Dr. Sfakianos on the Utility of Adjuvant Therapy in Bladder Cancer Management

John P. Sfakianos, MD, an assistant professor of urology and urologic oncology at the Icahn School of Medicine at Mount Sinai Health System, discusses the utility of adjuvant therapy in bladder cancer management.

One of the concerns that are always faced with removing bladder tumors is that it is done through the urethra, says Sfakianos. The tumor is scraped away in this confined space causing concern that tumor cells may be spread to different areas. It is known that the disease itself is multifocal, because whatever caused the first tumor was likely a carcinogen in the urine, which is in contact throughout the remainder of the bladder; this can likely cause the same damage in another area of the bladder.

When surgeons go in to remove the tumors, adjuvant therapy will immediately be used, usually in the form of chemotherapy, such as mitomycin or gemcitabine. Adjuvant therapy is recommended to be used up to 24 hours after resection, and the sooner this therapy is used the better. It is believe that this approach minimizes the ability for the cancer cells to spread to other parts of the bladder. Morever, if there is damage and the tumor develops somewhere else, adjuvant therapy can reduce the recurrence of these non-muscle invasive tumors, concludes Sfakianos.