Bladder cancer 2015: Personalized medicine meets ‘molecular selection’
December 27, 2014 | by Tami Dennis
Surgery for bladder cancer isn’t what it used to be; it’s better – much better. Advances in robotic surgeries have greatly improved both the options and the quality of life for people diagnosed with bladder cancer.
These advances, which are constantly giving way to even newer ones, mean that the entire bladder doesn’t always have to be removed. When it does, not only can highly skilled surgeons sometimes create an artificial bladder, they can even create an internal reservoir (different from a bladder and known as an Indiana pouch) using the large intestine and part of the small intestine. Such alternatives are usually preferred over the need for an external bag to collect the urine.
Much work remains, however, in the understanding of bladder cancer. Sumanta Pal, M.D., co-director of the Kidney Cancer Program at City of Hope, is leading several innovative studies in bladder cancer, with two of them focusing on what’s known as a molecular selection process.
“We frequently discuss the need for ‘personalized medicine’ – these trials exemplify that to its utmost,” Pal said. “In these studies, patients with advanced bladder cancer have comprehensive genetic profiling. If their genetic profile suggests changes in one of several genes, a treatment that caters to this genetic abnormality can be introduced.”
Such treatments are desperately needed. “The unfortunate reality in bladder cancer is that no new agents have been introduced over the past 30 years,” Pal said. “As such, this process of molecular selection of patients may represent a gigantic leap forward in our approach to the disease.”
Pal has also received grant funding to support a laboratory-based effort in which he will obtain more than 400 patient specimens from a national bladder cancer trial funded by the National Institutes of Health. “The intent of this research is to determine if there is an environment that surrounds bladder cancer that may predispose to spread of the disease,” Pal said.
The work is a reminder that research is not just about treatments, but also prevention.
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