High-speed radiotherapy can blast away bladder cancer in just four weeks – sparing patients longer treatment and life-changing surgery.
A landmark study has proved that an intense 20-day course of the treatment is more effective than lower doses given over six weeks – once the standard option.
Despite the higher doses of powerful radiation given, patients don’t suffer worse side effects and can get back to normal life faster, say experts.
Dr Ananya Choudhury, consultant oncologist at The Christie hospital in Manchester and joint study leader, said: ‘Our findings will have a big impact of the quality of life of bladder-cancer patients.
‘A four-week course means they can spend less time in hospital and can begin their recovery sooner.’
Eric Edwards, 64, from St Helens, Merseyside, began radiotherapy in June 2020 after surgery was unsuccessful at removing all of his bladder cancer
Every year, more than 10,000 people are diagnosed with this cancer in the UK.
The majority will have surgery to remove the cancer. However, if scans show it has spread into surrounding muscle tissue, further treatment is needed.
Typically, patients will then be given two options. One possible route is another surgery to remove the entire bladder, and sometimes the surrounding organs as well.
This is an intensive procedure and will leave the patient permanently disabled, requiring stoma bags to go to the toilet and a complete loss of sexual function.
Last October artist Tracey Emin, 57, revealed she had undergone this life-changing surgery, having been diagnosed with bladder cancer in the summer.
The other option is radiotherapy and chemotherapy. Rays of high-energy radiation is fired at the cancerous area in the bladder.
These destroy cancer cells but also damage healthy tissue. Patients will often have trouble going to the toilet after treatment. This can continue for years.
Because of worries around the impact of the side effects, doctors often opt to give longer courses of low-dose radiotherapy.
Researchers involved in the Institute of Cancer Research study compared patient data from two nationwide bladder-cancer studies, both of which have been running for more than ten years.
By comparing two groups of patients, they found that those on the 20-dose radiotherapy course had a 29 per cent lower risk of their cancer returning over the five years following the treatment than those receiving the 32-dose course.
The study also found that delivering larger but fewer doses didn’t increase the risk of side effects.
Dr Choudhury said scientists do not fully understand why a shorter, more intensive course is more effective but she said there are several possibilities.
‘It may be that the higher dose is hitting some sort of sweet spot where the cancer is more efficiently broken up and destroyed,’ she said. There is also the chance the shorter course gives the cancer less time to adapt to radiotherapy.’
One patient who saw the full effect of the four-week treatment is Eric Edwards, 64, from St Helens, Merseyside, who began radiotherapy in June 2020 after surgery was unsuccessful at removing all of his bladder cancer.
Eric, who is retired but used to work in a chemical plant, was diagnosed with bladder cancer in March 2020 and underwent two surgeries to have the cancer removed but was told it had spread to his muscles.
‘I was told I had a 50-50 chance of living more than five years,’ he says.
Eric was given the option to have his bladder removed but turned it down. ‘I didn’t want to lose my sex life and spend the rest of my years peeing into a bag.’
He began radiotherapy at Clatterbridge Hospital, Wirral. He wasn’t aware at the time there was another option than the four-week, 20-dose treatment offered.
While he suffered side effects, including constipation and nausea, these soon went away after radiotherapy finished.
In October, Eric was given the all-clear: there was no cancer anywhere in his body. ‘There’s a chance it’ll come back so I can’t claim I’m completely cured,’ he says. ‘But I’m in the best possible health I could be and I’ve still got my bladder.’
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