April 9, 2009

Intense bladder cancer therapy not better

Patients treated aggressively for early stage bladder cancer had no better survival rates than patients treated less aggressively, U.S. researchers said.

Researchers at the University of Michigan Comprehensive Cancer Center in Ann Arbor said that because bladder cancer is often treated as a chronic disease requiring lifelong surveillance, it is among the most expensive cancers to treat in the United States.

The researchers gathered data from the Surveillance, Epidemiology and End Results Medicare database and looked at 940 doctors who provided care to 20,713 early stage bladder cancer patients.

The study found that average per-patient treatment expenditures ranged from $2,830 for doctors in the low-intensity treatment category to $7,131 for doctors in the high-intensity category -- often involving more imaging procedures and more invasive surgical procedures like removing the bladder.

The study, scheduled to be published in the Journal of the National Cancer Institute, found the survival rates across all intensity categories were similar.

What this indicates is that some doctors are providing potentially unnecessary care, or care without measurable benefit to the patient, Dr. Brent Hollenbeck said in a statement. It makes sense to many doctors and patients that more would be better, but unfortunately there can be unintended consequences of unneeded care.

The study authors suggest certain patients might still benefit from greater intensity of care, but further research is needed to determine which patients would benefit.