Sat, Feb 22, 2003 page2

• Hospital develops advanced bladder cancer treatment

  GROUNDBREAKING The National Taiwan University Hospital treatment reduces the risk of recurrence in a new technique that will help improve the lives of patients

  • By Melody Chen / STAFF REPORTER
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  The National Taiwan University Hospital (NTUH) introduced yesterday a new therapy that can effectively reduce recurrences of bladder cancer while limiting harmful side effects.

  "Over the past four years, we have treated 50 patients with the new approach," said Pu Yeong-shiau (蒲永孝), the hospital's urologist. "Only 10 percent of the cases experienced a recurrence within 12 months of being treated."

  The normal recurrence rate of bladder cancer stands at around 50 percent within two years of removal.

  In the new treatment, named MDP intravesical combination chemotherapy, three anticancer agents are introduced into the bladder after the removal of the tumor, Pu said.

  Nationally, around 1,500 people contract bladder cancer every year and about 600 people die of the disease annually, according to the Department of Health.

  Seventy percent of bladder tumors are superficial, which means the cancer is lying on the surface of the bladder's walls and can be scraped off. In these cases, transurethral bladder tumor resection is used to remove the tumor.

  The operation is referred to as "transurethral" because it is performed through the urethra, Pu said.

  Patients undergoing the operation can keep their bladders, however, 30 percent of bladder tumors become invasive, meaning the cancer has grown into the walls of the bladder.

  In those cases, the bladder needs to be removed, Pu said.

  MDP intravesical combination chemotherapy is applied to patients who have undergone transurethral bladder tumor resection and still have their bladders.

  The most commonly used method to reduce recurrences is called intravesical BCG [Basillus Calmette-Guerin] therapy, Pu said.

  At present, BCG is the most proven and effective agent to reduce recurrences of bladder cancer and can reduce the recurrence rate to 40 percent, Pu said.

  However, according to Pu, although BCG therapy is highly effective, it also causes serious side effects.

  "Ninety percent of patients taking BCG therapy experience urinary problems such as continued pain and burning, frequency, blood or blood clots in the urine," Pu said.

  "Nearly 50 percent of the patients also suffer flu-like symptoms. Some even have serious complications such as tuberculosis and prostate tuberculosis," Pu said.

  In MND intravesical combination chemotherapy, three anticancer agents, mitomycin-C, doxorubicin and cisplatin are instilled into patients' bladders after the removal of the tumor.

  "We instill 30mm of mitomycin into the bladder 24 hours after removal of the tumor to kill the remaining cancer cells. The patient discharges the agent when he or she urinates," Pu said.

  "One week later, we instill 30mm of doxorubicin. Another week later we instill 30mm of cisplatin," Pu said.

  Eight cycles of the treatment are required to complete the therapy, which takes three years in all.

  "If a recurrence does not take place during the three years, it is very unlikely the cancer will return" Pu said.

  "The cost of MND intravesical combination chemotherapy is much lower than BCG therapy," Pu added.

  Pu also gave tips to prevent bladder cancer.

  "Don't smoke. Don't dye your hair or use too much cosmetics or nail polish -- those are cancer-triggering substances. Don't eat too much fried food or pickled vegetables," Pu said.

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