Bladder Cancer: Breaking the Research Barrier

“I am convinced I will die in front of a truck or by falling off a mountain or of a heart attack. I do not believe this is going to kill me.” Thomas Touzel’s confidence comes despite having already been through four surgeries to remove dozens of tumors from his bladder.  

Diagnosed in 2003 at the age of 64, right now he feels great. Most cases of bladder cancer are chronic but treatable, while others are lethal within a year or two. Touzel has the more treatable type. “They do a scope and do some chop-chop when necessary,” is how he describes his ongoing treatment. “It’s just a question of maintenance.”

Of the more than 61,000 new cases of bladder cancer estimated for the United States in 2006, about 90 percent will be in people over age 55 and nearly 45,000 will be men—white men for the most part. Although progress is being made in understanding the origins and development of the disease, experts say insufficient funding, poor accrual to clinical trials and lack of public awareness of bladder cancer have left promising new treatments under-researched.

Despite its ranking as the sixth most common cancer in the United States, according to the American Cancer Society, and a recurrence rate of at least 50 percent, the biggest challenge in terms of developing new treatments is enrolling patients in clinical trials, says Walter Stadler, MD, director of the genitourinary program at the University of Chicago Hospitals. Smoking is the biggest risk factor for bladder cancer, so since the disease mainly afflicts men who smoke and have concurrent diseases, “smoking history and things like hypertension and prior surgeries mean that these patients often have problems with kidney function, and that limits our ability to give certain chemotherapy drugs,” Dr. Stadler explains. Delayed enrollment also impacts eligibility. “By the time oncologists run out of options, the patients are too sick to enter a clinical trial,” says Dr. Stadler.

Funding for bladder cancer research is also an issue. Michael O’Donnell, MD, director of urologic oncology at the University of Iowa Hospitals, says researchers have made some promising discoveries in laboratory experiments for a possible vaccine that could target specific attributes of bladder cancer tumors. “Unfortunately, there is not much commercial interest in this kind of development,” Dr. O’Donnell says. While a lack of interest may in part stem from the perception of bladder cancer as an “old white man’s disease,” those affected are starting to take action.

A 2002 national task force identified the need for a nationwide advocacy group for bladder cancer to help establish research priorities at the national level and advocate for scientific studies and clinical trials. Three years later, the wife of a bladder cancer patient founded the Bladder Cancer Advocacy Network.

Talk about this article with other patients, caregivers, and advocates in the Bladder Cancer CURE discussion group.
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