Although bladder cancer is the most frequent cancer in the United States and around 85,000 new cases are diagnosed every year, it continues to receive only limited awareness, representation of interests and innovations in treatment. In fact, the supply standard has hardly changed in certain types of bladder cancer in 40 years.
The current standard for the supply of bladder cancer that was not metastasized was developed in 1921 to treat tuberculosis (TB). In the case of BCG immunotherapy, a weakened form of TB is inserted directly into the bladder, which stimulates the immune system to attack the cancer cells in the lining.
Although effective, there are obstacles to the use of BCG, including challenges in production and distribution. “We believe that about half of the patients worldwide has no access to this therapy that lasts for a long time and has been in rare care,” said Joshua Meeks, Md, Ph.D., Associate Professor of Urology, Biochemistry and Molecular Genetics at the Feinberg School of Medicine at Northwestern University.
He spoke in a panel at the latest Stat studio -Virtual event Bladder Cancer: progressive science, treatment and patient care, in which Chris Cutie, MD, Vice President and Disease leader of Bladder cancer at Johnson & Johnson, and Alex Filicevas, Executive Director of the World Bladder Cancer Coalition.
At the session, Meeks pointed out patient pollution as another obstacle for BCG. As a rule, patients receive treatment in the first year and have to record the solution for a longer period of time in their bladder. Cutie added that “dwell times are not ideal and compliance with patients is as important as we treat many patients.”
Cutie emphasized that these challenges accept current research efforts – in particular how treatment in the bladder can be maintained long enough to effectively target tumors, reduce the risk of recurring and to maintain the life capability. “How do we think of saving someone bubble,” he asked, “and to free them from treatments like BCG or even radical cystectomy?”
Filicevas also spoke of the need for new treatment options for reducing cystectomies for both the physical and mental health of the patient.
“We have patients who undergo radical cystectomy, and for many is the only option that is available today, a complete removal of the bladder and in some cases in which organs are surrounded.
It is a life -changing process with great effects of lifestyle, and adaptations to life after the operation are enormous and have a real influence on daily life, mobility for patients, their self -confidence and also relationships. “
Alex Filicevas, Executive Director of the World Blase Cancer Patient Coalition
Challenges and unscovered needs
Bladder cancer is difficult to diagnose because there is no screening for the disease and the first symptom – blood in the urine – is often ignored.
“Usually there is a gap from the time when someone has symptoms until they see a doctor,” said Meeks.
Treatment can then be delayed while tests are carried out to confirm the diagnosis, the biopsy of the tumor and determine whether the cancer has spread to other organs. In addition, the patient path can feel complex and weird – from the first symptoms to treatment and possible recurrence.
“As soon as they have been diagnosed, many patients do not fully understand what their diagnosis means or what they can expect from the treatments and their effects,” said Filicevas.
He added that the communication gap increases the fear and confusion of a patient and can also be influenced by their health literacy. According to Filicevas, patients often do not receive enough information about how the treatment options affect their quality of life.
Bladder cancer has remained behind other, top -class cancer in relation to research financing and has contributed to a lack of knowledge of the disease, but Cutie said that that changes. “Today we see a renaissance in a better understanding of the trivers of tumors – whether it is mutations, changes or mergers of genes – and how the immune system is still so important to treat the pre -tumor and to prevent it from restoring,” he said.
Promise of tomorrow
Bladder cancer can take both a physical and an emotional tribute for patients. As already mentioned, a BCG, other immunotherapies or intravesical therapy add an additional burden.
“We [at J&J] Try constantly trying to think about opportunities to deliver innovative local therapies that are really effective to optimize how we treat the tumor, and at the same time restrict the side effect in the bladder and the organs beyond the bladder, ”said Cutie. Bladder and they can still go and are still treated when they are on the golf course.”
Researchers are investigating new approaches for intravesical therapy, which in such a way deliver medication directly into the bladder and could reduce the need for repeated treatments. These innovations aim to reduce the burden on patients and at the same time maintain the effectiveness – and offer the possibility of better results and improved quality of life in the future.
“Innovation changes the landscape of the treatment of bladder cancer,” said Meeks. “This is a very optimistic area, and we talk about remedies as incredibly reasonable and close. I think that there will be a lot of innovation and excitement in the coming years.”
About bladder cancer
Although bladder cancer is not always at the top of public awareness at the head of public consciousness, it is one of the most common types of cancer in the USA. It is the sixth overall, the fourth among the men and the more tenth cause of all cancer deaths in the country. Bladder cancer worldwide is the top 10 highest cancer.
Bladder cancer occurs when urothelial cells mutate and become tumors in the lining of the bladder. They usually develop in the inner layer of the bladder (non-muscle invasive bladder cancer or nmibc), but can grow into deeper layers and/or to spread to other parts of the body, including bones, lungs or liver (muscle-invasive bladder cancer or mibc).
About 70% of bladder cancer diagnoses are for NMIBC.
In addition to BCG, NMIBC and bladder cancer can be treated in the early stages by removing tumors, radiation and chemotherapy, but have high recurrence rates. Studies show that between 31% and 78% of patients will develop recurrence or secondary bladder cancer within five years of treatment.