The findings come from an 11-year study at 126 U.S. medical centers led by H. Barton Grossman, MD, professor of urology at the University of Texas M.D. Anderson Cancer Center in Houston.
A smoking-related disease, bladder cancer each year kills 12,500 Americans. It likes to spread throughout the body, and spread quickly. Surgery is the best chance for survival, but the outlook is grim for people whose cancer has already invaded the muscles surrounding the bladder.
Getting radiation before surgery doesn't help the odds. But Grossman and colleagues say they hoped that chemotherapy could shrink the tumor, making surgery to remove the cancer more likely to succeed. They randomly assigned 307 patients with cancer that had spread to the muscles surrounding the bladder to receive either standard surgery or three rounds of chemotherapy before surgery.
The result: Patients who got chemo plus surgery lived an average of 31 months longer. And those who got surgery alone had a 66% greater chance of dying from their bladder cancer. The findings appear in the Aug. 28 issue of The New England Journal of Medicine.
Grossman suggests that the chemotherapy shrinks the tumor, making surgery more likely to succeed.
"There were significantly more patients in the [chemotherapy plus surgery] group who had no residual disease [after surgery]," Grossman says in a news release. "Those are the patients that have much better survival. The chemotherapy effectively down-staged their cancer."
For some patients, it worked so well that Grossman uses the "C" word: cure.
"Ten years after treatment, some of those patients are still alive," he says. "Chemotherapy before surgery provided a cure for them."