the availability of different treatment options. The authors also outline the use of traditional prognostic factors (clinicopathologic characteristics) and the current state of development of biological markers that hold promise in providing significant clinically useful prognostic information.

Bladder cancer is the most common urologic malignancy and is expected to affect approximately 54,000 people in 1998. Superficial bladder tumors (Tis, Ta, and T1 lesions) account for approximately 70% to 80% of these

MIAMI--In terms of randomized trial results, the M-VAC (methotrexate, vinblastine, Adriamycin, cisplatin) regimen should probably be considered the standard of treatment for metastatic bladder cancer, but the overall outlook with this regimen is not optimal, and newer treatments are needed.

WASHINGTON--Citing inadequate data to prove efficacy, ODAC (Oncologic Drugs Advisory Committee) voted unanimously against recommending that the FDA approve the new drug application for Anthra Pharmaceuticals’ valrubicin (Valstar).

A two-drug combination regimen may provide a more tolerable therapy for patients suffering from advanced bladder cancer, many of whom are elderly.

A US multicenter study led by Dr. William J. Ellis of the University of Washington has found that the new, quantitative BTA TRAK Assay improves the detection of recurrent bladder cancer over cytology, the standard microscopic method. These results were reported in the December 1997 issue of Urology.

HAMBURG-Although BCG is extremely effective in high-risk bladder cancer and carcinoma in situ, many physicians hesitate to use it because of the intense inflammation and systemic side effects it produces. Moreover, no consensus has yet been reached about whether BCG is actually superior to chemotherapy.

Anthracycline antibiotic use is limited by cardiac toxicity. The risk factors are cumulative dose, radiation to the chest and mediastinum, age, and preexisting myocardial impairment. Dexrazoxane (Zinecard) can prevent

Radical cystectomy remains standard management for patients with locally advanced T2 through T4, N0, M0 transitional cell carcinoma of the urinary bladder.

NEW ORLEANS--The enzyme telomerase is detectable in the majority of bladder washings from patients with bladder cancer, making it a reliable marker for cancer, according to several reports presented at the American Urolog-ical Association (AUA) annual meeting.

NEW ORLEANS--A large SWOG study presented at the American Urology Association (AUA) meeting confirms the efficacy of Bacillus Calmette-Guerin (BCG) as maintenance therapy for superficial bladder cancer, and a report from Italy shows its benefits as an adjuvant to surgery.

ROCKVILLE, Md--TICE BCG vaccine (Organon Teknika Corp.) has won the backing of the Food and Drug Administration's Oncologic Drugs Advisory Committee (ODAC) as a prophylaxis against recurrent papillary carcinoma of the urinary bladder.