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Management of bladder cancer
1Department of Solid Tumor Oncology, Roswell Park Cancer Institute, State University of New York at Buffalo, USA.
Current Problems in Cancer
|January 1, 1995
Summary
Bladder cancer management ranges from surgery for localized tumors to chemotherapy for metastatic disease. Innovative treatments and understanding resistance mechanisms are crucial for improving survival rates in advanced bladder cancer.
Area of Science:
- Oncology
- Urologic Oncology
Background:
- Bladder cancer presents diverse histologic types and stages, from localized to metastatic.
- Current treatments include transurethral resection, radical surgery, radiotherapy, and chemotherapy.
- Despite advances, 5-year survival for invasive bladder cancer remains around 50%.
Purpose of the Study:
- To review current bladder cancer management strategies.
- To highlight innovative treatments and ongoing research for advanced disease.
- To emphasize the importance of understanding treatment resistance.
Main Methods:
- Review of preclinical and clinical data on bladder cancer.
- Analysis of current treatment modalities for localized, invasive, and metastatic disease.
- Discussion of emerging therapeutic agents and resistance mechanisms.
Main Results:
- The methotrexate, vinblastine, doxorubicin, and cisplatin (MVAC) regimen shows high response rates in metastatic bladder cancer but limited survival benefit.
- New agents like paclitaxel, gemcitabine, and others show promise in clinical trials.
- Understanding p-glycoprotein and p53 protein expression is key to overcoming treatment resistance.
Conclusions:
- Effective management of metastatic bladder cancer requires palliative care alongside novel treatment strategies.
- Further clinical trials are essential to evaluate new agents and combination therapies.
- Improving bladder cancer survival hinges on a deeper understanding of resistance mechanisms and well-designed clinical studies.