Radiotherapy could spare bladder cancer patients surgery

Radiotherapy is an effective treatment for aggressive bladder cancer and could spare patients surgery that removes the whole bladder, according to a study published in this month's International Journal of Radiation Oncology Biology Physics.

The Cancer Research UK study found that two different approaches to giving radiotherapy controlled the disease and had a low risk of severe side effects.

This part of the BC2001 radiotherapy study, led by researchers at The Institute of Cancer Research, London, and the University of Birmingham, compared giving radiotherapy to the whole bladder with targeted radiotherapy focused on the tumour.

Both types of treatment prevented the tumour from returning for over 60 per cent of patients for at least two years. And for many whose disease returned, it was not aggressive and only needed local treatment.

After five years of follow-up the survival rates were around 40 per cent for both radiotherapy approaches, a figure comparable to patients who have surgery to remove their bladder. In addition, patients receiving either type of radiotherapy had a low risk of severe side effects.

The standard treatment for aggressive bladder cancer is to remove the bladder. This can cause severe side effects and usually results in patients wearing a plastic bag to collect urine.

Dr Robert Huddart, lead investigator of the study based at The Institute of Cancer Research, London, said: "Our study was part of the largest ever clinical trial of radiotherapy in bladder cancer and shows that patients with the disease can be treated effectively with radiotherapy. With similar success rates to surgery and fewer side effects whilst allowing patients to retain a functioning bladder, radiotherapy should be seen as an alternative to surgery.

"The introduction of image guided radiotherapy and more sophisticated ways of giving radiotherapy will hopefully further reduce any side effects that patients experience."

Kate Law, director of clinical research at Cancer Research UK, said: "Previous results from this trial changed how doctors treat bladder cancer, showing that giving patients chemotherapy and radiotherapy is better than radiotherapy alone. Many thousands of patients take part in Cancer Research UK-funded clinical trials every year, and it's only by carrying out studies like this that we can test different approaches to find the most effective and safest treatments."