BLADDER CANCER NEWS

Researchers Recruiting Men and Women Diagnosed with Bladder Cancer within the Last Four Years for a Telephone Survey
October, 2009
Baylor College of Medicine and the Michael E. DeBakey VA Medical Center (both in Houston, Texas) are conducting a research program to understand how bladder cancer affects the lives of men and women.  They are looking for people who have been diagnosed with bladder cancer in the past four years who are willing to complete a telephone survey about your experiences with cancer.  The results will be used to create a new patient education and counseling program.

For more information on this research and how to participate, click here.

New Drug Approved for Bladder Cancer
September, 2009
Valstar, an intravesical therapy drug for bladder cancer, is now available.  It is FDA-approved for patients with BCG-refractory carcinoma in situ (CIS) for whom immediate removal of the bladder would be associated with unacceptable medical risks.  Click here for more information.

Congratulations to the First John Quale Traveling Fellowship Awardees.
August, 2009
Gayathri Ghadalapaka, David DeGraff, Peter O’Donnell, and Amit Patel were each awarded a John Quale Traveling Fellowship to enable them to attend the Fourth Annual Bladder Cancer Think Tank. The Bladder Cancer Think Tank is the only annual scientific conference in North America that focuses solely on bladder cancer research. BCAN has hosted this meeting for the past two years.

Gayathri Ghadalapaka is a graduate student at Texas A&M University. Her area of research is “Natural products and their synthetic derivatives as anticancer agents against bladder cancer models”.

David DeGraff is a second year Post-Doctoral Fellow at Vanderbilt University Medical Center. His current research focuses on the role of Forkhead transcription factors in normal prostate and urinary bladder development, and the roles of Forkhead transcription factors in the molecular etiology of prostate cancer, urinary bladder cancer and benign urinary bladder diseases.

Peter O’Donnell completed his medical Hematology/Oncology fellowship training this year at the University of Chicago and is currently pursing an additional year of research training in Clinical Pharmacology and Pharmacogenomics. His research focuses on germline genetic predictors of platinum susceptibility.

Amit Patel is a chief resident at the Glickman Urological and Kidney Institute in Cleveland Ohio. His research interests include novel therapies for use in bladder cancer mouse models.

More Bladder Cancer News

Clinical trial recruiting smokers for bladder cancer screening test

April 29, 2009
Doctors at the:

• University of Rochester, Rochester, NY
• University of Texas M.D. Anderson Cancer Center, Houston TX
• Baylor College of Medicine, Houston, TX, and
• Laval University in Quebec, Canada

need men over the age of 60 who have smoked at least 20 years to participate in an international clinical study to improve bladder cancer screening techniques. Study participants cannot have had a previous diagnosis of bladder cancer.  Participants will be asked to complete daily urine tests during two 10-day periods. For more information: click here.

Updates from American Urology Association’s Annual Meeting in Chicago in April 2009

April 29, 2009

Bladder Cancer mortality jumps 30% when diagnosis is delayed. Link to news story

Improved cystoscopy imaging method (currently unavailable in the US until FDA approval) shows improved detection of bladder tumors and reduced recurrence. Link to news story

 

Diet and Bladder Cancer - Yogurt and Selenium

March 30, 2009
Yogurt? Selenium? Can they affect bladder cancer? Find out about new studies that explore the relationship between bladder cancer, eating yogurt and selenium levels. Read More (from Outlook, BCAN's Newsletter, Winter 2009)

Firefighters May be at Increased Risk for Bladder Cancer

May 19, 2008
Firefighters may be at increased risk for bladder cancer and should be considered for routine annual screening, say University of California, San Francisco, researchers. Link to news story

Eating Vegetables Can Reduce Your Bladder Cancer Risk

December 12, 2007
A recent study shows that eating broccoli or cabbage three times each month may reduce your risk of developing bladder cancer by 40%.  To learn more, click here.

AUA Releases New Guidelines on Non-Muscle Invasive Bladder

December 12, 2007
The American Urological Association (AUA) recently published new guidelines on the treatment of non-muscle invasive bladder cancer.The Guideline reviews a number of current treatments and reaches conclusions on issues such as immunotherapy versus chemotherapy for low risk disease, the need for repeat resections, and maintenance BCG therapy.  For more details, click here.

RESEARCHERS FIND BROCCOLI PREVENTS OR SLOWS BLADDER CANCER

October 25, 2007
Researchers at Ohio State University believe that consumption of cruciferous vegetables such as broccoli, cauliflower, brussel sprouts and kale, may help prevent or slow the progression of bladder cancer. The researchers hypothesized this effect and confirmed it in laboratory experiments using compounds found in cruciferous vegetables. Interestingly, the compounds had the strongest effect on the most aggressive forms of bladder cancer cells. The researchers presented their findings at the July 18, 2005 annual meeting of the Institute of Food Technologists, held in New Orleans. The full text of this announcement may be found by clicking here. In a separate but related report, Discover Magazine, in its January, 2005 issue, listed the finding that "Broccoli Kicks Cancer" as one of the top 100 science stories of 2004. In that report, scientists at the University of Illinois at Urbana-Champaign isolated a substance called sulforaphane from cruciferous vegetables and conducted in vitro tests against breast cancer cells. Within hours, the cancer cells stopped dividing.  Sulforaphane was found to work by interrupting the cell division process of cancerous cells, while leaving normal cells untouched. The lead researcher, Keith Singletary, cautioned that what happens in the test tube may not be what happens in the body, and that further research is needed.

NSAIDs may protect against bladder cancer

August 29, 2007
NEW YORK (Reuters Health) - Regular use of non-steroidal anti-inflammatory drugs (NSAIDs), especially aspirin, may decrease the risk of bladder cancer, particularly more advanced, high-grade tumors containing alterations in the tumor suppressor protein TP53, results of a study suggest. For more details click here.

Stopping Smoking Might Reduce Tumor Recurrence in Non-Muscle Invasive Bladder Cancer

August 16, 2007
Researchers have found that continued smokers have a 2.2-fold greater risk of bladder cancer recurrence compared to those who quit smoking. They evaluated 265 male patients with Ta or T1 disease some of whom were non-smokers, quitters, and continued smokers. Researchers found that the 3 year recurrence free survival of continued smokers was 45% compared to the 70% for quitters. For more details, click here.

Improved Outcomes with Higher Volumes for Radical Cystectomy

August 15, 2007
According to an online publication in the Journal of Urology patients with bladder cancer who undergo surgery to remove their bladder have improved outcomes if they receive treatment at a medical center where large volumes of these procedures are performed. Researchers at Vanderbilt recently conducted a clinical study of 6,728 patients with bladder cancer who had undergone a radical cystectomy and found that the mortality rate for patients undergoing the surgery was .54% for those treated in a facility performing more than 50 radical cystectomies per year, compared with 2.7% for those treated in a facility performing 10 or less procedures per year. For more details, click here.

DNA in Urine May Detect Bladdder Cancer

July 24, 2007
According to an article recently published in the Journal of the National Cancer Institute, testing a small number of genes in a urine sample may help detect bladder cancer.  While these results need further confirmation, such testing may provide a non-invasive, effective method to screen for bladder cancer. Patients who have undergone initial treatment for non-invasive bladder cancer often receive follow-up cystoscopies to detect a recurrence.  During a cystoscopy, a doctor places a lighted tube into the bladder to search for abnormal areas of tissue that indicate cancer.  As an invasive procedure, cystoscopy has its limitations.  Physicians also rely on urine cytology to detect bladder cancer.  However, urine cytology is not always accurate. Researchers are exploring tests that are less invasive than cystoscopy and more accurate than urinary cytology. Researchers from Johns Hopkins recently conducted a clinical study to evaluate the accuracy of detecting bladder cancer by testing a small number of genes from a urine sample.  This study included 175 patients with all different stages of bladder cancer and 94 patients without bladder cancer.  DNA from urine samples was tested to find a small number (panel) of genes with properties that indicated the presence of bladder cancer.  82% of bladder cancers were identified from testing of the gene panel, and 96% of the tests that were positive for bladder cancer were accurate in the diagnosis. The researchers concluded that the testing of this specific panel of genes within a urine sample identities the presence of bladder cancer with high accuracy compared to standard testing.  Further testing of this gene panel is required to confirm its accuracy and potential use in a clinical setting.  For more details, please click here.

One Reason Why Bladder Cancer Hits More Men Than Women

April 23, 2007
Bladder cancer strikes three times as many men as women. According to a study in the April 4 issue of the Journal of the National Cancer Institute, researchers discovered one reason why bladder cancer is more prevalent in men--androgen receptors, molecular proteins that are more active in men, play a key role in development of the disease. This finding could lead to new types of treatment for the disease. For more details, click here.

Early Menopause Related to Bladder Cancer Risk

March 29, 2007
Researchers have found that women who go through menopause at a younger age seem to be at greater risk of developing bladder cancer. The study, which was completed at the University of Minnesota School of Public Health, analyzed more than 37,000 women between the ages of 55 and 69 from Iowa. The risk of bladder cancer was 32 percent higher for those women who reached menopause between the ages of 43 and 47, compared to those women who were above the age of 48. For more details, click here.

BCG/MITOMYCIN BETTER THAN BCG ALONE

February 8, 2007
A recent article printed in the journal "Lancet Oncology" reported that a study performed in Italy showed that administering Mitomycin C with BCG improves the outcome compared to BCG alone.  Approximately 211 patients were divided into two groups, one receiving BCG alone, and the other receiving BCG and Electromotive Mitomycin C. At the median follow-up period of 88 months, the following results were noted: -Those treated with BCG/Mitomycin remained cancer free for 69 months on average, compared to 21 months for the BCG-only group. This was a difference of 4 years. -Cancer recurred in 41.9% of BCG/Mitomycin/Patients, compared with 57.9% of BCG-only patients. - Cancer progressed in 9.3% of BCG/Mitomyin patients compared with 21.9% of BCG-only patients. -Overall mortality was 21.5% in BCG/Mitomycin patients, compared with 32.4% of BCG-only patients  -Mortality caused by bladder cancer was 5.6% in the BCG/Mitomycin patients, compared with 16.2% in the BCG-only group. The researchers thus concluded that treatment with the combination of BCG and Electromotive Mitomycin C gave superior results to those treated with BCG alone.The detailed news release may be viewed by clicking here.

Scientists Establish Link Between Gonorrhea and Bladder Cancer

January 16, 2007
New research suggests that men who have contracted the sexually transmitted infection gonorrhea in their past are at a greater risk to have bladder cancer. After analyzing the histories of 286 bladder cancer patients, scientists at the Harvard School of Public Health confirmed a link between the sexually transmitted infection and cancer. The severity and frequency of the gonorrhea symptoms may affect the severity of the risk. This study was published in the British Journal of Cancer. For more details, click here.

Childhood Exposure to Secondhand Smoke Linked to Bladder Cancer

December 5, 2006
A recently released study in the International Journal of Cancer suggests that children and adolescents may be even more susceptible to the harmful effects of tobacco smoke than adults. Results from the study, partially funded by Cancer Research UK, suggest that exposure to secondhand smoke at a young age increases the risk of bladder cancer in later life.  The research team looked at data from nearly 430,000 people and found that exposure to secondhand smoke during childhood was associated with an almost 40 per cent increased risk of bladder cancer in later life compared to no exposure.  The researchers also found that for every five years later in life that people started smoking, their risk of developing bladder cancer was reduced by 19 per cent. This suggests that the younger a person is when they take up smoking, the greater their risk of the disease. For the complete text of this article, please click here.

Use of Personal Permanent Hair Dye Is Not Linked to Bladder Cancer Risk

December 5, 2006
An occupational exposure to hair dyes by hairdressers and barbers has been shown to increase their bladder cancer risk. Hair dyes contain small amounts of aromatic amines, which are shown to be carcinogenic in animals. However, in the September 2006 issue of Cancer Epidemiology Biomarkers and Prevention, researchers from M.D. Anderson Cancer Center report that personal use of hair dyes does not increase the risk of bladder cancer. For more information on this study, please click here.

Frequent Bacon Consumption Linked to Elevated Risk of Bladder Cancer

December 5, 2006
Doctors at the Harvard School of Public Health in Boston found that people who ate bacon five times a week or more were nearly 60 percent more likely to develop bladder cancer. Some meat products contain nitrosamines, which are known to cause the cancer, according to a report published in the American Journal of Clinical Nutrition. But the studies that have attempted to investigate the meat-bladder cancer link have been small and most have not separated out the effects of different types of meat. This  study looked at data for 47,422 men and 88,471 women. People who ate bacon and other processed meats frequently were also more likely to smoke and to take in more fat and fewer vitamins, the researchers found. They were also less likely to exercise.  For a copy of the report, please click here.

EU Bans 22 Hair Dye Substances to Ensure Safety

July 24, 2006
The European Commission recently banned 22 chemicals used in permanent hair dyes because of evidence that long-term use of these chemical may be associated with development of bladder cancer.  This ban becomes effective December 1, 2006.  According to news reports, most of the banned substances no longer are used in hair dyes.  For more details, please click here.

New Study Shows Benefit of Urovysion DNA Test

July 24, 2006
A study published in the July 2006 edition of Journal of Urology has shown that UroVysion, a DNA-based urine test that detects important genetic changes in bladder cells, has almost twice the sensitivity of conventional urine cytology tests as an aid for the initial diagnosis of bladder cancer in patients with hematuria (blood in their urine) suspected of having bladder cancer. Sensitivity refers to the likelihood that a patient with bladder cancer will have a positive test result and is a standard indicator of the predictive value of a diagnostic test. The study involved 497 patients, all of whom had confirmed hematuria within three months of enrollment.  The results showed that UroVysion detected 69% of bladder tumors, while cytology detected 38%.  When low grade, low stage tumors were excluded, UroVysion detected 83% of the cases, while cytology detected only 50%.  In addition, the “negative predictive value” or probability that negative UroVysion results were not associated with bladder cancer wad 98.5%.  Dr. Michael Sarosdy, lead investigator for this study stated, “These data certainly argue strongly for the use of the UroVysion assay, particularly if urine cytology results are negative.”  For the complete text of the article, please click here.

Intravesical Taxotere Effective in Recurrent Non-Invasive Bladder Cancer

July 24, 2006
According to an article recently published in the Journal of Clinical Oncology, administration of the chemotherapy agent Taxotere (docetaxel) directly into the bladder appears to be an effective treatment option for patients with non-invasive bladder cancer that has recurred following standard therapies. Patients with non-invasive bladder cancer are routinely treated with surgical removal of the cancer and often times, additional therapy placed directly into the bladder (intravesical) to decrease the risk of cancer recurrence or progression to more invasive disease.  The standard treatments have been mitomycin C or BCG, which is an immunotherapy agent derived from a weaned form of bacterium related to bacteria that cause tuberculosis.  While these therapies are beneficial, recurrences are common. Researchers from Columbia University Medical Center recently conducted a clinical study to evaluate intravesical administration of Taxotere in patients with recurrent noninvasive bladder cancer.  The trial included 18 patients who had received at least one prior intravesical treatment for their disease. 56% of patients had no evidence of cancer following treatment with intravesical Taxotere.  Those who did experience a cancer recurrence did not experience progression of their cancer, and no severe side effects were reported.  The researchers concluded that intravesical administration with Taxotere appears to provide an effective treatment alternative for patients with non-invasive disease whose cancer has recurred following prior therapies.  For the complete text of this article, please click here.

Repeated Surgery May Benefit Patients with Stage I Bladder Cancer

May 26, 2006
According to a Turkish study recently published in The Journal of Urology,  repeated transurethral resection (TUR) among patients with Stage I bladder cancer may improve patient outcomes.  Stage I bladder cancer refers to cancer that has spread to the connective tissue just beneath the inner lining of the bladder, but does not involve the bladder muscle.  Patients with State I bladder cancer are often treated with TUR (removal of the tumor using an instrument passed through the urethra) and adjuvant therapy to decrease the risk of cancer recurrence or progression to more invasive disease.  Adjuvant therapy often involves intravesical therapy (placement of the drug directly into the bladder) with mitomycin or BCG. Although this therapy is beneficial, recurrences of bladder tumors are common.  The researchers in Turkey evaluated the effect of repeated TUR to determine if the procedure would reduce the risk of recurrence.  In the study which involved 148 patients with newly diagnosed Stage I bladder cancer, 26% of the patients who received repeated TURs (performed two to six weeks apart) experienced a cancer recurrence, compared to 63% of patients who received on a single TUR.  The benefit of repeated TU was most apparant for patients with high grade tumors (grade 2 or grade 3).  Overall survival, however, was similar in the two groups.  For more details, please click here.

Cell Genesys Announces Results for New Bladder Cancer Drug

May 26, 2006
Cell Genesys recently announced results of a Phase 1 trial indicating that CG0070 is safe and may have anti-tumor activity in bladder cancer patients.  In the trial, which was presented at the AUA meeting in Atlanta, nine bladder cancer patients who failed on the current standard therapy were treated with CG0070.  Three patients had a complete response at follow-up cystoscopy, indicating that the oncolytic virus-based therapy has anti-tumor activity.  Joseph Vallner, President and CEO of Cell Genesys stated “We. . . believe that this study strongly supports advancement of CG0070 into a multiple-dose phase 1 trial.  We are optimistic that the dual mechanism of action of CG0070 might result in enhanced local anti-tumor activity as well as potential systemic anti-tumor immunity following local administration.”  For the text of the article, click here.

Cystectomy v. BCG for T1 High Grade Bladder Cancer: The Debate Continues

May 26, 2006
At the annual meeting of the Society of Urologic Oncology, held in Atlanta during the annual meeting of the American Urological Association, well-known bladder cancer experts discussed the question of whether T1high grade bladder cancer should be treated by cystectomy or by BCG.  The session was moderated by Dr. Seth Lerner, Baylor College of Medicine, who noted in his introduction that the presence of CIS (carcinoma in situ)worsens the prognosis of high grade T1 disease. Dr. Mark Soloway, University of Miami School of Medicine, presented the argument for managing stage T1 bladder cancer with intervesical BCG therapy.  According to Dr. Soloway, cystectomy for stage T1 disease is over-treated in 25-40% of patients. But Dr. Soloway also cited data on 319 of his patients who had cystectomy, 30 % of which were not organ confined.  According to Dr. Soloway, this serves as evidence that doctors are currently waiting too long to treat many patients. Better patient selection through re-resection will help to identify patients at risk for progression or understaging.  Dr. Soloway cited the excellent response rates to BCG in these types of tumors and that a significant percentage of these patients would never need to go on to cystectomy.  Dr. Soloway also referred to the data on BCG maintenance therapy and its role in decreasing tumor progression. Dr. Eila Skinner, USC Norris Cancer Center presented the case for management of stage T1 bladder cancer with cyctectomy.  She discussed the risks of understaging T1 disease and the fact that metastatic bladder cancer is not curable.  Dr. Skinner was concerned that BCG may delay recurrence but may not impact long-term cancer specific survival.  According to Dr. Skinner, the USC series for patients who had cystectomy shows that the survival curves for T1 and T2 tumors are extremely similar.  As such, she felt that these types of tumors are similar and should be treated the same.  For more details, click here.

Screening for Bladder Cancer is Beneficial

May 26, 2006
Urine tests that screen for bladder cancer can help people get treated for the disease before it spreads and save money by reducing the need for expensive care, as reported during the AUA Annual Meeting in Atlanta.  According to Dr. Edward Messing, chairman of Urology at the University of Rochester Medical Center, testing healthy men for hematuria—microscopic amounts of blood in their urine—can reduce the number of bladder cancer deaths by 20 percent.  Dr. Messing and fellow urologist, Dr. Ralph Madeb, analyzed bladder cancer rates and deaths for a group of 1,575 men over age 50 who took a home urine test between 1987 and 2002 and a similar group not screened for bladder cancer.  In all, 530 men were diagnosed with bladder cancer.  No one who was in the screening group died of bladder cancer, but 20% of those in the unscreened group died of the disease.  According to Dr. Messing, “I think we have proven that screening for bladder cancer is important and that it will save lives.  We even have better tools now that we can look at the molecular make-up of the cells and see if they are likely to become cancerous.  We need a major study to do this.”  For more details, please click here.

STUDY FINDS TAP WATER MAY RAISE BLADDER CANCER RISK

May 8, 2006
Pooled data from six case-control studies suggest that higher consumption of tap water-based drinks may slightly increase the risk of bladder cancer among men.  The study, which appeared in the International Journal of Cancer, was led by Dr. Christina M. Villanueva from Institute Municipal d’Investigacio Medica in Barcelona, Spain. The investigators found that the increased risk of bladder cancer with tap water consumption was “consistently found in all six studies, making chance an unlikely explanation.”  However, they cautioned that for now, the finding that tap water “is associated with a slight increased risk of bladder cancer” does not readily translate into public health recommendations. The results are based on 2,749 bladder cancer cases and 5,150 cancer-free controls.  Most of the subjects resided in the U.S., Canada or Finland, with data from subjects in Franc and Italy also included.  The study founded that the risk of bladder cancer was 50% higher in men who drank more than 2 liters of tap water daily compared with those who drank 0.5 liters or less.  Results among women were less constant. The association between bladder cancer and tap water consumption suggest to investigators that the increased risk may be related to the cancer-causing contaminants in tap waters, such as disinfection by-products.  For the complete story, please click here.

NEW BLADDER CANCER DRUG FAST TRACKED BY FOOD AND DRUG ADMINISTRATION

May 8, 2006
The U.S. Food and Drug Administration (FDA) has granted “fast track” designation to Bioniche Life Sciences” Urocidin to be used for the treatment of non-muscle invasive bladder cancer in patients who are not responsive to BCG, the current standard therapy.  BCG—bacillus calmette-guerin—is a live, attenuated strain of mycobacterium bovis (cow tuberculosis), a therapy that is often associated with treatment-limiting side effects. Fast Track designation means that when data from the ongoing phase III clinical trial with Urocidin becomes available, the company could expect an expedited review by FDA of its biologics licensing application for the drug.  This ultimately means that Urocidin could be available for use by uro-oncologists in patients who are non-responsive to BCG in a shorter amount of time. Bioniche will be starting another Phase III program with Urocidin.  This second trial will involve approximately 630 patients and will compare Urocidin to BCG as a first-line therapy in non-muscle invasive bladder cancer at high risk of recurrence or progression.  For more details, please click here

HEAVY MARIJUANA USE LINKED TO INCREASED RISK FOR BLADDER CANCER

February 8, 2006
Pot smokers could be putting themselves at risk for developing bladder cancer, according to the results of a study of middle-aged men who were seen at two Veterans Administration facilities.  Marijuana smoking “might be an even more potent stimulant” of malignancy than cigarette smoking, according to Dr. Martha K. Terris of the Medical College of Georgia.  The study was published in the medical journal Urology. The study involved 52 men, ages 44 to 60, with transitional cell carcinoma.  88.5 percent of the patients had a history of smoking marijuana, and nearly 31 percent still smoked pot at the time of the study.  According to the investigators, marijuana could be more cancer-promoting than tobacco because it has a longer half-life and because marijuana is smoked without a filter and is held longer in the lungs. The researchers advise that younger patients with symptoms that might suggest bladder cancer, who aren’t usually considered high risk, should be questioned about a history of marijuana use.  In addition, bladder cancer patients may want to reconsider the use of marijuana to treat the side effects of chemotherapy.  For the text of the news article, please click here.

SEX HORMONES AFFECT BLADDER CANCER RISK IN WOMEN

February 8, 2006
Menopausal status as well as age at menopause may modify the risk of women developing bladder cancer, researchers suggest in the American Journal of Epidemiology.  The risk in men is greater than that in women. Hormonal factors may be involved, according to the investigators, because “gender differences in cigarette smoking patterns, occupational exposures and other differences in known risk factor distributions cannot explain the excess bladder cancer observed for males.” Dr. Monica McGrath and colleagues from Brigham and Women’s Hospital and Harvard Medical School used the Nurses’ Health study to examine hormonal and reproductive factors in relation to bladder cancer risk in women.  During 26 years of follow up, 336 women developed bladder cancer.  Those past menopause were nearly twice as likely to develop the cancer compared with pre-menopausal women.   The researchers also observed a significant increase in bladder cancer risk with earlier menopause (age 45 years or younger) compared with later menopause (50 years or older).  This association, however, was influenced by cigarette smoking status. The investigators note that the drop in estrogen levels with menopause has been associated with bladder dysfunction and frequent urinary tract infections.  It may be “that women who experience early menopause are at an increased risk of bladder cancer because they have recurrent urinary tract infections and concurrent inflammation starting at an earlier age.”  For the text of the article, please click here.

NEW URINE TEST HELPS DETECT RECURRING BLADDER CANCER

January 23, 2006
A new urine test used in combination with cystoscopy, a visual exam of the bladder using a long lighted tube, detects 99 percent of recurring bladder cancers, according to a recent study reported in the Journal of the American Medical Association. The new BladderChek test measures the protein NMP22.  High levels of this protein in urine may signal bladder cancer.  On its own, the NMP22 test has not been very accurate at finding bladder cancers. But researchers thought it might be better than urine cytology at finding cancers that cystoscopy missed. The  BladderChek test has advantages over urine cytology in that it can be done in a doctor’s office and usually gives results within 30-50 minutes.  It is also less expensive and less complicated than urine cytology, which must be performed by trained specialists in a laboratory. The study was led by H. Barton Grossman,M.D., Professor of Urology at the University of Texas M.D. Anderson Cancer Center in Houston.  There were 668 bladder cancer survivors in the study across 23 facilities in the United States.  Bladder cancer was diagnosed in 103 patients.  Cystoscopy was the most accurate test, finding 94 of the cancers (91%) all by itself.  The BladderChek test alone found only 51 cancers.  But combining  Bladderchek with cystoscopy found 99% of the cancers.  In contrast, urine cytology alone found only 12 cancers, and combined with cystoscopy, found 94% of cancers, but that improvement was statistically no better than cystoscopy alone. These results suggest that the BladderChek test could be a useful tool for improving detection of bladder cancer recurrences and reducing the cost of follow-up care.  According to Dr. Grossman, given the high rate of recurrence for bladder cancer, patients and doctors need better ways to find recurrences early so that patient can be treated promptly.  If a relapse is caught early, the patient has a better chance of surviving.  For more information about this study, click here.

STUDY SHOWS LONG-TERM USE OF NSAIDS CUTS RISK OF COLO-RECTAL CANCER

October 25, 2005
The August 24-31 issue of the Journal of the American Medical Association reports on a study conducted at Harvard University that shows that long-term use of  NSAIDS, such as aspirin, ibuprofen, naproxen, and other anti-inflammatory medications, substantially reduced the risk of colo-rectal cancer. The degree of protection was found proportional to the dosage of the NSAIDS taken. The report cautions that heavy usage of NSAIDS can cause serious side effects in some people, such as gastro-intestinal bleeding. More detail can be found by clicking here.

GREEN TEA - MIRACLE OR MYTH?

October 25, 2005
Many articles have appeared in the news media about the general health benefits of green tea. Some articles have suggested that green tea also has anti-cancer effects. These benefits supposedly accrue from the rich supply of anti-oxidants in green teas, plus the presence of a substance that is believed to block the spread of cnceer cells while leaving normal cells unaffected. At least one study, being conducted at UCLA, has even narrowed the investigative focus to green tea's effects on bladder cancer. Preliminary lab tests have shown some promising results, This study is still underway. Details can be found by clicking here. How much green tea extract is needed? Studies to date do not answer this question conclusively. However, the July, 2005 issue of Prevention Magazine reports on a study performed by UCLA on green tea extracts vs either black or green tea. The researchers gave 30 people either green tea, black tea, or green tea extract capsules containing identical amounts of antioxidants, called flavonoids. Green tea extracts were found to produce up to 123% higher blood antioxidant levels than either of the teas. The article recommends the intake of at least 400 mg of flavonoids a day. Unfortuantely, the article does not tell how many cups of tea or capsules of extract this represents. A recent news release from the FDA states that they have reviewed several studies of green tea benefits, and cannot confirm any efficacy against cancer, or at best see only weak effects. This article may be viewed by clicking here. The comments of Sin Hang Lee, M.D., who had requested that the FDA approve health claims made for green tea, made rebuttal comments in response to the FDA statement. His opinion can be viewed by clicking here. As is frequently the case, until more conclusive studies are completed, the patient/consumer must weigh both sides of this issue and reach their own conclusion as to whether to consume green tea or green tea extracts for its possible health benefits.

BLADDER SURGERY SAFER IN HIGH-VOLUME HOSPITALS

October 25, 2005
As has been often suggested by bladder cancer survivors and in various publications, consideration should be given to having a cystectomy performed at a hospital that has handled a high volume of such surgeries. The overall success and safety of any major surgical procedure is dependent not only on the skills of the surgeon, but also on the skills of the cadre of medical professionals at the hospital who also attend the patient, such as the anesthesiologist, nurses and duty physicians. A study was recently performed at the M.D. Anderson Cancer Center in Houston, Texas to determine the safety of the number of bladder operations performed by hospitals in Texas. Data from 133 hospitals and 1302 cystectomies was examined to compare the mortality rate to the volume of operations. As was expected, the mortality rate varied significantly by the volume of cystectomies performed. The highest mortality rate of 3.1 percent was observed in hospitals that performed less than 3 cystectomies a year. Hospitals performing 4 to 10 cystectomies a year had a lower mortality rate of 2.9 percent. Hospitals performing more that 10 cystectomies a year experienced a much lower mortality rate of 0.7 percent. However, mortality rates at lower-volume hospitals which had a high ratio of registered nurses to patients were similar to that of high-volume hospitals, which provides an alternative to those who cannot have surgery performed at a high-volume hospital. The full article may be read by clicking here.

BREAST CANCER DRUG MAY HELP BLADDER CANCER PATIENTS

October 25, 2005
Two studies published recently in the New England Journal of Medicine and cited in numerous news articles show that treatment with trastuzumab (Herceptin) can dramatically improve outcomes in women with breast cancers that are HER2-positive. Approximately 20% of breast-cancer patients express large amounts of a protein called HER-2. When these patients are treated with traditional chemotherapy plus Herceptin, the rate of breast-cancer recurrence is cut in half and the risk of death is reduced by 33%. For more information about this breast-cancer finding, please click here: A study at the University of Michigan suggests that Herceptin  may also be of value in treating metastatic bladder cancer. This study, the results of which were presented at the May 2005 meeting of the American Society of Clinical Oncology,  showed that half of patients with advanced bladder cancer also had high levels of the HER2 protein, which is targeted by the  Herceptin drug. The patients in the study were given both Herceptin and traditional chemotherapy, and 70% of the patients had shrinkage in their tumors. Maha Hussain, M.D., professor of internal medicine and urology at the University of Michigan Medical School, said of the findings:  “I think this trial provides an approach for metastatic bladder cancer that has not previously been explored.  This opens up the possibility of targeted therapies for bladder cancer." For more information about this study, please click here.

MARRIAGE TIED TO BETTER BLADDER CANCER SURVIVAL

October 25, 2005
According to a study recently reported in the journal Cancer, the support of a spouse may help bladder cancer patients live longer lives.  The researchers used data from a national cancer registry to follow nearly 6000 Americans treated for bladder cancer between 1983 and 2000.  After more than 3 years of follow-up, the researchers found that those patients who were married had better survival rates than single patients, even when weighing factors such as age and cancer stage at diagnosis. According to the study authors, led by Dr. John L. Gore of the University of California, Los Angeles, the reason for the marriage advantage is unknown, but several potential explanations were offered.  Spouses may be responsible for getting their partners to see the doctor when the first possible symptoms of cancer arise.  In addition, spouses may urge the patients to adopt more healthy lifestyles, including urging them to quit smoking, which is a major risk factor for bladder cancer. It is also possible that the support of a spouse affects a patient’s immune defenses.  The researchers noted that a study of breast cancer patients found that those who were either married or felt they had strong support from family and friends had greater activity in certain immune system cells that help destroy tumor cells.  For more information, please click here.

FLOURESCENT LIGHT REDUCES RECURRENCE OF BLADDER CANCER

October 25, 2005
The Journal of Urology has reported on the results of a study showing that the use of fluorescent light during a cystoscopy to detect and remove cancerous cells reduces the rate of recurrence of the cancer. During a standard cystoscopy procedure, the surgeon uses a white light to examine the bladder, and then removes any areas of tissue which appear suspicious for cancer. This type of surgery is called resection. The new procedure, called ALA for short, involves the instillation of a photosensitizing agent in the bladder, which is absorbed by cancerous cells, and during the subsequent cystoscopy light of a specific wavelength is used which causes the cancerous cells to fluoresce. The surgeon can then more easily spot the suspicious areas and remove them. The results at 2, 12, 26 and 60 months following this procedure show a considerably longer time to recurrence for those patients who received the ALA-guided resection. The group subjected to the standard method showed recurrence rates of 41%, 61%, 73% and 75% respectively, while the group receiving the ALA method had recurrence rates of 16%, 43%, 59% and 59%. The study authors recommend that anyone undergoing cystoscopy for suspected bladder cancer ask their physician about the possibility of using the ALA  procedure, due to its dramatically-improved results and cost effectiveness. The full content of the article on this procedure can be found by clicking here. Promising results were also reported in the September, 2005 issue of the Journal of Urology concerning a study conducted by Dutch and German researchers of Hexaminolevulinate (HAL) fluorescent cystoscopy. In the study sample, the percentage of malignant bladder tumors detected by the HAL imaging technique was 96%, while the conventional white light cystoscopy detected 77%. The new procedure was found to have an excellent safety profile and led to treatment of 17-22% more patients than the white-light method. This new imaging technique appears promising for some bladder tumors, CIS and dysplasia which might otherwise be missed. The full text of the article can be read by clicking here.

NEW BLADDER CANCER TEST LOOKS PROMISING

October 25, 2005
Italian researchers have developed a urine test that detected 90% of cases of bladder cancer in 134 men tested, according to a report published in a recent issue of the Journal of the American Medical Association. The test was also performed on 84 men without bladder cancer, and ruled out the disease in these men with similar accuracy. The test measures the level of the enzyme telomerase in a urine sample. This enzyme is present in almost all cancer cells, and is rarely seen in normal cells. The test can detect low-grade cancers, as well as cancers which are at an early stage, which makes it a potentially-effective tool for screening high-risk patients for bladder cancer. The telomerase test is believed to be more accurate than either the cytology or nuclear matrix protein tests, but takes 2-3 days to get results. For further details, please click here

MARKERS IN BLADDER CANCER--AN EVOLVING SCIENCE

October 15, 2005
Bladder cancer is usually signaled initially by symptoms that the patient is experiencing, such as blood in the urine or urinary discomfort. Depending on the symptoms presented, the doctor may test a urine sample for bacterial infection or conduct an internal examination of the bladder using a cystoscope inserted through the urinary tract. If bladder cancer is a possibility, the doctor may order a biomarker test for bladder cancer using a sample of voided urine. Cytology has been the traditional test for several decades, but other test methods have recently become available, including FISH (Flouresence In Situ Hybridization), and Bladder Chek NMP-22(Nuclear Matrix Protein-22). In a recent interview, Dr. Michael A. O'Donnell, professor and Director of Urologic Oncology at the University of Iowa (and a member of BCAN’s Scientific Advisory Board) discussed developments in marker tests and how they compare with cystoscopy and cytology in the diagnosis of bladder cancer.  Dr. O’Donnell explained that while urologists would like to have a test for bladder cancer “that’s at least the equivalent of PSA for prostate cancer,” he does not think any of the new tests yet achieve that result.  According to Dr. O'Donnell, each test has its limitations.  He stated:  “The important message is:  Don’t treat on the basis of any of these newer tests alone.  Use them to raise your level of suspicion about looking for something.”  Dr. O’Donnell further stated, “[W]e’re at the first stage of markers, and there will likely be improvements in development, including a panel of markers that perhaps some day could be made cost effective.  Right now, they have limitations; they clearly are more sensitive than cytology, but less specific.  You just have to understand the marker and what you can do with it.”   The complete interview may be read by clicking here.

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