Radiotherapy As Good As Surgery For Bladder Cancer Treatment

Radiotherapy has proved to be more effective than surgery for treating muscle-invasive bladder cancer according to a recent study from the United Kingdom.

Researchers from the Pyrah Department of Urology at the St. James’s University Hospital, Leeds, UK, compared the survival rates of 169 patients over a five year period from 1996 to 2000. 97 of the patients received radiotherapy while 89 had surgery to completely remove the bladder (known as a radical cystectomy).

The five year survival rates were actually greater in the patients who had received radiotherapy compared to those who had surgery, despite the fact that the average age of the radiotherapy patients was 75 compared to 68 for those treated with surgery. Generally younger patients would be expected to have higher survival probabilities. Cancer recurrence rates were also similar between the two groups.

The study raises doubts on the status of the radical cystectomy as the “gold standard” of bladder cancer treatment.

According to research leader Dr Anne Kiltie of the Cancer Research Clinical Centre at the University of Leeds “Until now surgery has been considered better than radiotherapy in the treatment of bladder cancer that has spread to the muscle wall of the bladder.”

Radiotherapy could become the treatment of choice by oncologists, particularly in older patients who may not be well enough to undergo surgery and whose life could be severely affected by bladder removal. Bladder surgery increases the risk of post-operative infection and can cause incontinence requiring the patient to use a catheter.

The study has been published in the January 2008 edition of the International Journal of Radiation Oncology Biology Physics.

Around a quarter of bladder cancer patients have muscle-invasive bladder cancer at the time of diagnosis. 5-year survival rates for this form of the disease are around 50-60%. Even after radical cystectomy, cancer recurrence occurs in 20-30% of patients, generally within 2 years of the original surgery. The prognosis following cancer recurrence is typically poor with most patients living less than a year.