April 10, 2009

Intense Treatment Doesn’t Boost Chances for Patients With Early Bladder Cancer

It may not be worth it for patients with early bladder cancer to get more intensive therapy for their disease.

A new study from the University of Michigan Health System finds intense treatment within two years of when a patient is first diagnosed does not seem to lead to better survival than less intensive treatment.

Researched looked at 20,713 patients diagnosed with early bladder cancer between 1992 and 2002. They estimated the intensity of treatment based on Medicare costs in the first two years after patients were diagnosed.

The average cost of medical care was $2,830 in patients with the least intense treatment compared with an average cost of $7,131 in those with the most intense therapy.

Results show more intensive treatment was not associated with better overall survival and patients who had more intense early treatment were more likely to have major interventions later.

The authors write, "Compared with patients treated by low-treatment intensity urologists, those treated by high-treatment intensity urologists were nearly two and one-half times more likely to undergo radical cystectomy and nearly twice as likely to receive any major medical intervention, even after accounting for patient differences."

Bladder cancer is the fifth most common cancer in the United States, but the best way to treat it is still not clear. Current treatment guidelines favor more intense therapy, but the treatment can vary depending on the urologist.

SOURCE: Journal of the National Cancer Institute, published online April 7, 2009