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Understanding the Shortcomings of Cystoscopy in Muscle Invasive Bladder Cancer

May 19, 2018

Alexander Kutikov, MDAlexander Kutikov, MD

PHILADELPHIA (May 19, 2018) – Researchers at Fox Chase Cancer Center are seeking to solve a diagnostic dilemma inherent in current treatment recommendations for bladder cancer. Presently, the standard of care for all patients whose tumors have reached the muscle layer is radical cystectomy, the removal of the bladder. However, as many as 30 percent of patients who undergo this surgery, especially after receiving chemotherapy, do not harbor residual cancer in their bladders.

With current methods and technologies, there is no reliable way to identify which patients can safely avoid the surgery. Cystoscopy is used, but falls short for some bladder cancer patients. The Fox Chase trial is designed to understand why and how cystoscopy misses some cancers, and to see if there are other diagnostic tests that may work more effectively alone or in combination with cystoscopy.

“Radical cystectomy with urinary diversion is a high-risk, life-changing surgery, and our goal is to find a way to spare patients for whom it is not necessary,” said Alexander Kutikov, MD, chief of the Division of Urology and Urologic Oncology at Fox Chase and senior author of the study.

The research team will present their study at the American Urological Association (AUA) annual meeting in San Francisco this weekend.

This trial marks the first time the true negative predictive value of a normal cystoscopic evaluation  is being identified, allowing researchers to establish how often bladder cancer hides under the mucosa and evades endoscopic diagnosis. The trial remains open for enrollment, and the team is hopeful their findings will make it possible to develop better screening and testing to identify patients who can avoid radical cystectomy.

“Huge opportunities exist to provide more accurate diagnostic evaluation for patients,” Kutikov said.

       

The Hospital of Fox Chase Cancer Center and its affiliates (collectively “Fox Chase Cancer Center”), a member of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence five consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship and community outreach. It is the policy of Fox Chase Cancer Center that there shall be no exclusion from, or participation in, and no one denied the benefits of, the delivery of quality medical care on the basis of race, ethnicity, religion, sexual orientation, gender, gender identity/expression, disability, age, ancestry, color, national origin, physical ability, level of education, or source of payment.
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