Bladder Cancer: Challanges and opportunities – Part I
Bladder cancer will affect over 60,000 patients in 2009. Although being diagnosed with such a disease no doubt effect an emotional and physical toll on afflicted patients., I would like to highlight some ameliorating facts and point to opportunities in fighting this disease.
Bladder cancer is best looked at as two diseases rather than one: A “superficial” disease and a “deep” disease. The superficial one can lead to recurrences and in a minority of cases will lead to progression into deep disease. Frequent follow-ups and urine cytology examination will help identify early recurrences and hopefully prevent progression in patients with superficial disease.
Research opportunities in the superficial type of bladder cancer reside in finding markers that will help us better identify which lesions are more likely to progress. By identifying such markers of early recurrence and high risk of progression, one can then limit intense follow up efforts to high risk patients while extending intervals between doctor visits and cystoscopies in low risk patients.
Next time will talk about challanges and opportunities in the more aggressive “deep” disease category of bladder cancer.
December 21st, 2008 at 10:12 am
Dr. Netto,
Great post. The “two disease” concept is an interesting yet puzzling one worthy of several more posts. What is the evidence for two diseases? Do they have different causes? Would the markers of each be different? Bladder cancer is somewhat of an “orphan disease,” meaning that few scientists work on it. My sense is that it will take a lot more work to answer these questions and that this will take some time given the few organizations doing the work.
As for the topic of markers, this is also an interesting and worthy topic that has special meaning in bladder cancer, where markers (usually proteins that can be measured with some sort of a laboratory test) can be found in blood, urine, and/or tissue — each with a different kind of usefulness. Looking forward to hearing more about them!