Post surgical flushing of the bladder with Gemcitabine reduces chances of bladder cancer recurrence by 34%
New research published in the latest edition of the Journal of the American Medical Association (JAMA) shows a simple procedure post surgery can reduce bladder cancer recurrence.
The journal reported a 34% reduction in the risk of recurrence in low grade bladder cancer patients when they were flushed with gemcitabine mixed with normal saline within three hours of surgery.
Smoking is the single most important risk factor for bladder cancer and males are affected more than females
Bladder cancer is the second most common malignancy of the urinary passage in the United states of America affecting about 80000 people each year and is one of the commonest malignancies of the urogenital tract worldwide. Although most data in India is reported from tertiary care centres, a study from Rajasthan by Sharma et al reported that urinary bladder cancer is the second most common after prostate cancer among the urogenital cancers in India.
Smoking is the single most important risk factor for bladder cancer and males are affected more than females.
The research was carried out by a team lead by Dr. Edward M. Messing, M.D., a SWOG investigator and professor of urology, and a professor of oncology and pathology, at the University of Rochester School of Medicine and Dentistry and a physician at the Wilmot Cancer Institute.
The SWOG team conducted the randomized, double-blind clinical trial involving 406 eligible patients at 23 cancer centers. After scrapping the tumor out in an operation called TURBT (transurethral resection of bladder tumour) which is done through a cystoscope (a hollow tube equipped with a lens which is inserted through the urethra and slowly advanced into the urinary bladder), 201 patients received the chemotherapy drug, gemcitabine, mixed with saline, administered via catheter to the bladder area within three hours after surgery.
The second group of 205 patients received saline alone. Gemcitabine is an anticancer drug which works by blocking new DNA and killing any dividing cells and is used intravenously to treat several other cancers including advanced bladder cancer. Patients were followed up quarterly with cystoscopies over 2 years, then semiannually for 2 years. Results showed that there was a 34% reduction in the risk of bladder cancer recurrence in the gemcitabine group compared to the saline alone group.
“The real importance of this study is that we now have a readily available drug that’s fairly inexpensive, well-tolerated, and effective,” Messing said. “One of the biggest issues with low-grade bladder cancer is that it frequently returns. I know some patients who have to undergo four surgeries a year, and if we can cut down on these recurrences, we will save a lot of people a lot of pain, money, and time lost to recovery,” he added.
