ometimes numbers tell a story, but sometimes they obscure one. According to the latest figures from the National Cancer Institute, the death rate for people diagnosed with bladder cancer has hardly budged during the past 30 years. But experts who treat the disease tell a different and more hopeful tale—and they credit a surge in clinical trials for much of it.
“Clinical trials are how we got here,” says Dr. Guru Sonpavde, director of the bladder cancer program at Dana-Farber Cancer Institute and associate professor of medicine at Harvard Medical School in Boston. “All the new drugs we have coming out that have changed the outcomes for patients with bladder cancer—all of this has come from clinical trials.”
Like Boorjian, he highlights the game-changing effect that immune checkpoint inhibitors have had on the treatment of bladder cancer. This and other advancements have led to an explosion in new research—and with it, a need for more people to participate in clinical trials. Not everyone with bladder cancer will be a good candidate for a clinical trial. For some, the current standard of care may provide the most effective treatment for the disease. “For a patient that has low-grade bladder cancer, a resection”—that is, surgical removal of the tumor—“has a very high cure rate,” Kamat says. “For this -patient, it may not be advisable to participate [in a trial] because the standard of care is so effective.
If you decide you want to proceed—that is, if you give your informed consent—you’ll likely undergo some type of screening process to ensure you meet the trial’s criteria. It may involve additional testing—scans, biopsies, blood tests—as well as an examination of your medical records. “Sometimes we start doing these evaluations and something comes out that renders the patient ineligible,” Sonpavde says.
On the other hand, clinical trials usually will not cover the cost of lodging or transportation for those who participate. This can be a major barrier for those who don’t live in cities or near research institutions. Also, participants are typically not compensated.Almost every facet of bladder cancer is now the focus of clinical research. But several areas are the subject of particularly intense interest.
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