He bladder cancer It is one of the most frequent cancers, however not many know about it. In Argentina, they are diagnosed 3,700 cases per yearthat is to say 10 per day. When found in an early stage, survival rates exceed 80% while, if diagnosed late, survival may be less than 25%, according to estimates by the Argentine Association of Clinical Oncology (AAOC).
Among the preventable factors, the link between smoking and bladder cancer is increasingly proven: it is estimated that the fifty% of all diagnosed cases are due to this cause and that smokers have three times more risk of suffering from it.
under the International Day of this disease, Infobae consulted the oncologist Fernando Galanternikclinical researcher and head of the CEMIC Genitourinary Tumors unit, about how the pathology progresses in the body and what the treatments are.
This cancer is usually more prevalent in men and its early detection improves the chances that treatment will be effective. However, this can be difficult as, in early stages, it can progress without symptoms. Among the most common signs are: bleeding in the urine (present in 90% of cases), pain when urinating and pelvic pain.
The most common symptom of bladder cancer is the presence of blood in the urinecall hematuria. Beyond the fact that most of the time this bleeding is due to stones in the urinary tract or urinary tract infections, it is indistinguishable from that which can be caused by bladder cancer, therefore making a consultation with a specialist is extremely important,” he said. Dr. Galanternik.
The therapeutic options are associated with the degree of extension of the disease. “Most bladder cancers —close to 80%— are superficial, which means that they grow and invade only the most superficial layers of the inner part of the bladder that is in contact with urine, these tumors can be operated and take out”, explained the CEMIC specialist.
In addition, the oncologist pointed out that after this procedure, there are treatments to lower the chances that another polyp or tumor will grow again and both chemotherapy or even BCG Vaccine, which decreases the risk of recurrence of the disease.
In more advanced cases, “when the disease penetrates further into the bladder wall, into the muscle, we talk about bladder cancer.” invasive muscle, whose main treatment is surgery. In these cases, the disease is already at risk of spreading with metastasis therefore, in addition to surgical procedurethere are also chemotherapy treatments that have been shown to reduce the risk of the disease returning.”
“Urothelial carcinoma, or advanced bladder cancer, occurs when the disease has metastasized beyond the bladder and nearby nodes to distant parts of the body.” At this stage, experts speak of a very serious and incurable disease and whose five-year survival is very low.
The doctor Galanternik stressed that scientific research today offers new therapies: “In recent years, treatments include chemotherapythe immunotherapywhich seek to activate the immune system to attack the tumor, and also the targeted treatments, such as the use of erdafitinib, which belongs to what we call precision medicine.
The goal of personalized medicine is to identify and target specific therapies to the patients who are most likely to respond. One of the treatments recently approved in our country is intended for patients with locally advanced or metastatic urothelial cancer in which the tumor presents FGFR genomic alterations.
In February, the National Administration for Drugs, Food, and Medical Technology (ANMAT) authorized the use in Argentina of oral therapy erdafitinib, indicated for those patients who have not responded or have relapsed after prior chemotherapy treatment and who present an alteration in the fibroblast growth factor receptor gene (FGFR), enzymes involved in various functions vital to cell function and proliferation.
“If we identify that there is a specific mutation in a gene (which is called FGFR by fibroblast growth factor receptors) that can be associated with malignant transformation, the patient can be indicated erdafitinib as precision medicine, since it inhibits the activity of the protein associated with that gene”, expressed the oncologist and added: “Patients with advanced bladder cancer are in a situation of much riskTherefore, having another tool such as precision medicine in the fight against the disease, beyond chemotherapy, is very encouraging”.
erdafitinib, the first oral treatment developed to treat 15 to 20% of patients with locally advanced or metastatic urothelial carcinoma (the most common type of bladder cancer) is a development of Janssen -Johnson & Johnson Pharmaceutical Companies-.
The results of the clinical studies demonstrated an objective response rate of 40.4% and a disease control rate of 79.8%, including patients who had not previously responded to immunotherapy. They also showed a median duration of response of 5.6 months.
“If one compares the different studies with chemotherapy in patients who have already progressed to a treatment and that of the BLC2001 Study Group, it is impressive that with the arrival of Erdafitinib an improvement in the response rate of the patients is observed. Only 9 out of 100 had a reduction in tumors with chemotherapy, while with Erdafitinib, there are 40 out of 100 cases, which we hope translates into better life expectancy,” he said. Galanternik.
Refering to preventionthe oncologist stressed that smoking greatly increases the chances of bladder cancer, which is why No Smoking it is a key preventive measure. In addition, it is recommended drink plenty of fluids. “There are studies that show that when you drink a lot of fluids and there is a lot of kidney filtration, all those possible toxins that can be carcinogenic, that is, that cause mutations and are associated with the generation of cancer, are diluted by increasing the diuretic rate. ”.
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