Radiotherapy better option for bladder cancer, says Cancer Research UK.
Doctors typically opt to remove the whole bladder when the cancer is advanced. Doing so could cure the disease but might result in continence problems that the person will have to live with for the rest of his life, the noted non-profit organization says.
AdvertisementHence surgery should not necessarily be recommended as "gold standard" care, the organization stresses.
Bladder cancer is the fifth most common cancer in the UK, with 10,093 new cases diagnosed in 2004.
Fred Walker, 67 and of Knottingley in West Yorkshire, was diagnosed with bladder cancer in 1983. He had his bladder removed.
He said: "I know from my own experience that losing your bladder has a daily impact on your life which for some people could be more devastating than the cancer itself.
"Body disfigurement and embarrassment caused by having your bladder removed can be quite hard to accept.
"I have spoken to many people who would welcome an alternative to living with a urostomy bag as a result of surgery."
A recent study by a team from the Leeds Institute of Molecular Medicine at the University of Leeds found that survival rates among bladder cancer patients treated with radiotherapy were the same as those associated with radical cystectomy - surgery involving the complete removal of the bladder, BBC reports.
They looked at the medical records of 169 patients treated for invasive bladder cancer between 1996 and 2000.
Of those, 97 had been treated with radiotherapy, while 89 had undergone surgery.
Both groups had comparable survival rates at five years and eight years after treatment (53-57%), despite the radiotherapy group being on average seven years older.
There was also no real difference in how likely the disease was to return in the two treatment groups - 34% of the radiotherapy treatment group experiencing recurrence, compared with 37.5% of those treated with surgery.
Dr Anne Kiltie, lead author of the research published in the International Journal of Radiation Oncology Biology Physics, said: "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.
"Although radiotherapy carries its own long term side effects, the interesting finding in our study was that the older, less fit patients did as well as the younger, fitter patients who had surgery to treat their cancer.
"Since bladder cancer is a disease of older people, radiotherapy will play an increasingly important role as the population ages, and this study encourages us to believe that such elderly patients will not be disadvantaged by having an alternative curative treatment."
Dr Lesley Walker of Cancer Research UK said: "This study certainly opens the debate on which treatments should be recommended for invasive bladder cancer patients."
He said more research was needed to establish if radiotherapy should replace surgery as the gold standard treatment for these patients.
Professor Alan Horwich of the Institute of Cancer Research said more work was also needed to improve the survival rates of bladder cancer patients.
"Work is ongoing to see if adding in chemotherapy could improve survival."
He said it was important to select the best treatment protocol for the individual - for some it might be surgery, while for others it might be radiotherapy.
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