A surgery-free option

Radiation therapy may be as good as bladder surgery at helping patients survive advanced bladder cancer, a new study shows.

Researchers analyzed outcomes from more than 12,000 patients worldwide to compare survival of those who had radical cystectomy surgery versus those who had radiation. The result could influence decision-making by patients and their physicians in the treatment of muscle-invasive bladder cancer.

Radical cystectomy is surgical removal of the bladder and is considered the gold-standard treatment for advanced bladder cancer.

“Radical cystectomy remains the preferred option for some patients, but this review opens the door to greater evaluation of radiation therapy as a beneficial alternative. The decision must be made on a case-by-case basis,” said Dharam Kaushik, M.D., assistant professor of urology and senior author of the study. He collaborated with the Cleveland Clinic on the research.

Based on the analysis, Dr. Kaushik and the team have launched a pilot clinical research study to evaluate survival among 30 patients with advanced bladder cancer—15 treated with surgery and 15 with radiation.

“There is a lot of controversy about this. We want to see if the finding holds,” he said.

An estimated 77,000 cases of bladder cancer were diagnosed in 2016, with more than three-fourths of cases affecting men, according to the American Cancer Society. An estimated 16,000 Americans died of the disease in 2016.

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