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Simpler bladder cancer test cuts costs, overtreatment, study says

June 28 (UPI) — For patients with bladder cancer, a simple test can cut down on care costs, overtreatment and side effects, according to a study.

Georgetown-led investigators said their test significantly and more inexpensively improves the identification of bladder tumors that likely will become invasive. Their findings were published Thursday in Clinical Cancer Research.

In 2018, the American Cancer Society estimates there will be 81,190 new cases of bladder cancer and 17,240 deaths due to the disease in the United States.

Dr. Todd Waldman, a professor of oncology at Georgetown’s Lombardi Comprehensive Cancer Center, said the study “validates this test that helps predict whether an early stage bladder cancer will recur and progress.”

Among patients treated for early stage lesions that didn’t invade the bladder wall, 30 percent will not have lesions recur, Waldman said. Twenty percent of those with a recurrence will develop an invasive cancer.

Waldman, who worked with researchers from the United States and Denmark, found the new test is 2.4 times more accurate than current diagnostic procedures at identifying tumors likely to recur after treatment, and is 1.9 times more accurate at predicting tumors that are likely to progress, invade the bladder wall and spread.

In the current diagnostics, patients undergo a cystoscopy, in which a lighted optical scope examines the inside of the bladder. This occurs every three months for two years after removal of the tumor, and every six to 12 months afterward.

In the study, 82 patients in the United States and Europe participated for prediction of recurrence and then 253 were examined for prediction of progression to muscle invasion over five years.

In the test, 52 percent of the tumors with intact STAG2 expression recurred, compared to 25 percent without them. And in terms of progression, 38 percent recurred with the STAG2 and 16 percent without.

The test examines bladder tumors that had been removed during initial surgery for over-expression of the STAG2 gene, which Waldman found is linked to development of potentially deadly bladder tumors.

He said it’s a “very simple and very robust” procedure for pathologists.

And the patients will avoid constant surveillance and possibly aggressive treatment that can produce significant side effects.

“We are closer to our goal of lowering the risk of both aggressive bladder cancer and over-surveillance and treatment side effects in bladder cancer patients,” Waldman said.

In 2017, researchers from the University Hospital of Lyon in France developed a simple urine test to more accurately predict the recurrence of bladder cancer as well. They tested the urine of 348 bladder cancer patients for a faulty protein known as TERT.

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