About Intravesical Treatment for Bladder Cancer

About 1 in 84 women and 1 in 27 men are likely to develop bladder cancer during their lifetime. The American Cancer Society estimates that 71,000 people will contract bladder cancer in the United States in 2009 and that more than 14,000 will die of the disease. The death rate has been declining for two decades, though, in part because of intravesical treatment for bladder cancer, in which medication is put into the bladder through a catheter or tube rather than a needle or taken in a pill.

Bladder Cancer Statistics

• More than 90 percent of the people who get bladder cancer are over 55, and most are men. Likewise, white people are three times as likely to get a bladder cancer diagnosis as blacks, and Hispanics are at even smaller risk for it. However, when black Americans get a diagnosis of bladder cancer, it is usually more advanced than for whites.

Recognized Treatment Options

• Four treatments are recognized for bladder cancer: intravesical treatment, surgery (which includes transurethal resection, aka TUR), chemotherapy and radiation. TUR is generally the first course of action taken with bladder cancer in the early stages, and according to a 2008 Pharmaceutical Research article, it has a success rate of 80 percent. However, this stage of cancer recurs almost 70 percent of the time, so physicians usually follow TUR with intravesical treatment to help prevent a recurrence.

Intravesical Treatment

• Intravesical treatment allows the treatment substance to reach the cancerous area quicker and aids in reducing potential damage to any other cells or muscle tissues outside the cancerous area. Substances used include bacillus Calmette-Guérin (BCG), interferon and anti-cancer drugs. These treatments are used only against noninvasive (stage 0) and minimally invasive (stage 1) bladder cancers.

Bacillus Calmette-Guérin

• The most effective low-stage bladder cancer intravesical treatment is bacillus Calmette-Guérin (BCG), a bacterium that was also responsible for tuberculosis. However, a six-week treatment of BCG (given once a day through a catheter) can prove to have positive medical benefits too. In fact, since BCG is a bacterium--and our immune system rushes to attack bacteria--it attracts our body's infection-fighting cells to it. Once the immune system is engaged by BCG in the bladder, it begins killing cancer cells there.

Interferon

• A protein that has the ability to stimulate the body's immune system is interferon-alpha; therefore it is one of the substances used in the intravesical treatment arsenal against bladder cancer. Interferon-alpha is also manufactured naturally by certain cells in the body as well, so it is not a foreign material like BCG. However, the body doesn't make enough interferon-alpha to fight cancer, so this substance, in large doses, is introduced into the body during cancer treatment in order to boost the immune system response and to shrink tumors.

Anti-Cancer Drugs

• Intravesical chemotherapy most often introduces mitomycin or thiotepa, which kill cancer cells in the lining of the bladder. These medications do not affect cells outside the bladder.